26
|
Diener HC. [Not Available]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2016; 84:230-232. [PMID: 27100849 DOI: 10.1055/s-0042-105062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
27
|
Mitsikostas DD, Ashina M, Craven A, Diener HC, Goadsby PJ, Ferrari MD, Lampl C, Paemeleire K, Pascual J, Siva A, Olesen J, Osipova V, Martelletti P. European Headache Federation consensus on technical investigation for primary headache disorders. J Headache Pain 2016; 17:5. [PMID: 26857820 PMCID: PMC4747925 DOI: 10.1186/s10194-016-0596-y] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 02/02/2016] [Indexed: 01/03/2023] Open
Abstract
The diagnosis of primary headache disorders is clinical and based on the diagnostic criteria of the International Headache Society (ICHD-3-beta). However several brain conditions may mimic primary headache disorders and laboratory investigation may be needed. This necessity occurs when the treating physician doubts for the primary origin of headache. Features that represent a warning for a possible underlying disorder causing the headache are new onset headache, change in previously stable headache pattern, headache that abruptly reaches the peak level, headache that changes with posture, headache awakening the patient, or precipitated by physical activity or Valsalva manoeuvre, first onset of headache ≥50 years of age, neurological symptoms or signs, trauma, fever, seizures, history of malignancy, history of HIV or active infections, and prior history of stroke or intracranial bleeding. All national headache societies and the European Headache Alliance invited to review and comment the consensus before the final draft. The consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura. Persistent aura without infarction and migrainous infarction require brain MRI, MRA and MRV. Brain MRI with detailed study of the pituitary area and cavernous sinus, is recommended for all TACs. For primary cough headache, exercise headache, headache associated with sexual activity, thunderclap headache and hypnic headache apart from brain MRI additional tests may be required. Because there is little and no good evidence the committee constructed a consensus based on the opinion of experts, and should be treated as imperfect.
Collapse
|
28
|
Diener HC. [Multidimensional prevention of dementia diseases]. MMW Fortschr Med 2015; 157:39. [PMID: 26985502 DOI: 10.1007/s15006-015-3658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
29
|
Obermann M, Bude V, Holle D, Naegel S, Hagenacker T, Diener HC, Katsarava Z. EHMTI-0072. Anodal transcranial direct current stimulation alleviates pain in trigeminal neuralgia. J Headache Pain 2014. [PMCID: PMC4181854 DOI: 10.1186/1129-2377-15-s1-e21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
30
|
Naegel S, Biermann J, Obermann M, Theysohn N, Diener HC, Holle D. EHMTI-0240. Modulation of central pain processing by anodal direct current stimulation – a fMRI study. J Headache Pain 2014. [PMCID: PMC4181993 DOI: 10.1186/1129-2377-15-s1-e20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
|
31
|
Burmeister J, Holle D, Bock E, Ose C, Diener HC, Obermann M. EHMTI-0202. Study protocol of BoTN: a randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of botulinum toxin injections in the treatment of trigeminal neuralgia. J Headache Pain 2014. [PMCID: PMC4180179 DOI: 10.1186/1129-2377-15-s1-c9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
32
|
Wurthmann S, Naegel S, Steinberg BS, Theysohn N, Diener HC, Obermann M. EHMTI-0124. Central vestibular system modulation in vestibular migraine - a VBM study. J Headache Pain 2014. [PMCID: PMC4182152 DOI: 10.1186/1129-2377-15-s1-e42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
33
|
Diener HC, Bingel U. Surgical treatment for migraine: Time to fight against the knife. Cephalalgia 2014; 35:465-8. [PMID: 25143552 DOI: 10.1177/0333102414545895] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Abstract
Systemic thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) remains the only effective and approved medical treatment of acute ischemic stroke. Several studies have demonstrated the importance of rapid recanalization. The efficacy of thrombectomy has so far not been sufficiently shown in randomized clinical trials; therefore, inclusion of suitable patients in one of the currently ongoing randomized trials is of great importance. The early treatment with magnesium after acute ischemic stroke during the pre-hospital phase did not prove to be neuroprotective. Intermittent pneumatic compression of the lower extremities in immobilized stroke patients effectively prevents deep venous thrombosis and pulmonary embolism. In patients with lacunar stroke the combination of aspirin and clopidogrel is not superior to aspirin alone and causes more bleeding complications. The novel oral anticoagulants are superior to warfarin in secondary prevention and carry a lower risk of intracranial and systemic bleeding complications. New studies will investigate whether dabigatran or rivaroxaban are superior to aspirin in secondary prevention after cryptogenic stroke.
Collapse
|
35
|
|
36
|
Diener HC. [Lacunar stroke: aggressively lowering blood pressure?]. MMW Fortschr Med 2013; 155:34. [PMID: 24482927 DOI: 10.1007/s15006-013-2430-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
37
|
Ivry RB, Diener HC. Impaired velocity perception in patients with lesions of the cerebellum. J Cogn Neurosci 2013; 3:355-66. [PMID: 23967816 DOI: 10.1162/jocn.1991.3.4.355] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In three psychophysical experiments, cerebellar patients were impaired in making perceptual judgments of the velocity of moving stimuli. Performance was normal when the judgment concerned the position of the stimuli (Experiment 1). The dissociation between the velocity and position tasks suggests the cerebellar group was selectively impaired in velocity perception. EOG data were obtained in Experiments 2 and 3 to assess whether the deficit was oculomotor in origin. Perceptual errors were not correlated with the occurrence of intrusive eye movements. These results provide a novel demonstration of the role of the cerebellum in perceptual functions that require precise timing.
Collapse
|
38
|
Diener HC. [Episodic migraine: what prevents the next attack?]. MMW Fortschr Med 2013; 155:29. [PMID: 24006586 DOI: 10.1007/s15006-013-2028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
39
|
Wurthmann S, Schulte Steinberg B, Nägel S, Holle D, Theysohn N, Diener HC, Obermann M. Veränderungen der grauen Substanz bei Patienten mit vestibulärer Migräne. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
40
|
Buckanie N, Nägel S, Holle D, Rosenow F, Knake S, Diener HC, Katsarava Z, Obermann M. Kein olfaktorisches Defizit bei Patienten mit episodischem Clusterkopfschmerz. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0033-1337282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
41
|
Dodick D, Diener HC, Turkel C, DeGryse R, Brin M. OnabotulinumtoxinA for chronic migraine treatment: 75% responder analysis from double-blind, randomized, placebo-controlled phase of PREEMPT. J Headache Pain 2013. [PMCID: PMC3620253 DOI: 10.1186/1129-2377-14-s1-p197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
42
|
Weimar C, Weber R, Schlamann M, Hajjar K, Buck T, Diener HC. [Diagnostic and treatment of acute ischemic stroke]. Dtsch Med Wochenschr 2013; 138:423-36. [PMID: 23423939 DOI: 10.1055/s-0032-1327391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The incidence of first stroke in Germany is about 200.000, most of which are ischemic. The benefit of stroke unit treatment and systemic thrombolysis has been shown in large randomized trials. Diagnostic work-up besides neurologic examination includes cerebral imaging by CT or MR imaging including angiography, ultrasound of brain supplying arteries, ECG and Holter ECG and - if indicated - transesophageal echocardiography. Aspirin is the cornerstone of early secondary prevention in the acute phase, thereafter secondary prevention is determined by stroke etiology. Carotid endarterectomy or stent-assisted angioplasty are indicated in patients with hemodynamic or arterio-arterial stroke etiologies due to high-grade carotid stenosis. For cardioembolism due to atrial fibrillation, oral anticoagulation with vitamin K-antagonists or new oral anticoagulants should be started after the acute phase. In patients with non-cardioembolic stroke etiologies, platelet inhibitors are used for secondary prevention.
Collapse
|
43
|
Gaul C, Roguski J, Shanib H, Totzeck A, Görlinger K, Diener HC, Weber R. Efficacy and safety of occipital nerve blocks in cluster headache: a prospective observational study. J Headache Pain 2013. [PMCID: PMC3620288 DOI: 10.1186/1129-2377-14-s1-p60] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
44
|
Diener HC, Dodick DW, DeGryse RE, Turkel CC. OnabotulinumtoxinA for treatment of chronic migraine: PREEMPT 24-week pooled subgroup analysis of patients without medication overuse. J Headache Pain 2013. [DOI: 10.1186/1129-2377-14-s1-p204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
45
|
Diener HC, Dodick DW, DeGryse RE, Turkel CC. OnabotulinumtoxinA for treatment of chronic migraine: PREEMPT 24-week pooled subgroup analysis of patients without medication overuse. J Headache Pain 2013. [PMCID: PMC3620307 DOI: 10.1186/1129-2377-1-s14-p204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
46
|
Hajjar K, Fulton RL, Diener HC, Lees KR, Alexandrov A, Bath PMW, Bluhmki E, Claesson L, Curram J, Davis SM, Donnan G, Diener HC, Fisher M, Gregson B, Grotta J, Hacke W, Hennerici MG, Hommel M, Kaste M, Lees KR, Lyden P, Marler J, Muir K, Sacco R, Shuaib A, Teal P, Wahlgren NG, Warach S, Weimar C. Does the cognitive measure Cog-4 show improvement among patients treated with thrombolysis after acute stroke? Int J Stroke 2012; 8:652-6. [PMID: 22813096 DOI: 10.1111/j.1747-4949.2012.00848.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the established measure of disability post stroke, the modified Rankin Scale emphasizes motor function and may underestimate the importance of cognitive impairment in more disabled patients. A subset of four items from the National Institutes of Health Stroke Scale has been proposed to assess cognitive function after stroke (Cog-4), and to correlate with modified Rankin Scale. Items correspond to orientation, executive function, language, and inattention. We investigated responsiveness of Cog-4 to treatment with thrombolysis and whether it offers information that supplements modified Rankin Scale. METHODS We included 6268 patients from the Virtual International Stroke Trials Archive: 2734 received intravenous thrombolysis and 3534 were treated conservatively. We compared day 90 outcomes between treated and untreated groups, by modified Rankin Scale (illustrative) and by Cog-4 (primary measure) adjusting for age, baseline National Institutes of Health stroke scale, hemispheric lateralisation as well as baseline Cog-4 and baseline National Institutes of Health Stroke Scale excluding baseline Cog-4 separately. Analysis of Cog-4 was repeated within strata of 90 day modified Rankin Scale. Statistical analyses included proportional odds logistic regression and Cochran-Mantel-Haenszel test. RESULTS Modified Rankin Scale showed a difference between treatment groups of expected magnitude (odds ratio 1·56; 95% confidence interval 1·43-1·72; P < 0·001). After adjustment for imbalance in baseline prognostic factors, the distribution of Cog-4 scores at 90 days was better in thrombolysed patients compared with nonthrombolysed patients (odds ratio 1·31; 95% confidence interval 1·18-1·47; P = 0·006). However, Cog-4 analysis stratified by 90-day modified Rankin Scale was neutral between treatment groups (OR 1·01; 95% CI 0·90-1·14), and Cog-4 was not responsive to treatment group even within modified Rankin Scale categories 4 and 5 despite substantial cognitive deficits in these patients. CONCLUSION Although Cog-4 may be responsive to treatment effects, it does not provide additional information beyond modified Rankin Scale assessment.
Collapse
|
47
|
Diener HC, Rabe K, Gerwig M, Müller O, Sure U, Gaul C. [Neurostimulation for treatment of headaches]. DER NERVENARZT 2012; 83:994-1000. [PMID: 22801664 DOI: 10.1007/s00115-012-3571-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Only a small portion of patients with primary headaches are refractory to treatment concerning relief of headache episodes and prophylactic therapy of headaches. New methods of central and peripheral neurostimulation have been developed for these patients during the last few years and experience was mostly gained in small case series. The following overview gives a description of new stimulation methods, such as deep brain stimulation, occipital nerve stimulation, vagal nerve stimulation, neurostimulation of the sphenopalatine ganglion and transcranial magnetic stimulation.
Collapse
|
48
|
Gaul C, Christmann N, Schröder D, Weber R, Shanib H, Diener HC, Holle D. Differences in clinical characteristics and frequency of accompanying migraine features in episodic and chronic cluster headache. Cephalalgia 2012; 32:571-7. [DOI: 10.1177/0333102412444012] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Data on clinical differences between episodic (eCH) and chronic cluster headache (cCH) and accompanying migraine features are limited. Methods: History and clinical features of 209 consecutive cluster headache patients (144 eCH, 65 cCH; male:female ratio 3.4 : 1) were obtained in a tertiary headache centre by face-to-face interviews. Relationship between occurrence of accompanying symptoms, pain intensity, comorbid migraine, and circannual and circadian rhythmicity was analysed. Results: 99.5% of patients reported a minimum of one ipsilateral cranial autonomic symptom (CAS); 80% showed at least three CAS. A seasonal rhythmicity was observed in both eCH and cCH. A comorbid headache disorder occurred in 25%. No significant difference was detected between patients with comorbid migraine and without regarding occurrence of phonophobia, photophobia or nausea during cluster attacks. Patients with comorbid migraine reported allodynia significantly ( p = 0.022) more often during cluster attacks than patients without comorbid migraine. Conclusion: Occurrence of CAS and attack frequency, as well as periodic patterns of attacks, are relatively uniform in eCH and cCH. Multiple CAS are not related to pain intensity. Allodynia during cluster attacks is a frequent symptom. The unexpectedly high rate of accompanying migrainous features during cluster attacks cannot be explained by comorbid migraine.
Collapse
|
49
|
Nägel S, Holle D, Maderwald S, Orzada S, Bitz A, Katsarava Z, Diener HC, Ladd ME, Obermann M. Imaging Pain with ultra-high-field functional magnetic resonance imaging. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
50
|
Wurthmann FS, Nägel S, Holle D, Schulte Steinberg B, Theysohn N, Timmann-Braun D, Diener HC, Obermann M. Gray matter decrease in phobic postural vertigo-a VBM study. KLIN NEUROPHYSIOL 2012. [DOI: 10.1055/s-0032-1301669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|