Head cooling for exercise-induced headache

Menthol dural application alters meningeal arteries tone and enhances excitability of trigeminocervical neurons in rats

Headaches, including migraines, can have a causal relationship to exposure to cold, and this relationship may be both positive and negative, as cold can both provoke and alleviate cephalgia. The role of thermoreceptors responsible for transduction of low temperatures belongs to the transient receptor potential cation channel subfamily melastatin member 8 (TRPM8). These channels mediate normal cooling sensation and have a role in both cold pain and cooling-mediated analgesia; they are seen as a potential target for principally new anti-migraine pharmaceuticals. Using a validated animal migraine models, we evaluated effects of menthol, the TRPM8-agonist, on trigeminovascular nociception. In acute experiments on male rats, effects of applied durally menthol solution in various concentrations on the neurogenic dural vasodilatation (NDV) and firing rate of dura-sensitive neurons of the trigeminocervical complex (TCC) were assessed. Application of menthol solution in concentrations of 5 % and 10 % was associated with NDV suppression, however amplitude reduction of the dilatation response caused not by the vascular dilatation degree decrease, but rather due to the significant increase of the meningeal arterioles' basal tone. In electrophysiological experiments the 1 % and 30 % menthol solutions intensified TCC neuron responses to the dural electrical stimulation while not changing their background activity. Revealed in our study excitatory effects of menthol related to the vascular as well as neuronal branches of the trigeminovascular system indicate pro-cephalalgic effects of TRPM8-activation and suggest feasibility of further search for new anti-migraine substances among TRPM8-antagonists.

Systemic Cryotherapy in the Treatment of Autistic Children

Aim: Autistic disorders in children cover three developmental areas: social interaction, communication development disorders, and repetitive behavioral repertoire. Autistic children are a group resistant to therapeutic intervention due to their imapired contact with the environment, but the correction and compensation of disturbed functions through the interaction of motor and seems to be the most important goal of therapy. Materials and Methods: The study group consisted of 57 students of two special schools diagnosed with autism (age 6-16 (AVG 10 +/- 6), whose parents consented to participate in the research program, this 12 (21%) girls and 45 (79) %) boys. Fine and gross motor skills were assessed. The assessment of fine motoricity included the evaluation of the functions of individual parts of the body: throwing and catching a large ball, throwing tennis balls accurately into the basket while sitting on a chair, standing, lying on a mattress, pedalling on a stationary bike, performing unassisted squats, lifting the knees high in a standing position,unassisted jumping on a baton and kicking a volleyball. Large motor activity (change of place) included: walking up the stairs holding on to the handrail, stepping back and forth,going through the tunnel, walking on a ramp inclined at an angle of 45, traversing an obstacle course made of soft rollers of different sizes with the help of another person. After a two-week break, the subjects received a series of 10 treatments temperature at a temperature of - 110°C, each treatment lasting 2 minutes. The treatments took place once a day from Monday to Friday, excluding Saturdays and Sundays. After each treatment, the patient exercised for 1 hour in accordance with the previous results of fine and gross motor skills. Results: 1 child (10 entries) completed a full series of treatments. Other children: - 9 entries - 1 child, - 8 entries - 2 children, - 4 entrances – 2 children, - 3 entries - 1 child, - 2 children refused to continue the procedure after 30 seconds, - 2 child refused to enter the cryochamber. Conclusions: 1. It seems that cryogenic therapy should not be used in autistic children due to safety and the amount of work involved in preparing and conducting the procedures. 2. Parents’ attitudes towards the disease and their child’s treatment options make it difficult to cooperate and plan the therapy.3. In adult high-functioning autistics being treated at ZUL there is a very good tolerance of the procedure.

Experts' opinion about the primary headache diagnostic criteria of the ICHD-3rd edition beta in children and adolescents

BACKGROUND

The 2013 International Classification of Headache Disorders-3 (ICHD-3) was published in a beta version to allow the clinicians to confirm the validity of the criteria or to suggest improvements based on field studies. The aim of this work was to review the Primary Headache Disorders Section of ICHD-3 beta data on children and adolescents (age 0-18 years), and to suggest changes, additions, and amendments.

METHODS

Several experts in childhood headache across the world applied different aspects of ICHD-3 beta in their normal clinical practice. Based on their personal experience and the literature available on pediatric headache, they made observations and proposed suggestions for the primary headache disorders section of ICHD-3 beta data on children and adolescents.

RESULTS

Some headache disorders in children have specific features which are different from those seen in adults and which should be acknowledged and considered. Some features in children were found to be age-dependent: clinical characteristics, risks factors and etiologies have a strong bio psycho-social basis in children and adolescents making primary headache disorders in children distinct from those in adults.

CONCLUSIONS

Several recommendations are presented in order to make ICHD-3 more appropriate for use with children.