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Onofri A, Ferilli MAN, Tozzi E, Ursitti F, Sforza G, Olivieri L, Proietti Checchi M, Vigevano F, Valeriani M, Moavero R. How to Assess the Headache-Sleep Disorders Comorbidity in Children and Adolescents. J Clin Med 2021; 10:jcm10245887. [PMID: 34945182 PMCID: PMC8707479 DOI: 10.3390/jcm10245887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Sleep disorders and primary headaches are frequent health problems in childhood, and they are often comorbid in an individual, linked by a mutual and complex relationship. This comorbidity is frequent and well-documented, but the available literature is usually biased in favor of one aspect or another, mainly depending on the expertise of the authors. The aim of this paper is to review existing literature on the diagnostic assessment of comorbid primary headaches and sleep disorders, so as to propose practical suggestions to accurately investigate the presence of comorbid conditions in children evaluated for primary headaches or for sleep disorders.
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Affiliation(s)
- Agnese Onofri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Michela Ada Noris Ferilli
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Correspondence:
| | - Elisabetta Tozzi
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Fabiana Ursitti
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Giorgia Sforza
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Luca Olivieri
- Neuropsychiatric Clinic—Child Headache Center, Department of Life, Health and Environmental Sciences, San Salvatore Hospital L’Aquila, University of L’Aquila, 67100 L’Aquila, Italy; (A.O.); (E.T.); (L.O.)
| | - Martina Proietti Checchi
- Unit of Clinical Psychology, Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Federico Vigevano
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
| | - Massimiliano Valeriani
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Denmark Neurology Unit, Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
| | - Romina Moavero
- Neuroscience Department, Bambino Gesù Children’s Hospital IRCCS, Piazza di Sant’Onofrio 4, 00165 Rome, Italy; (F.U.); (G.S.); (F.V.); (M.V.); (R.M.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00133 Rome, Italy
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Onofri A, Olivieri L, Silva P, Bernassola M, Tozzi E. Correlation between primary headaches and learning disabilities in children and adolescents. Minerva Pediatr (Torino) 2021; 74:1-6. [PMID: 33858130 DOI: 10.23736/s2724-5276.21.06191-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Primary Headaches (H) and Learning Disabilities (LD) are frequent in childhood and can coexist in the same subject, but their correlation is not always clear. Aim of our study is to evaluate these relationship considering also any psychopathologies and their influence on the quality of life by considering an aspect such as school absences. METHODS 193 children (8-18y) with H and LD assessed consecutively at the Headache Center of L'Aquila, from 2013 to 2018 are the sample. School problems were evaluated by Italian batteries for LD; psychopathology screening by clinical interview and SAFA test. The sample was divided into 3 Groups [Group 1: patients with H (n = 122), Group 2: patients with LD (n = 37), Group 3: patients with H + LD (n = 34)] in order to compare subjects with H and LD vs subjects having only one disorder. RESULTS The most prevalent headache diagnosis was Migraine without Aura, but Chronic Tension Headache (CTH) showed a stronger impact on quality of life. LD have a higher prevalence in our sample (9.44%) than in general Italian population (3.2%). In Group 3 was higher prevalence of anxiety disorders (p = 0.050) and 50% of patients with CTH was absent from school due to headache. CONCLUSIONS LD can be related to headache chronicization and to a higher prevalence of psychopathologies and school absences, so an early diagnosis of LD in patients with H is crucial to prevent the worsening of the headache itself and of quality of life.
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Affiliation(s)
- Agnese Onofri
- Department of Life, Health and Environmental Sciences, Neuropsychiatric Clinic, Headache Centre, San Salvatore Hospital of L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Luca Olivieri
- Neuropsychiatric Clinic, San Salvatore Hospital of L'Aquila, L'Aquila, Italy
| | - Pamela Silva
- Neuropsychiatric Clinic, San Salvatore Hospital of L'Aquila, L'Aquila, Italy
| | - Michela Bernassola
- Department of Life, Health and Environmental Sciences, Neuropsychiatric Clinic, Headache Centre, San Salvatore Hospital of L'Aquila, University of L'Aquila, L'Aquila, Italy
| | - Elisabetta Tozzi
- Department of Life, Health and Environmental Sciences, Neuropsychiatric Clinic, Headache Centre, San Salvatore Hospital of L'Aquila, University of L'Aquila, L'Aquila, Italy -
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Papetti L, Loro PAD, Tarantino S, Grazzi L, Guidetti V, Parisi P, Raieli V, Sciruicchio V, Termine C, Toldo I, Tozzi E, Verdecchia P, Carotenuto M, Battisti M, Celi A, D'Agnano D, Faedda N, Ferilli MA, Grillo G, Natalucci G, Onofri A, Pelizza MF, Ursitti F, Vasta M, Velardi M, Balestri M, Moavero R, Vigevano F, Valeriani M. I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children. Cephalalgia 2020; 40:1459-1473. [PMID: 33146039 PMCID: PMC7684684 DOI: 10.1177/0333102420965139] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy. Methods During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis. Results We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05). Conclusions Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.
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Affiliation(s)
- Laura Papetti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Samuela Tarantino
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Licia Grazzi
- Headache Center, Neuroalgology Department, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Cristiano Termine
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Irene Toldo
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Elisabetta Tozzi
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Paola Verdecchia
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Marco Carotenuto
- Neuropsichiatria Infantile, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Matteo Battisti
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Angela Celi
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Noemi Faedda
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Michela An Ferilli
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giovanni Grillo
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Giulia Natalucci
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Agnese Onofri
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Maria Federica Pelizza
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Fabiana Ursitti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Michelangelo Vasta
- Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Margherita Velardi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Martina Balestri
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Romina Moavero
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Federico Vigevano
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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Onofri A, Necozione S, Tozzi E. Complementary and alternative medicine (CAM) in headache of children and adolescents: open-label Italian study. Clin Ter 2020; 171:e393-e398. [PMID: 32901780 DOI: 10.7417/ct.2020.2246] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of the present research is to evaluate and to compare various nutraceuticals and food supplements in the headaches prophylaxis. BACKGROUND Recently the use of complementary and alternative medicine, nutraceuticals and food supplements, in prophylaxis and attack therapy of headaches is spreading both in adulthood and in childhood age. MATERIALS AND METHODS 99 children, 6-17 years, females 44 and males 55, suffering from primary headaches and admitted to Headache Center in the years 2016- 2017 are the sample. 7 patients were excluded because they did not adhere to the study due to lack of therapeutic compliance and because they did not return to clinical controls. The patients referred to the Headache Center are selected consecutively. The open-label study evaluating clinical trial concerns the evaluation of the following parameters: headache diagnosis according to International Headache Society criteria (ICHD-III, 2013 beta version), migraine index; the prophylaxis and attack therapies at time zero and after 12 months. The compounds used to prophylaxis therapy are: Mg citrate, Mg oxide and Mg aspartate (compound n°1), Bisglycinate Mg + L-Tryptophan + Niacin + B2 Vitamin + D Vitamin (compound n°2), Oxide Mg + Partenium + Andrographis paniculata + coenzyme Q10, B2 Vitamin (compound n°3). Each compound was compared with the other to evaluate clinical efficacy. Attack therapy: Paracetamol, Ibuprofen, ketoprofen, Indomethacin. Informed consent was obtained for participation in the study by the parents of the children. Statistical analysis is made by Kruskal -Wallis test and analysis post hoc Conover. RESULT 22 females and 24 males suffer from Migraine without aura, 9 females and 12 males from Migraine with Aura, 11 females and 14 males from Tension Type Frequent Headache. The therapy as with compounds n°1, 2 and 3 is effective in reducing migraine index and reduces the use of attack therapy in all the cases very significantly (p=0.000001). In MwoA the compound n° 1 is less effective than compounds n° 2 and 3(p=0.00089).In MA compound n° 3 is less effective than compounds n° 2 and 1 (p=0.0044). In FETTH, compound n° 3 is less effective compared to compound n° 2 (p=0.052). CONCLUSION The use of nutraceuticals and food supplements appears to be effective and also encouraging as it is well accepted by parents and children themselves.
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Affiliation(s)
- A Onofri
- Neuropsychiatric Clinic, Department of Life, Health and Environmental Sciences, University of L'Aquila
| | - S Necozione
- Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - E Tozzi
- Neuropsychiatric Clinic, Department of Life, Health and Environmental Sciences, University of L'Aquila
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Toldo I, Brunello F, Morao V, Perissinotto E, Valeriani M, Pruna D, Tozzi E, Moscano F, Farello G, Frusciante R, Carotenuto M, Lisotto C, Ruffatti S, Maggioni F, Termine C, Di Rosa G, Nosadini M, Sartori S, Battistella PA. First Attack and Clinical Presentation of Hemiplegic Migraine in Pediatric Age: A Multicenter Retrospective Study and Literature Review. Front Neurol 2019; 10:1079. [PMID: 31681150 PMCID: PMC6803542 DOI: 10.3389/fneur.2019.01079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 09/24/2019] [Indexed: 01/04/2023] Open
Abstract
Background: Data on clinical presentation of Hemiplegic Migraine (HM) are quite limited in the literature, particularly in the pediatric age. The aim of the present study is to describe in detail the phenotypic features at onset and during the first years of disease of sporadic (SHM) and familial (FHM) pediatric hemiplegic migraine and to review the pertinent literature. Results: Retrospective study of a cohort of children and adolescents diagnosed with hemiplegic migraine, recruited from 11 Italian specialized Juvenile Headache Centers. Forty-six cases (24 females) were collected and divided in two subgroups: 32 SHM (16 females), 14 FHM (8 females). Mean age at onset was 10.5 ± 3.8 y (range: 2–16 y). Mean duration of motor aura was 3.5 h (range: 5 min−48 h). SHM cases experienced more prolonged attacks than FHM cases, with significantly longer duration of both motor aura and of total HM attack. Sensory (65%) and basilar-type auras (63%) were frequently associated to the motor aura, without significant differences between SHM and FHM. At follow-up (mean duration 4.4 years) the mean frequency of attacks was 2.2 per year in the first year after disease onset, higher in FHM than in SHM cases (3.9 vs. 1.5 per year, respectively). A literature review retrieved seven studies, all but one were based on mixed adults and children cohorts. Conclusions: This study represents the first Italian pediatric series of HM ever reported, including both FHM and SHM patients. Our cohort highlights that in the pediatric HM has an heterogeneous clinical onset. Children present fewer non-motor auras as compared to adults and in some cases the first attack is preceded by transient neurological signs and symptoms in early childhood. In SHM cases, attacks were less frequent but more severe and prolonged, while FHM patients had less intense but more frequent attacks and a longer phase of active disease. Differently from previous studies, the majority of our cases, even with early onset and severe attacks, had a favorable clinical evolution.
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Affiliation(s)
- Irene Toldo
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
| | - Francesco Brunello
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
| | - Veronica Morao
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiologic, Vascular, Thoracic Sciences and Public Health, University of Padova, Padua, Italy
| | | | - Dario Pruna
- Unit of Pediatric Neurology and Epileptology, "Brotzu" Hospital, Cagliari, Italy
| | - Elisabetta Tozzi
- Child Neuropsychiatry Unit, Juvenile Headache Center, University of L'Aquila, L'Aquila, Italy
| | - Filomena Moscano
- Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy
| | - Giovanni Farello
- Pediatric Clinic, Department of Life, Health and Environmental Science, University of L'Aquila, L'Aquila, Italy
| | | | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | - Ferdinando Maggioni
- Department of Neurosciences, Headache Centre, University Hospital of Padua, Padua, Italy
| | - Cristiano Termine
- Child Neuropsychiatry Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Gabriella Di Rosa
- Child Neuropsychiatry Unit, Department of Human Pathology of the Adult and Developmental Age, University Hospital "G. Martino", Messina, Italy
| | - Margherita Nosadini
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
| | - Stefano Sartori
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
| | - Pier Antonio Battistella
- Department of Woman's and Child's Health, Juvenile Headache Centre, University Hospital of Padua, Padua, Italy
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Toldo I, Rattin M, Perissinotto E, De Carlo D, Bolzonella B, Nosadini M, Rossi LN, Vecchio A, Simonati A, Carotenuto M, Scalas C, Sciruicchio V, Raieli V, Mazzotta G, Tozzi E, Valeriani M, Cianchetti C, Balottin U, Guidetti V, Sartori S, Battistella PA. Survey on treatments for primary headaches in 13 specialized juvenile Headache Centers: The first multicenter Italian study. Eur J Paediatr Neurol 2017; 21:507-521. [PMID: 28082014 DOI: 10.1016/j.ejpn.2016.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 01/03/2023]
Abstract
AIM The purpose of this retrospective multicenter study was to evaluate the use and the self-perceived efficacy and tolerability of pharmacological and non-pharmacological treatments in children and adolescents with primary headaches. METHODS Study of a cohort of children and adolescents diagnosed with primary headache, consecutively referred to 13 juvenile Italian Headache Centers. An ad hoc questionnaire was used for clinical data collection. RESULTS Among 706 patients with primary headaches included in the study, 637 cases with a single type of headache (migraine 76% - with and without aura in 10% and 67% respectively; tension-type headache 24%) were selected (mean age at clinical interview: 12 years). Acetaminophen and non-steroidal anti-inflammatory drugs (in particular ibuprofen) were commonly used to treat attacks, by 76% and 46% of cases respectively. Triptans were used overall by 6% of migraineurs and by 13% of adolescents with migraine, with better efficacy than acetaminophen and non-steroidal anti-inflammatory drugs. Preventive drugs were used by 19% of migraineurs and by 3% of subjects with tension-type headache. In migraineurs, flunarizine was the most frequently used drug (18%), followed by antiepileptic drugs (7%) and pizotifen (6%), while cyproheptadine, propanolol and amitriptyline were rarely used. Pizotifen showed the best perceived efficacy and tolerability. Melatonin and nutraceuticals were used by 10% and 32% of subjects, respectively, both for migraine and tension-type headache, with good results in terms of perceived efficacy and tolerability. Non-pharmacological preventive treatments (i.e. relaxation techniques, biofeedback, cognitive-behavioral therapy, acupuncture) were used only by 10% of cases (migraine 9%, tension-type headache 15%). DISCUSSION Non-steroidal anti-inflammatory drugs, especially ibuprofen, should be preferred to acetaminophen for acute attacks of migraine or tension-type headache, because they were usually more effective and well tolerated. Triptans could be used more frequently as first or almost second choice for treating migraine attack in adolescents. Non-pharmacological preventive treatments are recommended by some pediatric guidelines as first-line interventions for primary headaches and their use should be implemented in clinical practice. Prospective multicenter studies based on larger series are warranted to better understand the best treatment strategies for young people with primary headaches.
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Affiliation(s)
- Irene Toldo
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | - Martina Rattin
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | - Egle Perissinotto
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Italy.
| | - Debora De Carlo
- Juvenile Headache Centre, University Hospital of Padua, Italy.
| | | | | | | | - Angelo Vecchio
- Child Neuropsychiatry Division, University of Palermo, Italy.
| | | | | | - Cinzia Scalas
- Juvenile Headache Centre, University Hospital of Florence, Italy.
| | | | - Vincenzo Raieli
- Child Neuropsychiatry Division, "G.F. Ingrassia" Hospital, AUSL n°6, Palermo, Italy.
| | - Giovanni Mazzotta
- Child and Juvenile Neuropsychiatry Unit, ASL n°4, Terni, University of Perugia, Italy.
| | - Elisabetta Tozzi
- Department of Experimental Medicine, University of L'Aquila, Italy.
| | | | - Carlo Cianchetti
- Child and Adolescent Neuropsychiatry, University Hospital of Cagliari, Italy.
| | - Umberto Balottin
- Child Neuropsychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy.
| | - Vincenzo Guidetti
- Department of Pediatrics and Child and Adolescent Neuropsychiatry, University "La Sapienza" of Rome, Italy.
| | - Stefano Sartori
- Juvenile Headache Centre, University Hospital of Padua, Italy.
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Affiliation(s)
- Elisabetta Tozzi
- Neuropsychiatric Clinic, Hospital of L'Aquila, Department of life, health and environmental sciences, University L'Aquila, L'Aquila, Italy.
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Affiliation(s)
- Elisabetta Tozzi
- Departments of Life, Health and Environmental Sciences, Neuropsychiatric, University Hospital of L'Aquila, L'Aquila, Italy.
| | - Annarita Antenucci
- Departments of Life, Health and Environmental Sciences, Pediatric, University Hospital of L'Aquila, L'Aquila, Italy
| | - Simona Di Loreto
- Departments of Life, Health and Environmental Sciences, Pediatric, University Hospital of L'Aquila, L'Aquila, Italy
| | - Maria Maresca
- Departments of Life, Health and Environmental Sciences, Pediatric, University Hospital of L'Aquila, L'Aquila, Italy
| | - Giovanni Farello
- Departments of Life, Health and Environmental Sciences, Pediatric, University Hospital of L'Aquila, L'Aquila, Italy
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Tozzi-Ciancarelli M, Fedele F, Tozzi E, Di Massimo C, Oratore A, De Matteis G, D’Alfonso A, Troiani-Sevi E, Gallo P, Prencipe M. Age-dependent changes in human erythrocyte properties. Clin Hemorheol Microcirc 2016. [DOI: 10.3233/ch-1989-9611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M.G. Tozzi-Ciancarelli
- Department of Biotechnology and Biometry, School of Medicine, Collemaggio, L’Aquila, Italy
| | - F. Fedele
- Department of Medicine, School of Medicine, Collemaggio, L’Aquila, Italy
| | - E. Tozzi
- Department of Medicine, School of Medicine, Collemaggio, L’Aquila, Italy
| | - C. Di Massimo
- Department of Biotechnology and Biometry, School of Medicine, Collemaggio, L’Aquila, Italy
| | - A. Oratore
- Department of Biotechnology and Biometry, School of Medicine, Collemaggio, L’Aquila, Italy
| | - G. De Matteis
- Department of Medicine, School of Medicine, Collemaggio, L’Aquila, Italy
| | - A. D’Alfonso
- Department of Biotechnology and Biometry, School of Medicine, Collemaggio, L’Aquila, Italy
| | - E. Troiani-Sevi
- Department of Biotechnology and Biometry, School of Medicine, Collemaggio, L’Aquila, Italy
| | - P. Gallo
- Department of Medicine, School of Medicine, Collemaggio, L’Aquila, Italy
| | - M. Prencipe
- Department of Medicine, School of Medicine, Collemaggio, L’Aquila, Italy
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Matricardi S, Spalice A, Salpietro V, Di Rosa G, Balistreri MC, Grosso S, Parisi P, Elia M, Striano P, Accorsi P, Cusmai R, Specchio N, Coppola G, Savasta S, Carotenuto M, Tozzi E, Ferrara P, Ruggieri M, Verrotti A. Epilepsy in the setting of full trisomy 18: A multicenter study on 18 affected children with and without structural brain abnormalities. Am J Med Genet 2016; 172:288-95. [DOI: 10.1002/ajmg.c.31513] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Franzoni E, Matricardi S, Di Pisa V, Capovilla G, Romeo A, Tozzi E, Pruna D, Salerno GG, Zamponi N, Accorsi P, Giordano L, Coppola G, Cerminara C, Curatolo P, Nicita F, Spalice A, Grosso S, Pavone P, Striano P, Parisi P, Boni A, Gobbi G, Carotenuto M, Esposito M, Cottone C, Verrotti A. Refractory absence seizures: An Italian multicenter retrospective study. Eur J Paediatr Neurol 2015; 19:660-4. [PMID: 26239083 DOI: 10.1016/j.ejpn.2015.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Revised: 06/30/2015] [Accepted: 07/07/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND To evaluate evidence and prognosis of refractory cases of absence seizures. METHODS Subjects with refractory absence seizures were identified retrospectively in 17 Italian epilepsy pediatrics Centers. We analyzed age at onset, family history, presence of myoclonic components, seizure frequency, treatment with antiepileptic drugs (AEDs), interictal electroencephalography (EEG) and neuropsychological assessment. Two subgroups were identified: one with patients with current absence seizures and another with patients that had become seizure free with or without AED treatment. The chi-square test was applied. RESULTS A total of 92 subjects with drug-resistant absence seizures were analyzed. 45 subjects still show absence seizures (49%) and the other 47 became seizure free (51%) after a period of drug-resistance. The statistical analysis between these two groups showed no correlation between age of onset, family history and abnormalities at interictal EEG. Statistically significant differences were observed with regard to the number of AEDs used and intellectual disability. CONCLUSION Typical absence epilepsy classifiable as Childhood Absence Epilepsy could not be considered so "benign", as suggested in literature. A longer duration of disease and a higher frequency of seizure seem to be correlated with a higher presence of cognitive impairment. No significant risk factor was observed to allow the faster and better recognition of patients with worse prognosis.
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Affiliation(s)
- Emilio Franzoni
- Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
| | - Sara Matricardi
- Department of Pediatrics, University of Chieti, Chieti, Italy
| | - Veronica Di Pisa
- Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Antonino Romeo
- Epilepsy Center, Department of Child Neuropsychiatry and Neurophysiology, Fatebenefratelli and Oftalmico Hospital, Milan, Italy
| | - Elisabetta Tozzi
- Department of Child Neuropsychiatry, University of L'Aquila, L'Aquila, Italy
| | - Dario Pruna
- Child and Adolescent Neuropsychiatry, University of Cagliari, Cagliari, Italy
| | | | - Nelia Zamponi
- Pediatric Neurology Department, Polytechnic University of the Marche Region, Ancona, Italy
| | | | - Lucio Giordano
- Child Neuropsychiatric Unit, Civile Hospital, Brescia, Italy
| | - Giangennaro Coppola
- Department of Child and Adolescent Neuropsychiatric, Medical School, University of Salerno, Salerno, Italy
| | - Caterina Cerminara
- Department of Neurosciences, Pediatric Neurology Unit, Tor Vergata University, Roma, Italy
| | - Paolo Curatolo
- Department of Neurosciences, Pediatric Neurology Unit, Tor Vergata University, Roma, Italy
| | - Francesco Nicita
- Department of Pediatrics, Division of Child Neurology, Sapienza, University of Rome, Rome, Italy
| | - Alberto Spalice
- Department of Pediatrics, Division of Child Neurology, Sapienza, University of Rome, Rome, Italy
| | - Salvatore Grosso
- Department of Pediatrics, Pediatric Neurology Unit, S. Maria Alle Scotte Hospital, University of Siena, Italy
| | - Piero Pavone
- Department of Pediatrics and Pediatrics Emergency, University Hospital Policlinico Vittorio Emanuele, Catania, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Opthalmology, Genetics and Maternal and Child Health, University of Genova, G. Gaslini Institute, Genova, Italy
| | - Pasquale Parisi
- Neuroscience, Mental Health and Sensory Organs Department, Child Neurology, Headache Pediatric Center, Pediatric Sleep Disorder, Sapienza, University of Rome, Rome, Italy
| | - Antonella Boni
- IRRCS, The Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy
| | - Giuseppe Gobbi
- IRRCS, The Institute of Neurological Sciences of Bologna, Child Neurology Unit, Bologna, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Carlo Cottone
- Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Verrotti A, Carotenuto M, Altieri L, Parisi P, Tozzi E, Belcastro V, Esposito M, Guastaferro N, Ciuti A, Mohn A, Chiarelli F, Agostinelli S. Migraine and obesity: metabolic parameters and response to a weight loss programme. Pediatr Obes 2015; 10:220-5. [PMID: 24990114 DOI: 10.1111/ijpo.245] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 05/09/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Weight loss can determine significant improvement of migraine in obese patients. Herein, we evaluated a clinical sample of adolescent migraineurs with obesity who participated in an interdisciplinary programme for weight loss, in order to identify possible metabolic parameters associated with good migraine control. SUBJECTS AND METHODS Using a cross-sectional design, we evaluated 112 out of 135 adolescents who previously underwent our intervention programme. Based on persistence of headache, subjects for comparison were 40 migraine-free and 72 not migraine-free adolescents. Participants underwent anthropometric evaluations and biochemical tests. RESULTS Patients with persistence of migraine had significantly higher weight (P < 0.01), body mass index (P < 0.01), waist circumference (P < 0.01), homeostasis model assessment of insulin resistance (P < 0.001), triglyceride (P < 0.05), total cholesterol (P < 0.05) and low-density lipoprotein cholesterol (P < 0.05) values when compared with those who became migraine-free. Between potential predictors, only insulin resistance (odds ratio = 3.5, 95% confidence interval = 1.4-6.1; P < 0.001) was significantly associated with persistence of migraine after intervention programme. CONCLUSIONS Among obese adolescents with migraine who underwent an intervention programme for weight loss, patients who did not become migraine-free showed higher adiposity values than those who became migraine-free. Patients with insulin resistance had 3.5 times the odds of having persistence of migraine compared with those without.
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Affiliation(s)
- A Verrotti
- Department of Pediatrics, University of Perugia, Perugia, Italy
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Verrotti A, Cusmai R, Laino D, Carotenuto M, Esposito M, Falsaperla R, Margari L, Rizzo R, Savasta S, Grosso S, Striano P, Belcastro V, Franzoni E, Curatolo P, Giordano L, Freri E, Matricardi S, Pruna D, Toldo I, Tozzi E, Lobefalo L, Operto F, Altobelli E, Chiarelli F, Spalice A. Erratum to: Long-term outcome of epilepsy in patients with Prader-Willi syndrome. J Neurol 2014; 262:124-5. [PMID: 25428530 DOI: 10.1007/s00415-014-7579-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Alberto Verrotti
- Department of Pediatrics, University of Perugia, Perugia, Italy,
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Parisi P, Vanacore N, Belcastro V, Carotenuto M, Giudice ED, Mariani R, Papetti L, Pavone P, Savasta S, Striano P, Toldo I, Tozzi E, Verrotti A, Raucci U. Clinical guidelines in pediatric headache: evaluation of quality using the AGREE II instrument. J Headache Pain 2014; 15:57. [PMID: 25178699 PMCID: PMC4167157 DOI: 10.1186/1129-2377-15-57] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/03/2014] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool is a validated questionnaire used to assess the methodological quality of clinical guidelines (CGs). We used the AGREE II tool to assess the development process, the methodological quality, and the quality of reporting of available pediatric CGs for the management of headache in children. We also studied the variability in responses related to the characteristics of eleven Italian neuropediatric centers, showing similarities and differences in the main recommendations reported in CGs. METHODS A systematic literature search was conducted from January 2002 to June 2013 on Mediline, the Cochrane database, the National Guideline Clearinghouse website and the NHS evidence search tool, using the following terms: headache, cephalalgia, guidelines and children (MESH or text words). Six CGs providing information on the diagnosis and management of headache and specific recommendations for children were selected. Eleven neuropediatric centers assessed the overall quality and the appropriateness of all available CGs using of the AGREE II instrument. RESULTS Six CGs meeting the inclusion and exclusion criteria were identified and assessed by 11 reviewers. Our study showed that the NICE CGs was "strongly recommended" while the French and Danish CGs were mainly "not recommended". The comparison between the overall quality score of the French CGs and the NICE CGs was statistically significant (6.54 ± 0.69 vs. 4.18 ± 1.08; p =0.001). The correlation analysis between quality domain score and guideline publication date showed a statistically significant association only for the "editorial independence" domain (r = 0.842 p = 0.035). The intra-class coefficients showed that the 11 reviewers had the highest agreement for the Lewis CGs (r = 0.857), and the lowest one for the NICE CGs (r = 0.656). Statistical analyses showed that professionals from outpatient services dedicated pediatric headache assigned a higher overall quality score to the NICE CGs as compared to professionals from non-outpatient services (6.86 ± 0.38 vs. 6.0 ± 0.82; p = 0.038). CONCLUSIONS CGs resulted definitely of low-moderate quality and non "homogeneous". Further major efforts are needed to update the existing CGs according to the principles of evidence based medicine.
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Affiliation(s)
- Pasquale Parisi
- NESMOS Department, Chair of Paediatrics, Pediatric Headache Centre, Paediatric Sleep, Centre & Child Neurology, Faculty of Medicine & Psychology, “Sapienza University” c/o Sant’Andrea Hospital, Via di Grottarossa, 1035-1039 Rome, Italy
| | - Nicola Vanacore
- National Centre for Epidemiology, Surveillance, and Health Promotion, National Institute of Health, Rome, Italy
| | | | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Center for Childhood Headache, Second University of Naples, Naples, Italy
| | - Ennio Del Giudice
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Rosanna Mariani
- Department of Neuroscience, Headache Centre, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Laura Papetti
- Department of Pediatrics, Child Neurology, Sapienza University of Rome, Rome, Italy
| | - Piero Pavone
- Unit of Pediatrics and Pediatrics Emergency, University Hospital “Vittorio Emanuele”, Catania, Italy
| | - Salvatore Savasta
- Department of Pediatrics, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Pasquale Striano
- Department of Neurosciences, Pediatric Neurology and Muscular Diseases Unit, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, “G. Gaslini” Institute, Genova, Italy
| | - Irene Toldo
- Department of Woman and Child Health, Juvenile Headache Centre, University of Padua, Padua, Italy
| | - Elisabetta Tozzi
- Child and Maternal Department, Headache centre University and S. Salvatore Hospital L'Aquila, L'Aquila, Italy
| | | | - Umberto Raucci
- Paediatric Emergency Department, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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16
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Bellini B, Arruda M, Cescut A, Saulle C, Persico A, Carotenuto M, Gatta M, Nacinovich R, Piazza FP, Termine C, Tozzi E, Lucchese F, Guidetti V. Headache and comorbidity in children and adolescents. J Headache Pain 2013; 14:79. [PMID: 24063537 PMCID: PMC3849985 DOI: 10.1186/1129-2377-14-79] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 09/17/2013] [Indexed: 11/10/2022] Open
Abstract
Headache is one of the most common neurological symptom reported in childhood and adolescence, leading to high levels of school absences and being associated with several comorbid conditions, particularly in neurological, psychiatric and cardiovascular systems. Neurological and psychiatric disorders, that are associated with migraine, are mainly depression, anxiety disorders, epilepsy and sleep disorders, ADHD and Tourette syndrome. It also has been shown an association with atopic disease and cardiovascular disease, especially ischemic stroke and patent foramen ovale (PFO).
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Affiliation(s)
- Benedetta Bellini
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Via Dei Sabelli 108, Rome, Italy
| | | | - Alessandra Cescut
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Via Dei Sabelli 108, Rome, Italy
| | - Cosetta Saulle
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Via Dei Sabelli 108, Rome, Italy
| | | | | | | | | | | | | | | | - Franco Lucchese
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Guidetti
- Department of Pediatrics and Child Neuropsychiatry, Sapienza University of Rome, Via Dei Sabelli 108, Rome, Italy
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Agostinelli S, Accorsi P, Beccaria F, Belcastro V, Canevini MP, Capovilla G, Cappanera S, Bernardina BD, Darra F, Gaudio LD, Elia M, Falsaperla R, Giordano L, Gobbi G, Minetti C, Nicita F, Parisi P, Pavone P, Pezzella M, Sesta M, Spalice A, Striano S, Tozzi E, Traverso M, Vari S, Vignoli A, Zamponi N, Zara F, Striano P, Verrotti A. Clinical dissection of early onset absence epilepsy in children and prognostic implications. Epilepsia 2013; 54:1761-70. [PMID: 24032425 DOI: 10.1111/epi.12341] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Sergio Agostinelli
- Child Epilepsy Center; Department of Pediatrics; University of Chieti; Chieti; Italy
| | | | | | | | | | | | - Silvia Cappanera
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | | | - Francesca Darra
- Unit of Child Neuropsychiatry; University of Verona; Verona; Italy
| | - Luigi Del Gaudio
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Maurizio Elia
- Department of Neurology; Institute “Oasi”; Troina; Italy
| | | | - Lucio Giordano
- Child Neuropsychiatry Unit; Hospital “Civile”; Brescia; Italy
| | - Giuseppe Gobbi
- Department of Child Neuropsychiatry; Hospital “Maggiore”; Bologna; Italy
| | - Carlo Minetti
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Francesco Nicita
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Pasquale Parisi
- Child Neurology; II Faculty of Medicine; La Sapienza University; Rome; Italy
| | - Piero Pavone
- Department of Pediatrics; Hospital “V. Emanuele”; Catania; Italy
| | - Marianna Pezzella
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Michela Sesta
- Child Neurology; Children's Hospital “Giovanni XIII”; Bari; Italy
| | - Alberto Spalice
- Child Neurology Unit; Department of Pediatrics; La Sapienza University; Rome; Italy
| | - Salvatore Striano
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - Elisabetta Tozzi
- Department of Child Neuropsychiatry; University of L'Aquila; L'Aquila; Italy
| | - Monica Traverso
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Stella Vari
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | | | - Nelia Zamponi
- Department of Pediatric Neurology; Hospital “Ospedali Riuniti”; Ancona; Italy
| | - Federico Zara
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular diseases Unit; Department of Neurosciences; Institute “G. Gaslini”; Genoa; Italy
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Parisi P, Matricardi S, Tozzi E, Sechi E, Martini C, Verrotti A. Benign epilepsy of childhood with centro-temporal spikes (BECTS) versus migraine: a neuropsychological assessment. Childs Nerv Syst 2012; 28:2129-35. [PMID: 22961355 DOI: 10.1007/s00381-012-1867-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 07/17/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Epilepsy and migraine frequently show a clinical overlap. An increase in number of electroencephalographic abnormalities, such as centro-temporal spikes (CTS), may be observed in patients suffering from migraine, epileptic abnormalities that are typically in benign epilepsy of childhood with CTS (BECTS). The aim of this study is to better define the role of CTS in children with migraine compared to children with BECTS, in relation with their neuropsychological profile. METHODS Thirty-two children were enrolled and divided into three groups on the basis of their diagnosis: 16 children (eight males and eight females, aged 12.3 ± 2.58 years) affected by BECTS, 8 patients (four males and four females, aged 11.8 ± 3.47 years) affected by BECTS and migraine, and 8 children (four males and four females, aged 13.5 ± 1.79 years) affected by migraine showing CTS abnormalities. A cognitive and neuropsychological assessment was performed, using Wechsler Intelligence Scale for Children-third edition and NEPSY II, in all patients. RESULTS AND CONCLUSIONS A similar neuropsychological impairment was found in patients affected by BECTS and in those affected by BECTS and migraine; a significant deficit in short- and long-term verbal memory was evident in patients affected by migraine and CTS. CTS in patients with migraine can influence the neuropsychological tests, with a possible negative impact on language and learning development.
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Affiliation(s)
- Pasquale Parisi
- Child Neurology, NESMOS Dept., Faculty of Medicine and Psychology, Sapienza University, Via di Grottarossa, 1035-1039, Rome 00189, Italy.
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Agostinelli S, Traverso M, Accorsi P, Beccaria F, Belcastro V, Capovilla G, Cappanera S, Coppola A, Dalla Bernardina B, Darra F, Ferretti M, Elia M, Galeone D, Giordano L, Gobbi G, Nicita F, Parisi P, Pezzella M, Spalice A, Striano S, Tozzi E, Vignoli A, Minetti C, Zara F, Striano P, Verrotti A. Early-onset absence epilepsy:SLC2A1gene analysis and treatment evolution. Eur J Neurol 2012; 20:856-9. [DOI: 10.1111/j.1468-1331.2012.03871.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Accepted: 08/16/2012] [Indexed: 11/30/2022]
Affiliation(s)
- S. Agostinelli
- Department of Pediatrics; University of Chieti; Chieti; Italy
| | - M. Traverso
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - P. Accorsi
- Child Neuropsychiatry; Spedali Civili; Brescia; Italy
| | - F. Beccaria
- Department of Child Neuropsychiatry; C. Poma Hospital; Mantova; Italy
| | - V. Belcastro
- Department of Neuroscience; Sant'Anna Hospital; Como; Italy
| | - G. Capovilla
- Department of Child Neuropsychiatry; C. Poma Hospital; Mantova; Italy
| | - S. Cappanera
- Department of Pediatric Neurology; Ospedali Riuniti; Ancona; Italy
| | - A. Coppola
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | | | - F. Darra
- Unit of Child Neuropsychiatry; University of Verona; Verona; Italy
| | - M. Ferretti
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - M. Elia
- Department of Neurology; Oasi Institute for Research on Mental Retardation and Brain Aging; Troina; Italy
| | - D. Galeone
- Child Neurology; Children's Hospital Giovanni XXIII; Bari; Italy
| | - L. Giordano
- Child Neuropsychiatry; Spedali Civili; Brescia; Italy
| | - G. Gobbi
- Department of Child Neuropsychiatry; Maggiore Hospital; Bologna; Italy
| | - F. Nicita
- Department of Pediatrics; University of Rome ‘La Sapienza’; Rome; Italy
| | - P. Parisi
- Child Neurology; II Faculty of Medicine; ‘La Sapienza’ University; Rome; Italy
| | - M. Pezzella
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - A. Spalice
- Child Neurology Unit; Department of Pediatrics; ‘La Sapienza’ University; Rome; Italy
| | - S. Striano
- Department of Neurological Sciences; Federico II University; Naples; Italy
| | - E. Tozzi
- Department of Child Neuropsychiatry; University of L'Aquila; L'Aquila; Italy
| | - A. Vignoli
- Epilepsy Center; University of Milan; Milan; Italy
| | - C. Minetti
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - F. Zara
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - P. Striano
- Pediatric Neurology and Muscular Diseases Unit; ‘G. Gaslini’ Institute; Genoa; Italy
| | - A. Verrotti
- Department of Pediatrics; University of Chieti; Chieti; Italy
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20
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Verrotti A, Agostinelli S, D'Egidio C, Di Fonzo A, Carotenuto M, Parisi P, Esposito M, Tozzi E, Belcastro V, Mohn A, Battistella PA. Impact of a weight loss program on migraine in obese adolescents. Eur J Neurol 2012; 20:394-7. [PMID: 22642299 DOI: 10.1111/j.1468-1331.2012.03771.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Accepted: 04/24/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Increased headache frequency and severity have been observed in obese populations, but the real impact of a weight loss treatment on headache has not been studied. We investigated this issue in a sample of obese adolescents. METHODS In all, 135 migraineurs, aged 14-18 years, with body mass index (BMI) ≥ 97 th percentile, participating in a 12-month-long program, were studied before and after treatment. The program included dietary education, specific physical training, and behavioral treatment. RESULTS Decreases in weight (P < 0.01), BMI (P < 0.01), waist circumference (P < 0.01), headache frequency (P < 0.01) and intensity (P < 0.01), use of acute medications (P < 0.05), and disability (P < 0.05) were observed at the end of the first 6-month period and were maintained through the second 6 months. Both lower baseline BMI and excess change in BMI were significantly associated with better migraine outcomes 12 months after the intervention program. CONCLUSIONS Significant improvements in both adiposity and headache data were observed in obese adolescents with migraine who participated in a 12-month-long interdisciplinary intervention program for weight loss. Initial body weight and amount of weight loss may be useful for clinicians to predict migraine outcomes.
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Affiliation(s)
- A Verrotti
- Department of Pediatrics, University of Chieti, Chieti, Italy
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21
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De Carlo D, Toldo I, Dal Zotto L, Perissinotto E, Sartori S, Gatta M, Balottin U, Mazzotta G, Moscato D, Raieli V, Rossi LN, Sangermani R, Soriani S, Termine C, Tozzi E, Vecchio A, Zanchin G, Battistella PA. Osmophobia as an early marker of migraine: A follow-up study in juvenile patients. Cephalalgia 2012; 32:401-6. [DOI: 10.1177/0333102412438975] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Osmophobia is frequent in children with migraine (20–35%) but can also occur in up to 14% of cases with tension-type headache (TTH). So far, the prognostic role of this symptom in children with primary headaches has never been evaluated. Methods: A longitudinal prospective study was conducted on 90 young patients with TTH (37 with osmophobia, 53 without osmophobia). We evaluated whether osmophobia could predict the diagnosis transformation from TTH to migraine after a 3-year follow-up. Results and Discussion: In our cases the rate of diagnosis change was significantly greater in cases with osmophobia (62%) than in those without (23%). Osmophobia persisted at a 3-year follow-up in the majority of our cases (85%) and it was found to be one of the major predictors for the development of migraine; other predictors of evolution to migraine were phonophobia, a probable rather than certain diagnosis of TTH and olfactory triggers (p < 0.05). Conclusion: Our data confirm that osmophobia has an important diagnostic and prognostic role in children with primary headaches and should be systematically investigated at diagnosis and during follow-up.
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Affiliation(s)
- Debora De Carlo
- Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy
| | - Irene Toldo
- Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy
| | - Lara Dal Zotto
- Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy
| | - Egle Perissinotto
- Department of Environmental Medicine and Public Health, University of Padua, Italy
| | - Stefano Sartori
- Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy
| | - Michela Gatta
- Juvenile Headache Centre, Department of Paediatrics University of Padua, Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, “IRCCS Neurological Institute C. Mondino Foundation”, University of Pavia, Italy
| | | | | | - Vincenzo Raieli
- Child Neuropsychiatry Division “G.F. Ingrassia” Hospital, AUSL n°6, Palermo, Italy
| | | | | | - Stefano Soriani
- Department of Clinical and Experimental Medicine, Paediatrics, University of Ferrara, Italy
| | - Cristiano Termine
- Child Neuropsychiatry Unit, Department of Clinical and Biological Sciences Varese, Italy
| | - Elisabetta Tozzi
- Department of Experimental Medicine, University of L’Aquila, Italy
| | - Angelo Vecchio
- Child Neuropsychiatry Division, University of Palermo, Italy
| | - Giorgio Zanchin
- Headache Centre, Department of Neurosciences, University of Padua Medical School, Padua, Italy
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22
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Verrotti A, Coppola G, Spalice A, Di Fonzo A, Bruschi R, Tozzi E, Iannetti P, Villa MP, Parisi P. Peri-ictal and inter-ictal headache in children and adolescents with idiopathic epilepsy: a multicenter cross-sectional study. Childs Nerv Syst 2011; 27:1419-23. [PMID: 21445630 DOI: 10.1007/s00381-011-1428-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 03/07/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE Headache in epileptic population ranges from 8% to 15%. The aim of this paper was to study the clinical and temporal characteristics of primary headache comorbidity in idiopathic epileptic children. METHODS From June 2006 to June 2009, a cross-sectional multi-center study involving five Italian Child Neurology University Centers (two in Rome, one in Chieti, one in Naples, and one in L'Aquila) was conducted. Among 1,264 consecutively newly diagnosed, idiopathic, partial, or generalized, epileptic children, according to ILAE diagnostic criteria (aged between 5 and 15 years of age), we selected 142 children (11.2%) (130 of whom completed the study) who showed an associated peri-ictal and/or inter-ictal headache diagnosed according to the International Headache Society Criteria. Rare cases of "ictal epileptic headache", in which headache represents the sole ictal epileptic manifestation, were excluded from this study. RESULTS AND CONCLUSIONS Post-ictal headaches were most frequent (62%). Pre-ictal headaches were less common (30%). Inter-ictal headaches were described in 57.6%. Clear migrainous features were present in 93% of pre-ictal and 81.4% of post-ictal headaches. Inter-ictal headaches meet criteria for migraines in 87%. The association between partial epilepsy and migraine without aura is most common and reported in 82% of our patients with peri-ictal headache and in 76.5% of patients with post-ictal headache.
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23
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Verrotti A, Coppola G, Di Fonzo A, Tozzi E, Spalice A, Aloisi P, Bruschi R, Iannetti P, Villa MP, Parisi P. Should "migralepsy" be considered an obsolete concept? A multicenter retrospective clinical/EEG study and review of the literature. Epilepsy Behav 2011; 21:52-9. [PMID: 21497557 DOI: 10.1016/j.yebeh.2011.03.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 02/28/2011] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
The few reports that have been published on the current International Classification of Headache Disorders, Second Edition (ICHD-II), criteria for migralepsy and hemicrania epileptica have highlighted the considerable confusion regarding this "hot topic" within both headache and epilepsy classifications (ICHD-II and International League Against Epilepsy [ILAE]). Indeed, the ICHD-II describes a migraine-triggered seizure as a rare event in which a seizure occurs during migraine aura; on the other hand, hemicrania epileptica is described as an "ictal headache" that occurs "synchronously" with a partial seizure. To confuse matters even further, neither the term migralepsy nor the term hemicrania epileptica is included in the currently used ILAE classification. On the basis of both a review of "migralepsy" cases in the literature and 16 additional retrospective multicenter cases, we suggest that the term migraine-triggered seizure or migralepsy be deleted from the ICHD-II classification until unequivocal evidence is provided of its existence, and that the term ictal epileptic headache be introduced into the ILAE classification.
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Affiliation(s)
- Alberto Verrotti
- Child Neurology and Department of Pediatrics, University of Chieti, Chieti, Italy
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24
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Verrotti A, Parisi P, Loiacono G, Mohn A, Grosso S, Balestri P, Tozzi E, Iannetti P, Chiarelli F, Curatolo P. Levetiracetam monotherapy for childhood occipital epilepsy of gastaut. Acta Neurol Scand 2009; 120:342-6. [PMID: 19754870 DOI: 10.1111/j.1600-0404.2009.01264.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this open label pilot study was to evaluate the efficacy and tolerability of levetiracetam (LEV) as 'de novo' monotherapy in children and adolescents with late onset childhood occipital epilepsy-Gastaut type (COE-G). MATERIAL AND METHODS Twelve patients suffering from COE-G were enrolled in this prospective study. The age of seizures onset ranged from 6.1 to 16.2 years with a peak of frequency at mean (+/-SD) 10.54 +/- 2.77 years. Therapy with LEV was started at 10 mg/kg/day and, after titration, the final dose was generally achieved within 4 weeks and ranged from 20.7 to 45.2 mg/kg/day. RESULTS At the 6 month evaluation, 11 (91.6%) of the 12 patients studied were seizure free, and one (8.3%) showed four additional episodes. Electroencephalography (EEG) activity was normal in six (54.5%) patients, unchanged in two (18.1%) children, and in four (33.3%) patients sporadic occipital abnormalities persisted. At the 12-month evaluation all patients were completely seizure free. Four patients (33.3%) continued to show some EEG abnormalities, while eight (72.8%) patients had normal EEG. At the 18-month evaluation all patients were seizure free and 10 patients (83.3%) showed a complete normalization of EEG abnormalities. DISCUSSION Monotherapy with LEV was effective and well tolerated in patients with COE-G. Nevertheless, prospective, large, long-term double-blind studies are needed to confirm these findings.
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Affiliation(s)
- A Verrotti
- Department of Paediatrics, University of Chieti, Chieti, Italy.
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25
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Paonessa A, Limbucci N, Tozzi E, Splendiani A, Gallucci M. Radiological strategy in acute stroke in children. Eur J Radiol 2009; 74:77-85. [PMID: 19216043 DOI: 10.1016/j.ejrad.2009.01.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Revised: 10/22/2008] [Accepted: 01/13/2009] [Indexed: 11/27/2022]
Abstract
The aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic or hemorrhagic, their etiologies and the correct diagnostic protocol for acute management. Forty-one consecutive pediatric patients (age range 5-16 years) with an acute stroke observed in acute phase during a 10-year period, were retrospectively evaluated. Twenty-three patients underwent magnetic resonance imaging (MRI), 3 cases were studied by computed tomography (CT) without MRI, and 15 underwent both CT and MRI studies. In 9 cases, intra-arterial digital subtraction angiography (IADSA) was performed after non-invasive preliminary assessment. Seventeen hemorrhagic (41%) and 24 ischemic (59%) strokes were found. Among hemorrhagic forms, 5 cases were due to arteriovenous malformation (AVM), 7 to cavernoma, and 2 to aneurysm. Among ischemic forms, 2 were due to sickle-cell disease, 1 to hyperomocysteinemia, 1 to moyamoya syndrome, 1 to pseudoxantoma elasticum, 3 to prothrombotic state, 1 to Fabry's disease, 1 concomitant with CO intoxication, 5 to venous sinus thrombosis, and 4 to cardio-embolic state. Etiology remains unknown in 8 cases (20.5%). This study shows a moderate prevalence of ischemic over hemorrhagic strokes. Moreover, personal experience suggests that MRI is always more informative than CT and in selected cases should be the first-choice examination in the acute phase.
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Affiliation(s)
- Amalia Paonessa
- Dept. of Neuroradiology, University Hospital S. Salvatore, L'Aquila, Italy.
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26
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Verrotti A, Cerminara C, Coppola G, Franzoni E, Parisi P, Iannetti P, Aloisi P, Tozzi E, Cusmai R, Vigevano F, Chiarelli F, Curatolo P. Levetiracetam in juvenile myoclonic epilepsy: long-term efficacy in newly diagnosed adolescents. Dev Med Child Neurol 2008; 50:29-32. [PMID: 18173626 DOI: 10.1111/j.1469-8749.2007.02009.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the efficacy and tolerability of levetiracetam (LEV) monotherapy in juvenile myoclonic epilepsy (JME). The study group consisted of 32 patients with epilepsy (20 males, 12 females) with a mean age of 13 years 3 months (SD 7y 11mo) at seizure onset. LEV was administered as the first drug; all patients were followed up at 6 and 12 months. The dose that achieved seizure control ranged from 1000 to 2500mg/daily. At 6-month evaluation: 15 patients were seizure free; 14 patients were responders (>50% reduction in seizures); and three patients had marginal effects (<50% reduction of seizures). At 12-month evaluation: 29 patients were seizure free; three patients were responders. No patients reported adverse events. These data provide preliminary evidence that LEV may be effective for treating patients with newly diagnosed JME.
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Eisermann MM, DeLaRaillère A, Dellatolas G, Tozzi E, Nabbout R, Dulac O, Chiron C. Infantile spasms in Down syndrome--effects of delayed anticonvulsive treatment. Epilepsy Res 2003; 55:21-7. [PMID: 12948613 DOI: 10.1016/s0920-1211(03)00088-3] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
To investigate the impact of treatment lag in infantile spasms (IS) on treatment response, occurrence of later epilepsy, and long-term cognition and behavior in patients with one single etiological entity, we examined 18 patients with Down syndrome (DS) and earlier IS retrospectively (follow-up period of 32-180 months with a mean of 85.1 months), and determined their history and present condition, in terms of previously mentioned items. There was a statistically significant correlation between treatment lag and lag to cessation of spasms (R=0.55, P=0.02), developmental quotient (DQ) (R=-0.75, P=0.003), and score of autistic features (AF) (R=0.57, P=0.04). Moreover we found that the later the response to treatment of IS, the lower was the DQ (R=-0.86, P=0.001) and the higher was the score of autistic features (R=0.5, P=0.06). A long duration of spasms also determined a low DQ (R=-0.93, P<0.0001) and a high score of autistic features (R=0.66, P<0.01). All patients with persistent epilepsy (n=5) had had a treatment lag of over 2 months. Conversely, for all children treated within 2 months (n=8) spasms ceased within 3 months of treatment and none of them had later epilepsy. This group of patients with a treatment lag of less than 2 months had earlier treatment response (P=0.002), higher DQ (P=0.004) and lower score of autistic features (P=0.006). The data stress the importance of a short treatment lag in view of mental development and prevention of later epilepsy and autistic features, and raise the question of antiepileptogenic effect in this specific condition.
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Affiliation(s)
- Monika Maria Eisermann
- Department of Neuropediatrics, Hôpital Saint Vincent de Paul, 82, Avenue Denfert Rochereau, F-75674 Paris cedex 14, France.
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28
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Marrelli A, Tozzi E, Porto C, Cimini N, Aloisi P, Valenti M. Spectral analysis of visual potentials evoked by pattern-reversal checkerboard in juvenile patients with headache. Headache 2001; 41:792-7. [PMID: 11576204 DOI: 10.1046/j.1526-4610.2001.01145.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Changes in visual evoked potentials, mainly affecting the amplitude of the major positive wave, are referred to by many authors and are related to the pathophysiological basis of primary headache. We performed both transient pattern-reversal visual evoked potentials and spectral analysis by means of fast Fourier transform of 8-Hz steady-state pattern-reversal visual evoked potentials in 34 children affected with migraine (14 with aura, 20 without aura), and compared them with 14 patients with tension-type headache and 10 healthy subjects. The amplitude of the response to the transient stimulation (P100) was higher and the latency shorter in the patients with headache compared with the controls, but the difference was not statistically significant. The absolute power of the first harmonic (1F) obtained by the spectral analysis of the steady-state stimulation was increased in all the patients with headache compared with the controls, and the increase was significant in patients with migraine. These data seem to confirm the hypothesis of abnormal processing of visual input in migraineurs and could be interpreted as neurophysiological support for the theory that different headache types are related conditions. Furthermore, the spectral analysis of steady-state pattern-reversal visual evoked potentials could be proposed as a test to diagnose migraine.
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Affiliation(s)
- A Marrelli
- Unità Operativa di Neurofisiopatologia, Ospedale S. Salvatore-Coppito; Clinica Pediatrica, Università di L'Aquila, L'Aquila, Italy
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29
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Tozzi E, Renzetti G, Florio I, Cascani G, Conti G, Gentile T, Papola F. HLA in migraine and coeliac children. J Headache Pain 2000. [DOI: 10.1007/s101940070014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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30
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Tozzi E, Florio I, Mesturino A, Marrelli A, Criscione S. [Hemicrania and photosensitive epilepsy in pediatric age]. Clin Ter 1998; 149:357-60. [PMID: 10052248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Photosensitive epilepsy is joined to headache. Aim of the present study was the follow up of children suffering from headaches in order to verify if headache can be the only symptom of epileptic photosensitivity. PATIENTS AND METHODS Thirteen children affected by headache were examined. They were screened on the basis of photosensitivity showed on the EEG. During following 6 patients had seizures. RESULTS Antiepileptic drugs (VPA, CBZ, CZM) improved seizures and headache. In the others patients migraine therapy improved epileptic photosensitivity on the EEG. CONCLUSIONS Headache can be the only symptom of epileptic photosensitivity. Migraine and photosensitive epilepsy in childhood are of particular interest because of growing features of occipital lobe. This has therapeutic significance.
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Affiliation(s)
- E Tozzi
- Clinica Pediatrica Università degli Studi di L'Aquila, Italia.
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31
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Abstract
Changes in visual evoked potentials and decreased intracellular magnesium levels have been separately described in patients affected by migraine both during the attacks and in the interictal periods. An inverse correlation between increased P100 amplitude and lowered serum magnesium levels was found in children suffering from migraine with and without aura in a headache-free period. A 20-day treatment with oral magnesium pidolate seemed to normalize the magnesium balance in 90% of patients. After treatment, the reduced P100 amplitude confirmed the inverse correlation with the serum magnesium level. These data seem to suggest the hypothesis that higher visual evoked potential amplitude and low brain magnesium level can both be an expression of neuronal hyperexcitability of the visual pathways related to a lowered threshold for migraine attacks.
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Affiliation(s)
- P Aloisi
- Servizio di Neurofisiopatologia, University of L'Aquila, Italy
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32
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Abstract
Results of this study confirm the link between migraine and alterations of platelet responsiveness. Our data suggest that in migraineurs the perturbated platelet microviscosity, analyzed by means of fluorescence polarization, appears responsible for the decrease of stimulation-induced influx of external calcium through the platelet membrane. These findings suggest that platelet membrane microviscosity may be considered as a more significant platelet marker of migraine rather than the well-known and nonspecific phenomenon of platelet hyperaggregation, evaluated by time-transmittance variations induced by adenosine diphosphate and collagen.
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Affiliation(s)
- E Tozzi
- Department of Experimental Medicine, University of L'Aquila, Italy
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33
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Tozzi-Ciancarelli M, Di Massimo C, Tozzi E, Mascioli A, De Matteis G, Carolei A. Influence of a selective 5HT1-receptor agonist GR43175 on platelet responsiveness. Cephalalgia 1995. [DOI: 10.1046/j.1468-29821995.1506472.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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34
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Tozzi-Ciancarelli MG, Di Massimo C, Tozzi E, Mascioli A, De Matteis G, Carolei A. Influence of a selective 5HT1-receptor agonist GR43175 on platelet responsiveness. Cephalalgia 1995; 15:472-36. [PMID: 8706109 DOI: 10.1046/j.1468-2982.1995.1506472.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The possible interaction of sumatriptan, a selective 5HT1-receptor agonist, with platelet responsiveness has been investigated. Stimulation of platelet rich plasma with sumatriptan (1-100 microM) did not induce shape change, aggregation or modification of intraplatelet cytosolic calcium levels. Total inhibition of aggregation induced by 20 microM 5HT was observed in platelets preincubated for 20 min with 100 microM sumatriptan. In the same model, platelet stimulation with 4 microM adenosine 5'-diphosphate (ADP), concentration known to induce an irreversible single-phase curve, determined a decrease of aggregatory response. Concentrations from 1 microM to 50 microM of sumatriptan did not influence the aggregatory response induced by 5HT and ADP. These effects appear not to be determined by modifications of platelet calcium homeostasis. The possibility to modulate platelet responsiveness by sumatriptan offers a further approach for evaluating the probable link between platelet behaviour and pathophysiology of migraine.
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35
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Tozzi E, Gentile T, Angelini R, Meucci M, Marrelli A, Aloisi P, Papola F, Cervelli C, Matteis FD. Coeliac Disease, Headache and Epilepsy: Report of Seven Cases. Cephalalgia 1995. [DOI: 10.1177/0333102495015s1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- E. Tozzi
- Clinica Pediatrica, Università L'Aquila
| | | | | | | | - A. Marrelli
- Servizio di Neurofisiopatologia Ospedale L'Aquila
| | - P. Aloisi
- Servizio di Neurofisiopatologia Ospedale L'Aquila
| | - F. Papola
- Centro regionale di immunoematologia e Tipizzazione tissutale L'Aquila ITALY
| | - C. Cervelli
- Centro regionale di immunoematologia e Tipizzazione tissutale L'Aquila ITALY
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36
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Tozzi E, Tozzi-Ciancarelli M, Di Massimo C, Mascioli A, Gentile T, de Matteis F. Hemorheological parameters and body weight loss in obese children. Clin Hemorheol Microcirc 1994. [DOI: 10.3233/ch-1994-14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- E. Tozzi
- Dept. of Experimental Medicine, Paediatric Clinic, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
| | - M.G. Tozzi-Ciancarelli
- Dept. of Biomedical Sciences and Technology and Biometry, Laboratory of Human Physiology, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
| | - C. Di Massimo
- Dept. of Biomedical Sciences and Technology and Biometry, Laboratory of Human Physiology, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
| | - A. Mascioli
- Dept. of Biomedical Sciences and Technology and Biometry, Laboratory of Human Physiology, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
| | - T. Gentile
- Dept. of Experimental Medicine, Paediatric Clinic, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
| | - F. de Matteis
- Dept. of Experimental Medicine, Paediatric Clinic, School of Medicine, University of L'Aquila, Collemaggio, 67100 L'Aquila - Italy
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Tozzi-Ciancarelli MG, Di Massimo C, Mascioli A, Tozzi E, Gallo P, Fedele F, Dagianti A. Rheological features of erythrocytes in acute myocardial infarction. Cardioscience 1993; 4:231-4. [PMID: 8298063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
There is evidence that oxidative insult plays a role in the development of acute myocardial infarction. Significance has also been attributed to changes in viscosity of the blood and in the deformability and aggregation of erythrocytes affecting their rheological behavior. In a group of patients with myocardial infarction we found a decreased erythrocyte filtration and an increased blood viscosity with no significant change in plasma viscosity. These changes were accompanied by alterations in the microviscosity of the erythrocyte membrane assessed by measuring the polarization of specific fluorescent molecules. From our data it is evident that there is an increase in the rigidity of the membrane at the lipid/protein boundary, with an associated increase in the fluidity of the deep lipid core of the membrane, while no changes were observed in the dynamic behavior of the membrane proteins. These physico-chemical perturbations in the membrane could be the basis for the decreased filtration of erythrocytes. We found, however, no evidence of lipid peroxidation in the erythrocyte membrane.
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Affiliation(s)
- M G Tozzi-Ciancarelli
- Department of Biomedical Sciences and Technology and Biometry, University of L'Aquila, Italy
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Tozzi-Ciancarelli MG, Tozzi E, De Matteis G, Di Massimo C, Mascioli A, D'Andrea F, Marini C, Prencipe M. Erythrocyte membrane fluidity in subjects affected with reversible ischemic attacks (RIA). Riv Eur Sci Med Farmacol 1991; 13:43-9. [PMID: 1796196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
It is well recognized that in subjects with cerebrovascular disease (CVD), changes in hemorheological properties may occur in about 50% of the patients. This paper concerns a study on microhemorheological perturbations of the erythrocyte membranes in a group of 20 RIA's patients, treated with Pentoxifylline. At the admission of the subjects to the study a trend to an increased whole blood viscosity and erythrocyte aggregation was associated to alterations of membrane fluidity analyzed by means of the fluorescent probes in the patients with respect to the controls. At the end of pharmacological treatment and wash-out, our data indicate a clear modification in erythrocyte membrane which results improved. Our results underline how the improvement of the erythrocyte membrane fluidity, induced by pentoxifylline, is a basic factor of blood flow in the microcirculation.
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Affiliation(s)
- M G Tozzi-Ciancarelli
- Department of Biotechnology and Biometry, School of Medicine, University of L'Aquila, Italy
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Tozzi E, Tozzi-Ciancarelli MG, Di Giulio A, D'Alfonso A, Farello G, Spennati GF, de Matteis F. In vitro and in vivo effects of erythrocyte phototherapy on newborns. Biol Neonate 1989; 56:204-9. [PMID: 2529913 DOI: 10.1159/000243124] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The photodynamic action of the bilirubin is associated with severe consequences observed during 'in vitro' irradiation of the erythrocytes. This paper is designed to evaluate the bilirubin photodynamic effects which occur 'in vitro' and 'in vivo' on erythrocytes in healthy and jaundiced infants. The in vitro bilirubin sensitized photoreaction damages the erythrocytes mainly at the membrane level. In particular, a dramatic decrease of ATPase activity and an increased susceptibility to lipid peroxidation, expressed as malondialdehyde production, were observed. For in vivo studies, specific fluorescent probes have been used to verify probable changes on the functional architecture of the erythrocyte membrane in the phototherapy-treated infants. Our results showed that specific areas of the membrane are differently affected, mainly at lipid/protein interface. Although the role of the erythrocyte membrane is an important factor of the hemorheological behavior, the measurement of blood viscosity and erythrocyte aggregation and filtration did not show significant alterations during the overall time of phototherapy.
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Affiliation(s)
- E Tozzi
- Department of Medicine, School of Medicine Pediatrics Clinic, S. Salvatore Hospital, L'Aquila, Italy
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40
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Tozzi E, Scatena M, Castellacci E. [Anti-inflammatory local frigotherapy with a combination of escin, heparin and polyunsaturated phosphatidylcholine (EPL)]. Clin Ter 1981; 98:517-24. [PMID: 7307452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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41
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Tozzi E, Bottai M, Castellacci E. [Psychogenic scoliosis]. Arch Sci Med (Torino) 1978; 135:407-9. [PMID: 708091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Tozzi E, Castellacci E, Bottai M. [The prognosis of fractures in hemophiliacs has improved]. Arch Sci Med (Torino) 1978; 135:87-9. [PMID: 637680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A case of femoral fracture in diseased bone in an adult haemophiliac with relatively advanced arthropathy is referred to in discribing the principles underlying the relevant orthopaedic surgery, combined with suitable haematological preparation.
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Tozzi E. [Trend and consciousness of occupational problems in adolescents]. Minerva Pediatr 1970; 22:2291-2. [PMID: 5493384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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44
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Tozzi E. [Effect of N-acetyl-amino-6-hexanoic acid on consolidation of osseous fractures]. Minerva Med 1969; 60:1215-28. [PMID: 5781345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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45
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Tozzi E, Cesari M. [Gouty arthropathies]. Minerva Ortop 1969; 20:25-51. [PMID: 5402925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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