In 2005, an open-label study of feverfew/ginger suggested efficacy for attacks of migraine treated early during the mild headache Selumetinib phase of the attack. Methods/Materials.— In this multi-center pilot study, 60 patients treated 221 attacks
of migraine with sublingual feverfew/ginger or placebo. All subjects met International Headache Society criteria for migraine with or without aura, experiencing 2-6 attacks of migraine per month within the previous 3 months. Subjects had <15 headache days per month and were not experiencing medication overuse headache. Inclusion required that subjects were able to identify a period of mild headache in at least 75% of attacks. Subjects were required to be able to distinguish migraine from non-migraine headache. Subjects were randomized 3:1 to receive either sublingual feverfew/ginger Mdm2 inhibitor or a matching placebo and were instructed but not required to treat with study medication at the earliest recognition of migraine. Results.— Sixty subjects treated 208 evaluable attacks of migraine over a 1-month period; 45 subjects treated 163 attacks with sublingual feverfew/ginger and 15 subjects treated 58 attacks with a sublingual placebo preparation. Evaluable diaries were completed for 151 attacks of migraine in the population using feverfew/ginger and 57 attacks for those attacks treated with placebo. At 2 hours, 32% of subjects receiving active medication
and 16% of subjects receiving placebo were pain-free (P = .02). At 2 hours, 63% of subjects receiving feverfew/ginger found pain relief (pain-free or mild headache) vs 39% for placebo (P = .002). Pain level differences on a 4-point pain scale for those receiving feverfew/ginger vs placebo were −0.24 vs −0.04 respectively (P = .006). Feverfew/ginger was generally well tolerated with oral numbness and nausea being the most frequently occurring adverse event. Conclusion.— Sublingual feverfew/ginger appears safe and effective as a first-line abortive treatment for a population of migraineurs who frequently experience mild headache prior to the onset of moderate to severe
“Background.— It has been proposed that desaturation of oxygen during an apnea event is the trigger for cluster headache. Obstructive sleep apnea has been associated with a higher than normal cardiovascular morbidity ADAM7 and mortality. Some obstructive sleep apnea syndrome patients lack the sleep-related, nocturnal decrease, or “dip” in blood pressure, which is seen in normal individuals. Objective.— The aim of this study is to assess whether this non-dipper pattern is present in cluster headache patients. Design and Methods.— A total of 30 normotensive cluster headache patients underwent an ambulatory blood pressure monitoring. “Non dippers” were defined as patients with a nighttime mean blood pressure fall <10%. Results.— Fifteen cluster headache patients (50%) were non-dippers, a frequency higher than expected.