The objective of this study was to compare the efficacy of rizatriptan and ibuprofen in migraine. The study was a randomised placebo-controlled trial in a tertiary care teaching hospital. Migraine patients with <8 attacks/months were included. One hundred and fifty-five migraine patients were randomised to rizatriptan 10 mg (53), ibuprofen 400 mg (52) and placebo (50). Efficacy was assessed by headache relief, and headache freedom at 2 h and 24 h. Two-hour headache relief was noted in 73% in rizatriptan, 53.8% in ibuprofen and 8% in placebo groups. Headache freedom was achieved in 37.7% in rizatriptan, 30.8% in ibuprofen and 2% in placebo groups. Rizatriptan was superior to ibuprofen and placebo in relieving headache at 2 h but not at 24 h. Side effects were noted in 9 patients in rizatriptan, 8 in ibuprofen and 3 in placebo, all of which were nonsignificant. Rizatriptan and ibuprofen are superior to placebo. Rizatriptan is superior to ibuprofen in relieving headache, associated symptoms and functional disability.
Allodynic symptoms occurred in 57.1% patients with migraine. In allodynic patients with moderate-to-severe headache, rizatriptan resulted in greater pain relief compared with ibuprofen. These results need further confirmation in larger study.
Diabetes mellitus (DM) is occasionally associated with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) raising the question of coexistence or etiological link. The study compares, neurophysiological and outcome of CIDP patients with and without DM. Consecutive CIDP patients were subjected to detailed clinical evaluation, haematology, serum chemistry, vasculitis profile, paraproteins, myeloma screening and cerebrospinal fluid (CSF) examination. Electrodiagnostic (EDx) tests included motor and sensory conduction and F-wave studies. The patients were treated with oral prednisolone 1 mg/kg/day with or without azathioprine 1-2 mg/kg and followed up for 6 months. The clinical and EDx finding in CIDP with and without DM were compared. Thirty-five CIDP patients were included and nine had DM. CIDP with diabetes (CIDP-D) had higher frequency of autonomic dysfunction. In CIDP-D, motor (38.9% vs. 16.7%) and sensory (40.7% vs. 14.1%) nerve conductions were more frequently unrecordable or had reduced compound muscle action potential (CMAP) amplitude. F-waves were also more frequently unrecordable in CIDP-D (28.8% vs. 12.8%) compared with idiopathic CIDP (I-CIDP). The degree of conduction block was more in I-CIDP. At 6-month follow up, I-CIDP patients improved better than CIDP-D. CIDP-D patients present with higher frequency of autonomic dysfunction, electrophysiological evidences of associated axonal loss and had a poorer outcome at 6 months compared with I-CIDP.
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