Headache in Autoimmune Diseases

John, Seby; Hajj‐Ali, Rula A.

doi:10.1111/head.12306

Cited by 15 publications

(12 citation statements)

References 88 publications

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“…The majority of headaches resolve over time, independent of lupus-specific therapies [31]. Other studies found no association between migraine and SLE disease activity, biochemical or immunological markers and cerebral white matter hyperintensities [32,33].…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging (MRI) brain abnormalities of neuropsychiatric systemic lupus erythematosus patients in Mansoura city: Relation to disease activity

Zaky

Shaat

El-Bassiony

et al. 2015

The Egyptian Rheumatologist

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Aim of the work: To assess brain abnormalities in neuropsychiatric systemic lupus erythematosus (NPSLE) patients using magnetic resonance imaging (MRI) and to compare the findings to those in SLE patients without neuropsychiatric manifestations as well as to compare disease activity between SLE patients with and without MRI brain abnormalities.Patients and methods: The study was conducted on 55 SLE patients (48 female/7 male) with a mean age of 27.3 ± 4.6 years and disease duration of 4 ± 1.6 years. Patients with NPSLE (n = 30) and without neuropsychiatric (no-NPSLE) (n = 25) underwent MRI brain. The SLE disease activity index (SLEDAI), headache disability index and mini mental state score were considered.Results: Brain abnormalities were detected in 21 SLE patients (38.2%); 16 NPSLE and 5 no-NPSLE. The brain abnormalities included a significantly higher frequency of white matter changes in NPSLE (14 patients; 46%) compared to no-NPSLE patients (5 patients; 20%) (p = 0.038). In NPSLE patients, ischemia was present in 5 patients (16.7%), hemorrhage in 3 (10%) and encephalopathy in another 3 (10%). The SLEDAI was significantly higher in NPSLE patients with cognitive impairment(33.6 ± 9.1) and NPSLE patients with headache (24.2 ± 5.6) compared to the score in no-NPSLE patients (7.2 ± 4.7) (p = 0.001). Patients with MRI brain abnormalities had significantly longer disease duration (p = 0.03), higher SLEDAI (p = 0.001), mini mental state score (p = 0.005) and headache score (p = 0.019) than those without. The study revealed an MRI sensitivity of 0.64.

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Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging (MRI) brain abnormalities of neuropsychiatric systemic lupus erythematosus patients in Mansoura city: Relation to disease activity

Zaky

Shaat

El-Bassiony

et al. 2015

The Egyptian Rheumatologist

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“…The headache is more commonly described in some diseases (e.g., giant cell arteritis and primary central nervous system vasculitis) and is mainly reported at the onset of the disease; the characteristic is often not specific, raising important diagnostic problems [25].…”

Section: Headache In Autoimmune Disordersmentioning

confidence: 99%

Headache in multiple sclerosis and autoimmune disorders

Mantia

Prone

2015

Neurol Sci

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The headache may be considered among the neuropathic pain syndromes of multiple sclerosis (MS). Several studies have showed that it is more frequent in MS patients than in controls or general population. Headache may occur at the pre-symptomatic phase, at clinical onset and during the course of the disease. Tension-type headache and migraine without aura are the most common primary headaches reported in MS patients. The disease-modifying therapies, such as interferons, may cause or exacerbate headache, although the new available treatments do not seem to increase the risk of pain. Pharmacological and not pharmacological approach may be considered in selected patients to prevent the risk of headache, ameliorate quality of life and increase the adherence to treatment.

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“…2,6 Thunderclap headache, which is severe intensity headache that reaches maximum intensity very rapidly usually in less than 1 minute is almost never associated with PACNS. 7 This feature helps to clinically distinguish PACNS from one of its close mimics reversible cerebral vasoconstriction syndrome (RCVS). Stroke and transient ischemic attacks involving multiple vascular territories occur in 30 to 50% of patients with PACNS.…”

mentioning

confidence: 99%

CNS Vasculitis

John

Hajj‐Ali

2014

Semin Neurol

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Central nervous system vasculitis (CNSV) is a complex disease that poses considerable diagnostic and therapeutic challenges. It is divided into primary angiitis of the CNS (PACNS), or secondary angiitis of the CNS when associated with systemic conditions. Clinical presentation can be extremely variable and there is no classic presentation. In addition, there is no single diagnostic test and the sensitivity/specificity of all currently available tests is suboptimal. As such, an exhaustive approach with thorough historical data, physical examination, and corroborating investigations should be performed to exclude or confirm a diagnosis of CNSV. Infectious, neoplastic, and autoimmune conditions should be carefully evaluated. Knowledge of CNSV mimics is crucial given the therapeutic and prognostic implications. Reversible cerebral vasoconstriction syndrome is now recognized as the most common mimicker of PACNS. Much progress has been made in the understanding of PACNS histopathology, and specific clinical subsets and their response to treatment. Contrary to historical reports, recent PACNS cohorts achieved favorable clinical outcomes when early diagnosis and prompt treatment was initiated. Successful treatment with newer drugs has also been reported in PACNS cases. Newer imaging modalities hold promise for distinguishing inflammatory from noninflammatory vascular lesions. In this review, the authors provide a broad overview with updates on the types of adult CNSV along with its clinical assessment, diagnosis, and treatment.

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Headache in Autoimmune Diseases

Cited by 15 publications

References 88 publications

Magnetic resonance imaging (MRI) brain abnormalities of neuropsychiatric systemic lupus erythematosus patients in Mansoura city: Relation to disease activity

Magnetic resonance imaging (MRI) brain abnormalities of neuropsychiatric systemic lupus erythematosus patients in Mansoura city: Relation to disease activity

Headache in multiple sclerosis and autoimmune disorders

CNS Vasculitis

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