Professional Documents
Culture Documents
Introduction
ASNA Neuroinfection & 19th CNE 2018 1 ASNA Neuroinfection & 19th CNE 2018 2
5.9
pain Schwartz
14.3 Bank
Takeshima
14.0 12.2 Steiner 16.7
Stewart
Lipton 7.7
Zivadinov
1
26/07/2018
Migraine in children and Population or community-based surveys of Migraine in the elderly: Population or community-based
adolescents: 1-year prevalence >500 participants covering ages 6-18 y, surveys of >500 participants
using IHS or modified IHS criteria
1-year prevalence covering age >61 y
7.0 2.7
11.0 Zwart Metsähonkala
Laurel
3.8
Bener
11.0
9.9 Shivpuri
Barea
Africa Africa
Asia 3.7 (3 studies) Asia 7.0 (2 studies)
Australia Australia
Mean: 6.2 Mean: 7.4
Europe 6.8 (6 studies) Europe 7.8 (2 studies)
N. America Median: 6.5 N. America Median: 7.8
ASNA Neuroinfection & 19th CNE 2018 5 ASNA Neuroinfection & 19th CNE 2018 6
S. America 9.9 (1 study) S. America
Painful Cranial
Neuropathies, Other Facial
Pain & Other Headaches
IHS 2013, IHS 2018
ASNA Neuroinfection & 19th CNE 2018 7 ASNA Neuroinfection & 19th CNE 2018 8
2
26/07/2018
Chronic migraine
Complications of migraine
Preventive/ Profilaksis : reduce frequency,
Probable migraine duration & intensity of attacks
Efficacy in
clinical trials
Patient’s
Highly
clinical
Rapidly restore Minimal Avoidance of individualized
features
function recurrence side effects
Concomitant Treatment
comorbidities preferences
ASNA Neuroinfection & 19th CNE 2018 11 ASNA Neuroinfection & 19th CNE 2018 12
3
26/07/2018
• Triptans: drugs of choice in the acute attack, but contraindicated in • The goals of each are distinct but complementary, with the shared objective of
patients with vascular conditions (potential vasoconstrictive symptomatic control to minimise the effect of the illness on a patient’s lifestyle
properties)
4
26/07/2018
ASNA Neuroinfection & 19th CNE 2018 17 ASNA Neuroinfection & 19th CNE 2018 18
ASNA Neuroinfection & 19th CNE 2018 19 ASNA Neuroinfection & 19th CNE 2018 20
5
26/07/2018
ASNA Neuroinfection & 19th CNE 2018 23 ASNA Neuroinfection & 19th CNE 2018 24
6
26/07/2018
ASNA Neuroinfection & 19th CNE 2018 Becker, 2015 27 ASNA Neuroinfection & 19th CNE 2018 Becker, 2015 28
7
26/07/2018
Acute Migraine - Abortive Medications for Acute Migraine - Abortive Medications for
Emergency Department & Inpatient Treatment Emergency Department & Inpatient Treatment
ASNA Neuroinfection & 19th CNE 2018 Rozen, 2015 29 ASNA Neuroinfection & 19th CNE 2018 Rozen, 2015 30
ASNA Neuroinfection & 19th CNE 2018 Rozen, 2015 31 ASNA Neuroinfection & 19th CNE 2018 Rozen, 2015 32
8
26/07/2018
Red flags & other potential indicators of Dissatisfaction reason in Migraine Treatment
secondary headache
Only 29 % patient who satisfy with current migraine treatment
Several dissatisfaction reason with current migraine treatment
0 20 40 60 80 100
ASNA Neuroinfection & 19th CNE 2018 33 34 ASNA Neuroinfection & 19th CNE 2018
Preferentially COX-2
Selective Inhibitor
9
26/07/2018
Potassium Diclofenac (Cataflam Fast) is more effective than Potassium Diclofenac (Cataflam Fast) reduce associate symptome
sumatriptan in migraine attack
in pain relieve Kalium diklofenak mengurangi gejala penyerta pada serangan migren setelah 2 jam
ASNA Neuroinfection & 19th CNE 2018 39 ASNA Neuroinfection & 19th CNE 2018 40
10
26/07/2018
Summary
• Many recent studies had established for acute migraine treatment
• Choosing appropriate treatment should consider clinical condition,
comorbidity, pharmacodynamic and pharmacokinetic of drug
• Other modality such as lifestyle modification and prevent trigger
factor should be considered
ASNA Neuroinfection & 19th CNE 2018 41 ASNA Neuroinfection & 19th CNE 2018 42
11