Botulinum toxin injections relieve tension headaches, according to a study just published in the European Journal of Neurology . Most of the previous studies had been conducted in patients with migraines or chronic migraines (more than 15 days of headaches a month). There is much less evidence that Botox also helps tension headaches. Our experience at the NYHC treating patients with tension headaches with Botox injections has been also very positive. In this European study doctors used Dysport – a version of botulinum toxin type A that is not available in the US. However, Dysport is very similar to Botox. On the other hand, Myobloc, which is botulinum toxin type B, is a very different version of botulinum toxin and in several aspects is inferior to Botox.
Read MorePostpartum headaches are very common and are usually benign. A study presented at the meeting of the Society for Maternal-Fetal Medicine by Dr. Caroline Stella and her colleagues looked at 95 women with severe headaches that started 25 hours to 32 days after delivery and were not responsive to usual doses of pain medicines. Half of these women eventually were diagnosed to have migraine or tension-type headaches and they all responded to higher doses of pain drugs. In one quarter of patients headaches were due to preeclampsia or eclampsia and were relieved by intravenous magnesium or magnesium and high blood pressure medications. Fifteen women had spinal headaches due to complication of epidural analgesia and they responded to a “blood patch” procedure. Only one woman had a brain hemorrhage and one had thrombosis (occlusion) of a vein in the brain. The authors suggested that all these conditions should be considered when evaluating women with postpartum headaches and appropriate testing needs to be performed.
In another study presented at this meeting Dutch researchers found that women who suffered from an episode of eclampsia had persistent cognitive dysfunction 6-8 years later. This contradicts the widely held belief that women with eclampsia can expect full recovery. This study suggests that eclampsia needs to be treated early and aggressively (magnesium infusion is one of the main treatments) to prevent permanent brain injury. It is also important to understand that persistent cognitive dysfunction is not psychological in nature and that it should be treated with cognitive rehabilitation.
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