Focus on the management of thunderclap headache: from nosography to treatment

Thunderclap headache (TCH) is an excruciating headache characterized by a very sudden onset. Recognition and accurate diagnosis of TCH are important in order to rule out the various, serious underlying brain disorders that, in a high percentage of cases, are the real cause of the headache. Primary TCH, which may recur intermittently and generally has a spontaneous, benign evolution, can thus be diagnosed only when all other potential underlying causes have been excluded through accurate diagnostic work up. In this review, we focus on the management of TCH, paying particular attention to the diagnostic work up and treatment of the condition

Study circles improve the precision in nutritional care in special accommodations

Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition, appropriate nutritional care can be provided. Objectives: Do study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high BMI? Design: Pre and post intervention study. Setting: Special accommodations (nursing homes) within six municipalities were involved. Participants: In 2005, 1726 (90.4%) out of 1910 residents agreed to participate and in 2007, 1526 (81.8%) out of 1866 residents participated. Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities. Measurements: Risk of undernutrition was defined as involving any of: involuntary weight loss, low BMI, and/or eating difficulties. Overweight was defined as high BMI. Results: In 2005 and 2007, 64% of 1726 and 66% of 1526 residents respectively were at the risk of undernutrition. In 2007 significantly more patients in the study circle municipality were accurately provided protein and energy enriched food compared to in the no intervention municipalities. There was a decrease in the prevalence of low BMI in the study circle municipality and the prevalence of overweight increased in the policy document municipality between 2005 and 2007

Augustus d'Este--the first documented case of MS.

Multiple sclerosis is a chronic, inflammatory disease of the Central Nervous System, usually diagnosed in young adults, women in particular, the disease is a leading cause of chronic neurologic disability. MS was described for the first time by Charcot and Vulpian in 1866, even if some written description were available before; it is famous the autopathography of the English lord of Augustus of Este, descent of the Family of the Dukes of Este, who reigned for centuries of Renaissance in city of Ferrara

Being parents with epilepsy: thoughts on its consequences and difficulties affecting their children

Helena Gauffin,1 Gullvi Flensner,2 Anne-Marie Landtblom1,3 1Department of Neurology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; 2Department of Nursing, Health and Culture, University West, Trollhättan, Sweden; 3Department of Neuroscience, Uppsala University, Uppsala, Sweden Objective: Parents with epilepsy can be concerned about the consequences of epilepsy affecting their children. The aim of this paper is to describe aspects of what it means being a parent having epilepsy, focusing the parents’ perspectives and their thoughts on having children.Methods: Fourteen adults aged 18–35 years with epilepsy and subjective memory decline took part in focus-group interviews. The interviews were conducted according to a semi-structured guideline. Material containing aspects of parenthood was extracted from the original interviews and a secondary analysis was done according to a content-analysis guideline. Interviews with two parents for the Swedish book Leva med epilepsi [To live with epilepsy] by AM Landtblom (Stockholm: Bilda ide; 2009) were analyzed according to the same method.Results: Four themes emerged: (1) a persistent feeling of insecurity, since a seizure can occur at any time and the child could be hurt; (2) a feeling of inadequacy – of not being able to take full responsibility for one’s child; (3) acknowledgment that one’s children are forced to take more responsibility than other children do; and (4) a feeling of guilt – of not being able to fulfill one’s expectations of being the parent one would like to be.Conclusion: The parents with epilepsy are deeply concerned about how epilepsy affects the lives of their children. These parents are always aware that a seizure may occur and reflect on how this can affect their child. They try to foresee possible dangerous situations and prevent them. These parents were sad that they could not always take full responsibility for their child and could not live up to their own expectations of parenthood. Supportive programs may be of importance since fear for the safety of the child increases the psychosocial burden of epilepsy. There were also a few parents who did not acknowledge the safety issue of their child – the authors believe that it is important to identify these parents and provide extra information and support to them. Keywords: focus group interviews, qualitative research, secondary analysis, guilt, feeling of inadequacy, insecurit

Epidemiologic study of etiological factors in multiple sclerosis. Guidelines for future analytical research.

Review of analytical studies on multiple sclerosi