Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Electronic pupillometry in healthy controls. Response to symphaticomimetics.

The ocular sympathetic function was examined in 79 healthy volunteers (37 males and 42 females) by electronic pupillography. Pupillary diameters were first estimated under standard light conditions prior to drug application, these diameters being termed "basal values". Then, the pupils were stimulated pharmacologically by instillation of various sympathicomimetic drugs: tyramine tests were carried out in 42 individuals (24 females; 18 males), hydroxyamphetamine tests in 38 (22 females and 16 males), and phenylephrine tests in 43 individuals (23 females and 20 males). Generally, only a minor variation in the frequency of asymmetries was observed between sexes as well as between the various age groups, both when calculating the increase in pupillary diameter in millimeters, in per cent, and as the anisocoria index. In agreement with previous investigations, pupil size was found to diminish with age. The use of an age-matched control material is mandatory when comparing pupillographic recordings in patients in various categories, in the ordinary condition, as well as after topical drug administration