Migréna je záchvatovité neurologické onemocnění s výrazným dopadem na kvalitu života pacientů. Prevalence migrény se celosvětově pohybuje kolem 17 % u žen a 6 % u mužů, nejčastěji se vyskytuje mezi 30. a 40. rokem života. Migréna je druhou nejčastější příčinou disability po vertebrogenních onemocněních a třetí nejčastější neurologické onemocnění vůbec. Představuje tak pro společnost významnou ekonomickou zátěž, proto potřebujeme co nejdokonalejší a nejúčinnější terapii. V posledních třech letech máme již takovou léčbu k dispozici ve formě monoklonálních protilátek.

Migraine is an attack-like neurological disease with a significant impact on patients' quality of life. The prevalence of migraine worldwide is around 17% in women and 6% in men, with the most frequent occurrence between 30 and 40 years of age. Migraine is the second most common cause of disability after vertebrogenic disorders and the third most common neurological disorder overall. It represents a significant economic burden on society, which is why we need the most sophisticated and effective therapies. In the last three years, we already have such a treatment available in the form of monoclonal antibodies.

• MeSH
• biologická terapie MeSH
• humanizované monoklonální protilátky farmakologie   terapeutické užití   MeSH
• lidé MeSH
• migréna bez aury diagnóza   MeSH
• migréna s aurou diagnóza   MeSH
• migréna * diagnóza   farmakoterapie   prevence a kontrola   MeSH
• monoklonální protilátky farmakologie   terapeutické užití   MeSH
• tryptaminy farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Migraine and epilepsy are two paroxysmal chronic neurological disorders affecting a high number of individuals and being responsible for a high individual and socioeconomic burden. The link between these disorders has been of interest for decades and innovations concerning diagnosing and treatment enable new insights into their relationship. FINDINGS: Although appearing to be distinct at first glance, both diseases exhibit a noteworthy comorbidity, shared pathophysiological pathways, and significant overlaps in characteristics like clinical manifestation or prophylactic treatment. This review aims to explore the intricate relationship between these two conditions, shedding light on shared pathophysiological foundations, genetic interdependencies, common and distinct clinical features, clinically overlapping syndromes, and therapeutic similarities. There are several shared pathophysiological mechanisms, like CSD, the likely underlying cause of migraine aura, or neurotransmitters, mainly Glutamate and GABA, which represent important roles in triggering migraine attacks and seizures. The genetic interrelations between the two disorders can be observed by taking a closer look at the group of familial hemiplegic migraines, which are caused by mutations in genes like CACNA1A, ATP1A2, or SCN1A. The intricate relationship is further underlined by the high number of shared clinical features, which can be observed over the entire course of migraine attacks and epileptic seizures. While the variety of the clinical manifestation of an epileptic seizure is naturally higher than that of a migraine attack, a distinction can indeed be difficult in some cases, e.g. in occipital lobe epilepsy. Moreover, triggering factors like sleep deprivation or alcohol consumption play an important role in both diseases. In the period after the seizure or migraine attack, symptoms like speech difficulties, tiredness, and yawning occur. While the actual attack of the disease usually lasts for a limited time, research indicates that individuals suffering from migraine and/or epilepsy are highly affected in their daily life, especially regarding cognitive and social aspects, a burden that is even worsened using antiseizure medication. This medication allows us to reveal further connections, as certain antiepileptics are proven to have beneficial effects on the frequency and severity of migraine and have been used as a preventive drug for both diseases over many years. CONCLUSION: Migraine and epilepsy show a high number of similarities in their mechanisms and clinical presentation. A deeper understanding of the intricate relationship will positively advance patient-oriented research and clinical work.

• MeSH
• antikonvulziva terapeutické užití   MeSH
• epilepsie * etiologie   genetika   MeSH
• komorbidita MeSH
• lidé MeSH
• migréna s aurou * genetika   MeSH
• migréna * diagnóza   genetika   epidemiologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Migraine is a complex brain disorder explained by the interaction of genetic and environmental factors. In monogenic migraines, including familial hemiplegic migraine and migraine with aura associated with hereditary small-vessel disorders, the identified genes code for proteins expressed in neurons, glial cells, or vessels, all of which increase susceptibility to cortical spreading depression. The study of monogenic migraines has shown that the neurovascular unit plays a prominent role in migraine. Genome-wide association studies have identified numerous susceptibility variants that each result in only a small increase in overall migraine risk. The more than 180 known variants belong to several complex networks of "pro-migraine" molecular abnormalities, which are mainly neuronal or vascular. Genetics has also highlighted the importance of shared genetic factors between migraine and its major co-morbidities, including depression and high blood pressure. Further studies are still needed to map all of the susceptibility loci for migraine and then to understand how these genomic variants lead to migraine cell phenotypes.

• MeSH
• celogenomová asociační studie MeSH
• lidé MeSH
• migréna s aurou * MeSH
• migréna * genetika   MeSH
• šířící se kortikální deprese * fyziologie   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

INTRODUCTION: Headache is the most prevalent neurological manifestation in adults and one of the leading causes of disability worldwide. In children and adolescents, headaches are arguably responsible for a remarkable impact on physical and psychological issues, yet high-quality evidence is scarce. MATERIAL AND METHODS: We searched cross-sectional and cohort studies in Embase, Medline, Web of Science, and Cochrane databases from January 1988 to June 2022 to identify the prevalence of headaches in 8-18 years old individuals. The risk of bias was examined with the Joanna Briggs Institute (JBI) scale. A random-effects model was used to estimate the pooled prevalence of pediatric headache. Subgroup analyses based on headache subtypes were also conducted. RESULTS: Out of 5,486 papers retrieved electronically, we identified 48 studies that fulfilled our inclusion criteria. The pooled prevalence of primary headaches was 11% for migraine overall [95%CI: 9-14%], 8% for migraine without aura (MwoA) [95%CI: 5-12%], 3% for migraine with aura (MwA) [95%CI:2-4%] and 17% for tension-type headache (TTH) [95% CI: 12-23%]. The pooled prevalence of overall primary headache in children and adolescents was 62% [95% CI: 53-70%], with prevalence in females and males of 38% [95% CI: 16-66%] and 27% [95% CI: 11-53%] respectively. After the removal of studies ranked as low-quality according to the JBI scale, prevalence rates were not substantially different. Epidemiological data on less common primary headaches, such as trigeminal autonomic cephalalgias, were lacking. CONCLUSION: We found an overall remarkably high prevalence of primary headaches in children and adolescents, even if flawed by a high degree of heterogeneity. Further up-to-date studies are warranted to complete the picture of pediatric headache-related burden to enhance specific public interventions.

• MeSH
• bolesti hlavy epidemiologie   MeSH
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• migréna bez aury * MeSH
• migréna s aurou * MeSH
• mladiství MeSH
• prevalence MeSH
• průřezové studie MeSH
• tenzní bolesti hlavy * epidemiologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• metaanalýza MeSH
• přehledy MeSH
• systematický přehled MeSH

Kazuistika se zabývá výběrem vhodných psychofarmak ze skupiny antidepresiv u pacienta s úzkostnou poruchou a současně trpícího častými migrenózními záchvaty. V literatuře jsou hojně popisovány interakce serotonergních antidepresiv a látek ze skupiny triptanů (antimigrenózní léčiva). Obáváme se vzniku serotoninového syndromu, který může být v případě, že není adekvátně léčen, i život ohrožujícím stavem. V praxi je potřeba umět posoudit klinickou závažnost každé lékové interakce tak, abychom její význam nepřeceňovali, ani nepodcenili. Nesprávnou interpretací lékové interakce můžeme pacienta ohrozit vystupňovanými nežádoucími účinky nebo neúčinností terapie, případně ho ochudit o účinnou variantu léčby. Tato kazuistika si klade za cíl demonstrovat druhý popisovaný případ, kdy byl pacient zprvu v obavě z interakce nedostatečně léčen, což výrazně snižovalo jeho kvalitu života.

The case report deals with the selection of suitable psychotropic drugs from the group of antidepressants in a patient with anxiety disorder and at the same time suffering from frequent migraine attacks. The interactions of serotonergic antidepressants and triptans (antimigraine drugs) has been widely described in the literature. We deal with concerns from the development of serotonin syndrome, which can be a life-threatening side effect. In practice, there is a need to assess the clinical severity of each drug interaction so that we do not overestimate or underestimate its importance. By incorrect interpretation of the drug interaction, patient can be endangered with side effects or ineffectiveness of therapy. This case study aims to demonstrate the second case described, where the patient was initially undertreated for fear of interaction, which significantly reduced his quality of life.

• MeSH
• antidepresiva škodlivé účinky   MeSH
• dospělí MeSH
• lékové interakce * MeSH
• lidé MeSH
• migréna s aurou farmakoterapie   komplikace   MeSH
• serotoninový syndrom chemicky indukované   MeSH
• tryptaminy škodlivé účinky   MeSH
• úzkost farmakoterapie   komplikace   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Psoriáza je kožní onemocnění s multiorgánovým postiže- ním. Je asociována s řadou známých komorbidit; mezi méně známé patří migréna. Klinické studie prokazují zvýšený vý- skyt migrény u pacientů s psoriázou v důsledku systémového zánětu vzniklého působením cytokinů, zejména interleukinů IL-12 a IL-23. Článek shrnuje současné poznatky ve vztahu psoriázy a migrény a popisuje případ pacientky léčené sou- časně pro psoriázu a migrénu biologickými léčivy.

Psoriasis is a skin disease with a multiorgan involvement. It is associated with a number of known comorbidities; among the lesser known is migraine. Clinical trials show an increased incidence of migraine in patients with psoriasis due to systemic inflammation caused by cytokines, especially interleukins IL-12 and IL-23. The article summarizes current knowledge in the relationship between psoriasis and migraine and describes a case of a patient treated simultaneously for psoriasis and migraine with biological drugs.

• MeSH
• antiflogistika nesteroidní škodlivé účinky   terapeutické užití   MeSH
• humanizované monoklonální protilátky aplikace a dávkování   MeSH
• kombinovaná farmakoterapie MeSH
• komorbidita MeSH
• lidé středního věku MeSH
• lidé MeSH
• migréna s aurou * etiologie   farmakoterapie   komplikace   terapie   MeSH
• neúspěšná terapie MeSH
• parapsoriáza farmakoterapie   MeSH
• progrese nemoci MeSH
• psoriatická artritida farmakoterapie   MeSH
• psoriáza * farmakoterapie   komplikace   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• lidé MeSH
• migréna s aurou * diagnóza   patologie   terapie   MeSH
• mladý dospělý MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

This study aims to investigate whether intranetwork dynamic functional connectivity and causal interactions of the salience network is altered in the interictal term of migraine. Thirty-two healthy controls, 37 migraineurs without aura, and 20 migraineurs with aura were recruited. Participants underwent a T1-weighted scan and resting-state fMRI protocol inside a 1.5T MR scanner. We obtained average spatial maps of resting-state networks using group independent component analysis, which yielded subject-specific time series through a dual regression approach. Salience network regions of interest (bilateral insulae and prefrontal cortices, dorsal anterior cingulate cortex) were obtained from the group average map through cluster-based thresholding. To describe intranetwork connectivity, average and dynamic conditional correlation was calculated. Causal interactions between the default-mode, dorsal attention, and salience network were characterised by spectral Granger's causality. Time-averaged correlation was lower between the right insula and prefrontal cortex in migraine without aura vs with aura and healthy controls (P < 0.038, P < 0.037). Variance of dynamic conditional correlation was higher in migraine with aura vs healthy controls and migraine with aura vs without aura between the right insula and dorsal anterior cingulate cortex (P < 0.011, P < 0.026), and in migraine with aura vs healthy controls between the dorsal anterior cingulate and left prefrontal cortex (P < 0.021). Causality was weaker in the <0.05 Hz frequency range between the salience and dorsal attention networks in migraine with aura (P < 0.032). Overall, migraineurs with aura exhibit more fluctuating connections in the salience network, which also affect network interactions, and could be connected to altered cortical excitability and increased sensory gain.

• MeSH
• epilepsie MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mapování mozku MeSH
• migréna s aurou * MeSH
• nervová síť diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• antagonisté CGRP receptorů terapeutické užití   MeSH
• bolesti hlavy farmakoterapie   MeSH
• deprese * farmakoterapie   MeSH
• humanizované monoklonální protilátky terapeutické užití   MeSH
• komorbidita MeSH
• lidé MeSH
• migréna s aurou komplikace   MeSH
• migréna * farmakoterapie   MeSH
• serotoninový syndrom prevence a kontrola   MeSH
• Check Tag
• lidé MeSH

• MeSH
• bolesti hlavy etiologie   farmakoterapie   MeSH
• kongresy jako téma MeSH
• lidé MeSH
• migréna s aurou farmakoterapie   patofyziologie   MeSH
• migréna * farmakoterapie   patofyziologie   prevence a kontrola   MeSH
• monoklonální protilátky terapeutické užití   MeSH
• peptid spojený s genem pro kalcitonin antagonisté a inhibitory   terapeutické užití   MeSH
• polypharmacy MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• zprávy MeSH