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👍 | Tomoaki Ogura suddenly remarks Arienai's "off-color humor" on live broadcast ... The studio and viewers are frozen.


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Tomoaki Ogura suddenly remarks Arienai's "off-color humor" on live broadcast ... The studio and viewers are frozen

 
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In addition, he said that he was not diagnosed with a cluster headache, saying, "'You are too intense, aren't you?
 

Image: "Toku ..." on the 1th, which covered cluster headaches that can cause severe pain multiple times a day. → Continue reading

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Cluster headache

Cluster headache(Cluster headache) is a primary (not caused by others) characterized by intensely painful headache attacks.headacheIt is one of.The characteristic of pain is that severe pain centered on the orbital part, which is unilateral, occurs concentrated in a certain period (cluster period) and repeats seizures many times during the day.HypothalamusIt is believed that the dysfunction of is involved.Elevated metabolites of CGRP and VIP in jugular venous blood and nitrogen monoxide (NO) in cerebrospinal fluid were reported during the attack phase of cluster headache patients, and changes in neuropeptides in the trigeminal neurovascular system. Is thought to be caused by cluster headaches. In the "International Headache Classification 3rd Edition beta", it is classified as trigeminal nerve / autonomic nerve headache (TACs).[1].

Treatment includes preventive drugs aimed at preventing seizures and acute treatment drugs aimed at failing seizures.Japanese guidelines recommend subcutaneous sumatriptan and pure oxygen inhalation as acute treatments, and verapamil and corticosteroids as preventive agents for recurrent cluster headaches.[2].

Features[2]

Diagnostically important clinical findings
  • It is the most painful headache of all primary headaches.
  • Headaches appear on one side.
  • The frequency of headache attacks is 1 time / day to 1 times / day.
  • The duration of a single headache attack is 1-15 minutes.
  • The period of repeated headache attacks lasts from less than a month to several months, which is called the cluster period.
  • Cluster headaches appear once every few years to several times a year (excluding chronic cluster headaches)
  • Conjunctival congestion, lacrimation, nasal congestion (stuffy nose), rhinorrhea (nasal discharge), eyelid edema, frontal and facial sweating, frontal and facial red tide, ear closure, on the same side of the headache during an attack Miosis and drooping eyelids are observed.
  • Drinking alcohol during the non-cluster headache period induces headache, but not during the remission period (non-cluster period).
  • During the attack, he appears restless or agitated.
Clinical findings that can be used as a diagnostic reference
  • Mostly in men.
  • Women are less likely to have headaches during pregnancy.
  • The onset is often 20 to 40 years old.According to Japanese reports, the average age of onset is 29-40 years for men and 24-40 years for women.
  • During the cluster period, seizures are induced by alcoholic beverages, nitroglycerin, and histamine.
  • There are many heavy drinkers and heavy smokers.

治療

For the treatment of cluster headache, not only acute therapeutic agents but also preventive agents are administered.Cluster headache is a remedyPlacebo effectIs said to be difficult to come out.

Preventive treatment

As a general preventive drugVerapamil(240-360mg)[3],Lithium carbonate(600-900mg),Valproic acid(400-600mg),Topiramate(75mg),steroid(PSL 60-100 mg is administered once a day for 5 days and then reduced by 1 mg / day).

Preventive measures according to the guidelines of the National Institute for Health and Care TechnologyVerapamilShould be sought for expert assistance if this does not work.[3].

Acute treatment

Smartphones are used in acute careTriptanSubcutaneous injection[2],oxygen[3],ErgotamineIs.Subcutaneous sumatriptan injection is effective about 10 minutes after administration.Oxygen is 7 to 8 liters of pure oxygen, and the effect is often obtained in about 15 minutes.It is necessary to have an oxygen cylinder on hand.

According to the guidelines of the National Institute for Health and Care Technology, for sudden cluster headaches,Acetaminophen-NSAIDs-Opioid-Ergotamine・ Oral triptans should not be prescribed[3].

What is in the research stage

Harvard University researcher(English edition)Is investigating. In 2006, they interviewed cluster headache patients andPsilocybin19 out of 18 usersLSD5 out of 4 users of the drug could be a valid reason for the investigation, such as extending the period of remission (containment).[4]..For example, one man has been using mushrooms for three years without headaches.[5].

In 2010, there is no hallucinogenic effect but the chemical structure is similar(English edition)A case study was conducted using (also known as BOL-148).[6]..In a study, for example, one patient had 30 seizures per week for 1 years, but reduced to 40 per week.[7]..His efforts include scientific magazines and "National Geographic ChannelAs mentioned in the above, without the interest of major pharmaceutical companies, they launched entheogen and funded research to approve 2-Bromo-LSD.[8].

Local myths

  • In some American Indians and Scandinavian people, those who develop intense headaches with tears at regular intervals were targeted for demon extermination and execution because of the devil's possession.Later, it is said that this may be due to cluster headaches.
  • In some areas of Hubei Province, China, there are many areas where many people develop symptoms that appear to be cluster headaches.The medical basis for the occurrence of what appears to be cluster headaches in that area is unclear.Even in this area, the symptoms were thought to be due to possession of the devil and possession.Also, as a myth in the area, most of the people who develop symptoms are tall and smart young men, and many of them are sexually transmitted, so it may be one of the sexually transmitted diseases. It was being considered.


footnote

  1. ^ Japan Headache Society / International Headache Classification Committee.International Headache Classification 2014rd Edition beta Edition.Tokyo: Igaku-Shoin; 28. p.35-XNUMX.
  2. ^ a b c Edited by the clinical guideline development committee for chronic headache.Clinical guidelines for chronic headache 2013.Tokyo: Igaku-Shoin; 2013. p. 215-238.
  3. ^ a b c d UK National Institute of Medical Technology 2012.
  4. ^ Sewell, RA; Halpern, JH; Pope, HG (2006). “Response of cluster headache to psilocybin and LSD”. Neurology 66 (12): 1920–1922. two:10.1212 / 01.wnl.0000219761.05466.43. PMID 16801660. 
  5. ^ Eugenia Bourne "Chapter 10 Magic Mushroom Temptation" "Mycophilia-Mushroom Lovers-The Mysterious World of Unknown Mushrooms" (Supervised) Toshimitsu Fukiharu, (Translated) Translated by Koji Sato, Ryoko Tanaka, Pai International, 2016, 299 pages.ISBN 978-4-7562-4405-5. Mycophilia, 2011.
  6. ^ Karst, M .; Halpern, JH; Bernateck, M .; Passie, T. (2010). “The non-hallucinogen 2-bromo-lysergic acid esteramide as preventative treatment for cluster headache: An open, non-randomized case series” .. Cephalalgia 30 (9): 1140–1144. two:10.1177/0333102410363490. PMID 20713566. 
  7. ^ “Harvard's headache cure: LSD?”. Boston Business Journal(July 2010, 12). http://www.bizjournals.com/boston/news/2010/11/05/harvards-headache-cure-lsd.html 2016/4/10Browse. 
  8. ^ entheogen

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