Letter to the Editor
Migralepsy and migraine in the puerperal period
Migralepsia y migraña en el puerperio
Read
3833
Timeswas read the article
779
Total PDF
3054
Total HTML
Share statistics
array:25 [ "pii" => "S2173580818300087" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2016.12.001" "estado" => "S300" "fechaPublicacion" => "2018-04-01" "aid" => "1025" "copyright" => "Sociedad Española de Neurología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2018;33:202-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 592 "formatos" => array:3 [ "EPUB" => 61 "HTML" => 407 "PDF" => 124 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0213485317300269" "issn" => "02134853" "doi" => "10.1016/j.nrl.2016.12.008" "estado" => "S300" "fechaPublicacion" => "2018-04-01" "aid" => "1025" "copyright" => "The Authors" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2018;33:202-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2961 "formatos" => array:3 [ "EPUB" => 49 "HTML" => 2557 "PDF" => 355 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Migralepsia y migraña en el puerperio" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "202" "paginaFinal" => "204" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Migralepsy and migraine in the puerperal period" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Gazulla, A. Betancourt, L. Mata-Gazulla" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Gazulla" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Betancourt" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Mata-Gazulla" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173580818300087" "doi" => "10.1016/j.nrleng.2016.12.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580818300087?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485317300269?idApp=UINPBA00004N" "url" => "/02134853/0000003300000003/v1_201803271020/S0213485317300269/v1_201803271020/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S217358081830018X" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2017.01.001" "estado" => "S300" "fechaPublicacion" => "2018-04-01" "aid" => "1030" "copyright" => "Sociedad Española de Neurología" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2018;33:204-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1692 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 1363 "PDF" => 286 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Acute Pisa syndrome secondary to betahistine treatment in a patient with mild cognitive impairment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "204" "paginaFinal" => "205" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Pisa agudo tras tratamiento con betahistina en un paciente con deterioro cognitivo leve" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. López-Blanco, M.P. Guerrero-Molina, J. González-de la Aleja, J. Ruiz-Morales" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "López-Blanco" ] 1 => array:2 [ "nombre" => "M.P." "apellidos" => "Guerrero-Molina" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "González-de la Aleja" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Ruiz-Morales" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485317300312" "doi" => "10.1016/j.nrl.2017.01.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485317300312?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358081830018X?idApp=UINPBA00004N" "url" => "/21735808/0000003300000003/v1_201804060407/S217358081830018X/v1_201804060407/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2173580818300099" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2016.02.016" "estado" => "S300" "fechaPublicacion" => "2018-04-01" "aid" => "875" "copyright" => "Sociedad Española de Neurología" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2018;33:201-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 587 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 376 "PDF" => 173 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Late-onset meningeal lymphomatosis in mantle cell lymphoma controlled with chemotherapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "202" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfomatosis meníngea tardía en linfoma del manto controlada con quimioterapia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.J. Alonso, A. Cánovas, M.M. Riñón" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "Alonso" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Cánovas" ] 2 => array:2 [ "nombre" => "M.M." "apellidos" => "Riñón" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485316300019" "doi" => "10.1016/j.nrl.2016.02.014" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485316300019?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580818300099?idApp=UINPBA00004N" "url" => "/21735808/0000003300000003/v1_201804060407/S2173580818300099/v1_201804060407/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Migralepsy and migraine in the puerperal period" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "202" "paginaFinal" => "204" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Gazulla, A. Betancourt, L. Mata-Gazulla" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Gazulla" "email" => array:1 [ 0 => "josegazulla@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Betancourt" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Mata-Gazulla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neurología, Clínica Universidad de La Sabana, Chía, Cundinamarca, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Clínica Psiquiátrica Padre Menni, Pamplona, Navarra, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Migralepsia y migraña en el puerperio" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 34-year old woman with a history of right frontal pulsatile headache between the ages 11 and 20; episodes were preceded by a right faciobrachial tingling sensation and the appearance of a bright zigzag pattern at the centre of the visual field, extending to the periphery for more than 5<span class="elsevierStyleHsp" style=""></span>minutes. This left a right homonymous scotoma, white or black in colour, which lasted 20<span class="elsevierStyleHsp" style=""></span>minutes, scoring the maximum of 10 on the Visual Aura Rating Scale (VARS; scores are distributed as follows: 3 points for duration of aura 5-60<span class="elsevierStyleHsp" style=""></span>min, 2 points for progression of aura ≥5<span class="elsevierStyleHsp" style=""></span>min, 2 points for presence of scotoma, 2 points for zigzag lines, and 1 point for homonymous distribution of visual symptoms). A score of 5 on the scale is diagnostic of aura with a sensitivity of 91% and a specificity of 96%.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Eight days after a normal delivery, she experienced a persistent left frontal pulsatile headache for 2 days; she developed right homonymous hemianopia with the described characteristics. She subsequently presented complete vision loss in the form of white scotoma with photopsias; headache was holocranial and intense at that time. The neurological examination conducted at the emergency department revealed bilateral amaurosis with an intact pupillary light reflex. During the examination, the patient presented a generalised tonic-clonic seizure with no other previous manifestations; this lasted 2<span class="elsevierStyleHsp" style=""></span>minutes and resolved with intravenous diazepam.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was confused following the seizure; she experienced no further seizures after starting treatment with sodium valproate. Headache remitted 6<span class="elsevierStyleHsp" style=""></span>hours after administration of metamizole and dexketoprofen; amaurosis resolved after 48<span class="elsevierStyleHsp" style=""></span>hours (VARS, 2<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6). The patient subsequently experienced episodes of hemicranial headache without aura or epileptic seizures.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Brain MRI, cerebral pan-angiography, blood tests (including antinuclear antibodies and anti-β2 glycoprotein I levels), and urine and cerebrospinal fluid (CSF) analyses yielded normal results; 2 electroencephalographies (EEG) revealed normal bioelectrical activity, with no epileptiform discharges.</p><p id="par0025" class="elsevierStylePara elsevierViewall">During the postpartum period, the following diagnoses should be considered when an episode of headache with vision loss is accompanied by an epileptic seizure: (1) thrombosis of cerebral veins or arteries and reversible cerebral vasoconstriction syndrome, which may be ruled out by brain angiography; (2) posterior reversible encephalopathy syndrome, which may be ruled out by normal MRI results; (3) postpartum preeclampsia,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">2</span></a> which may be ruled out by absence of arterial hypertension and proteinuria; (4) occipital-onset epilepsy with secondary generalisation, which may be ruled out by a normal EEG reading and visual aura not suggesting seizures; (5) meningoencephalitis, which may be ruled out by normal CSF and neuroimaging findings; and (6) migralepsy.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our patient met the diagnostic criteria for migraine with aura according to the third edition of the International Classification of Headache Disorders, (ICHD-3 beta). An epileptic seizure occurring during migraine aura, or in the hour following the aura, is referred to as migralepsy (epileptic seizure triggered by migraine, according to ICHD-3 beta). Diagnosis requires: (1) presence of an epileptic seizure meeting diagnostic criteria for any type of seizure; (2) presence during migraine aura, or in the hour following aura, and (3) seizure not being attributable to other disorder.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3,4</span></a> Our case matches this definition, as the seizure took place during the migraine aura.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Although these diagnostic criteria are clear, cases have been described of migralepsy preceded by migraine without aura,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> its diagnosis in some published cases has been questioned,<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a> and the existence of migralepsy as an entity remains a topic of debate.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In migralepsy, migraine aura should be differentiated from epileptic visual hallucinations, which mainly consist of coloured, unstable circular images which consistently follow the same onset and progression patterns, lasting a few seconds and progressing faster than migraine.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">7</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The patient displays some unusual clinical manifestations: (1) recurrence of migraine during the postpartum period after 14 years without headache; (2) initial absence of migraine aura and a different location than that of headache; (3) non-habitual aura, consisting in right homonymous hemianopia followed by bilateral amaurosis with photopsias, suggestive of basilar migraine,<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3,8</span></a> and described in a case of migralepsy<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">6</span></a>; the duration of amaurosis was also surprising, exceeding that of headache. However, variability of aura characteristics and duration and headache location is a proven fact in migraine.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The mechanism associating migraine and epilepsy remains unknown.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> It has been suggested that the occipital cortex has a low excitation threshold during migraine aura; probably, as a consequence of this, the cortical spreading depression wave may facilitate the occurrence of epileptic seizures.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5,6,10</span></a> In support of this hypothesis, mutations of <span class="elsevierStyleItalic">SCN1A</span> (which codes for the Na<span class="elsevierStyleInf">v</span>1.1 ion channel) have been reported to cause both migraine and epilepsy.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Ovarian hormones affect the excitability of the cerebral cortex (oestrogens increase excitability and progesterone decreases it).<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a> Fluctuations in plasma levels of these hormones condition the occurrence of migraine and epilepsy,<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a> since migraine is more frequent in the catamenial period and less frequent during pregnancy and menopause.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">9,14,15</span></a> Ours is the first case of migralepsy during the postpartum period and such a prolonged duration of visual aura.</p><p id="par0060" class="elsevierStylePara elsevierViewall">This case illustrates the variability of migraine manifestations during the postpartum period, since aura may be different than normal, with longer duration, and migraine may manifest without aura<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">4,5,8</span></a> or cause a first episode of migralepsy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gazulla J, Betancourt A, Mata-Gazulla L. Migralepsia y migraña en el puerperio. Neurología. 2018;33:202–204.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0080" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The visual aura rating scale (VARS) for migraine aura diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.K. Eriksen" 1 => "L.L. Thomsen" 2 => "J. Olesen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-2982.2005.00955.x" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "2005" "volumen" => "25" "paginaInicial" => "801" "paginaFinal" => "810" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16162257" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0085" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Atypical posterior reversible encephalopathy syndrome (PRES) in de novo late post-partum eclampsia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.G. Jessani" 1 => "A. Moin" 2 => "S. Karnati" 3 => "Keshavamurthy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Assoc Phys India" "fecha" => "2016" "volumen" => "64" "paginaInicial" => "77" "paginaFinal" => "79" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0090" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The International Classification of Headache Disorders, 3rd edition (beta version)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Headache Classification Committee of the International Headache Society" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/0333102413485658" "Revista" => array:6 [ "tituloSerie" => "Cephalalgia" "fecha" => "2013" "volumen" => "33" "paginaInicial" => "629" "paginaFinal" => "808" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23771276" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0095" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migralepsy: a borderland of wavy lines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.Z. Crepeau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11910-013-0427-3" "Revista" => array:5 [ "tituloSerie" => "Curr Neurol Neurosci Rep" "fecha" => "2014" "volumen" => "14" "paginaInicial" => "427" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24395521" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0100" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migralepsy: is the current definition too narrow" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Maggioni" 1 => "E. Mampreso" 2 => "S. Ruffati" 3 => "F. Viaro" 4 => "V. Lunardelli" 5 => "G. Zanchin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "2008" "volumen" => "48" "paginaInicial" => "1129" "paginaFinal" => "1132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18705028" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0105" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migralepsy: a call for a revision of the definition" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G. Sances" 1 => "E. Guaschino" 2 => "P. Perucca" 3 => "M. Allena" 4 => "N. Ghiotto" 5 => "R. Manni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1528-1167.2009.02265.x" "Revista" => array:6 [ "tituloSerie" => "Epilepsia" "fecha" => "2009" "volumen" => "50" "paginaInicial" => "2487" "paginaFinal" => "2496" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19694799" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0110" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elementary visual hallucinations, blindness, and headache in idiopathic occipital epilepsy: differentiation from migraine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C.P. Panayiotopoulos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "1999" "volumen" => "66" "paginaInicial" => "536" "paginaFinal" => "540" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201433" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0115" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A nosographic analysis of the migraine aura in a general population" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.B. Russell" 1 => "J. Olesen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Brain" "fecha" => "1996" "volumen" => "119" "paginaInicial" => "355" "paginaFinal" => "361" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8800932" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0120" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Migraine pathophysiology: lessons from mouse models and human genetics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.D. Ferrari" 1 => "R.R. Klever" 2 => "G.M. Terwindt" 3 => "C. Avata" 4 => "A.M. van der Maagdenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(14)70220-0" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2015" "volumen" => "14" "paginaInicial" => "65" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25496898" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0125" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The occipital cortex is hyperexcitable in migraine: experimental evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.K. Aurora" 1 => "Y. Cao" 2 => "S.M. Bowyer" 3 => "K.M.A. Welch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Headache" "fecha" => "1999" "volumen" => "39" "paginaInicial" => "469" "paginaFinal" => "476" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11279929" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0130" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Genetic neurological channelopathies: molecular genetics and clinical phenotypes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Spillane" 1 => "D.M. Kullmann" 2 => "M.G. Hanna" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jnnp-2015-311233" "Revista" => array:6 [ "tituloSerie" => "J Neurol Neurosurg Psychiatry" "fecha" => "2016" "volumen" => "87" "paginaInicial" => "37" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26558925" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0135" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of ovarian hormones on human cortical excitability" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Smith" 1 => "L.F. Adams" 2 => "P.J. Schmidt" 3 => "D.R. Rubinow" 4 => "E.M. Wassermann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ana.10180" "Revista" => array:6 [ "tituloSerie" => "Ann Neurol" "fecha" => "2002" "volumen" => "51" "paginaInicial" => "599" "paginaFinal" => "603" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12112106" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0140" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Seizure exacerbation associated with inhibition of progesterone metabolism" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.G. Herzog" 1 => "C.A. Frye" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ana.10508" "Revista" => array:6 [ "tituloSerie" => "Ann Neurol" "fecha" => "2003" "volumen" => "53" "paginaInicial" => "390" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12601707" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0145" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology and comorbidity of headache" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Jensen" 1 => "L.J. Stovner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1474-4422(08)70062-0" "Revista" => array:6 [ "tituloSerie" => "Lancet Neurol" "fecha" => "2008" "volumen" => "7" "paginaInicial" => "354" "paginaFinal" => "361" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18339350" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0150" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Headache and migraine during pregnancy and puerperium: the MIGRA-study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.V. Kvisvik" 1 => "L.J. Stovner" 2 => "G. Helde" 3 => "G. Bovim" 4 => "M. Linde" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10194-011-0329-1" "Revista" => array:6 [ "tituloSerie" => "J Headache Pain" "fecha" => "2011" "volumen" => "12" "paginaInicial" => "443" "paginaFinal" => "451" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21442333" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003300000003/v1_201804060407/S2173580818300087/v1_201804060407/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003300000003/v1_201804060407/S2173580818300087/v1_201804060407/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580818300087?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 0 | 5 |
| 2024 October | 28 | 11 | 39 |
| 2024 September | 60 | 5 | 65 |
| 2024 August | 37 | 4 | 41 |
| 2024 July | 59 | 4 | 63 |
| 2024 June | 48 | 6 | 54 |
| 2024 May | 55 | 6 | 61 |
| 2024 April | 38 | 60 | 98 |
| 2024 March | 87 | 10 | 97 |
| 2024 February | 41 | 3 | 44 |
| 2024 January | 68 | 7 | 75 |
| 2023 December | 74 | 17 | 91 |
| 2023 November | 106 | 13 | 119 |
| 2023 October | 79 | 9 | 88 |
| 2023 September | 44 | 7 | 51 |
| 2023 August | 40 | 7 | 47 |
| 2023 July | 59 | 9 | 68 |
| 2023 June | 75 | 2 | 77 |
| 2023 May | 85 | 10 | 95 |
| 2023 April | 76 | 2 | 78 |
| 2023 March | 65 | 2 | 67 |
| 2023 February | 61 | 4 | 65 |
| 2023 January | 66 | 5 | 71 |
| 2022 December | 30 | 14 | 44 |
| 2022 November | 38 | 10 | 48 |
| 2022 October | 32 | 11 | 43 |
| 2022 September | 32 | 20 | 52 |
| 2022 August | 41 | 9 | 50 |
| 2022 July | 25 | 10 | 35 |
| 2022 June | 24 | 15 | 39 |
| 2022 May | 24 | 12 | 36 |
| 2022 April | 35 | 10 | 45 |
| 2022 March | 31 | 17 | 48 |
| 2022 February | 29 | 12 | 41 |
| 2022 January | 56 | 13 | 69 |
| 2021 December | 36 | 26 | 62 |
| 2021 November | 41 | 9 | 50 |
| 2021 October | 64 | 17 | 81 |
| 2021 September | 44 | 13 | 57 |
| 2021 August | 58 | 13 | 71 |
| 2021 July | 35 | 6 | 41 |
| 2021 June | 23 | 15 | 38 |
| 2021 May | 38 | 9 | 47 |
| 2021 April | 92 | 24 | 116 |
| 2021 March | 77 | 11 | 88 |
| 2021 February | 66 | 16 | 82 |
| 2021 January | 40 | 20 | 60 |
| 2020 December | 40 | 9 | 49 |
| 2020 November | 45 | 14 | 59 |
| 2020 October | 30 | 8 | 38 |
| 2020 September | 31 | 10 | 41 |
| 2020 August | 31 | 10 | 41 |
| 2020 July | 25 | 14 | 39 |
| 2020 June | 13 | 12 | 25 |
| 2020 May | 17 | 16 | 33 |
| 2020 April | 21 | 13 | 34 |
| 2020 March | 21 | 6 | 27 |
| 2020 February | 12 | 10 | 22 |
| 2020 January | 16 | 8 | 24 |
| 2019 December | 20 | 6 | 26 |
| 2019 November | 13 | 7 | 20 |
| 2019 October | 20 | 3 | 23 |
| 2019 September | 19 | 4 | 23 |
| 2019 August | 11 | 5 | 16 |
| 2019 July | 16 | 10 | 26 |
| 2019 June | 37 | 4 | 41 |
| 2019 May | 94 | 19 | 113 |
| 2019 April | 37 | 3 | 40 |
| 2019 March | 13 | 5 | 18 |
| 2019 February | 13 | 5 | 18 |
| 2019 January | 13 | 2 | 15 |
| 2018 December | 4 | 2 | 6 |
| 2018 November | 6 | 4 | 10 |
| 2018 October | 16 | 15 | 31 |
| 2018 September | 5 | 2 | 7 |
| 2018 August | 4 | 3 | 7 |
| 2018 July | 10 | 2 | 12 |
| 2018 June | 5 | 1 | 6 |
| 2018 May | 18 | 1 | 19 |
| 2018 April | 10 | 8 | 18 |
| 2018 March | 1 | 2 | 3 |
| 2018 February | 0 | 1 | 1 |
Show all
