Christian Lampl

Christian Lampl
Konventhospital Barmherzige Brüder Linz · Neurology with Stroke Unit and Neurogeriatry

Professor

About

139
Publications
36,934
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9,054
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January 2006 - present
Krankenhaus der Barmherzige Schwestern Linz, Austria
Position
  • CEO, Medical Director

Publications

Publications (139)
Article
Full-text available
Background A previous European Headache Federation (EHF) guideline addressed the use of monoclonal antibodies targeting the calcitonin gene-related peptide (CGRP) pathway to prevent migraine. Since then, randomized controlled trials (RCTs) and real-world evidence have expanded the evidence and knowledge for those treatments. Therefore, the EHF pane...
Article
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In this editorial we aim to provide an overview of Narrative-based Medicine (NBM) and highlight what it may offer to the care of individuals with headache disorders.
Article
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Background: Erenumab, a fully human monoclonal antibody that targets the calcitonin gene-related peptide receptor, has demonstrated efficacy and safety in the prevention of episodic and chronic migraine. There exists an unmet need to establish the safety of erenumab in older individuals, in view of existing multiple comorbidities, polypharmacy, an...
Article
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Introduction Chronic headache due to the overuse of medication for the treatment of migraine attacks has a prevalence of 0.5–2.0%. This guideline provides guidance for the management of medication overuse (MO) and medication overuse headache (MOH). Recommendations Treatment of headache due to overuse of analgesics or specific migraine medications...
Article
Background: Fremanezumab, a fully humanised monoclonal antibody (IgG2Δa) that selectively targets calcitonin gene-related peptide (CGRP), has demonstrated efficacy as a preventive treatment for adults with episodic migraine (EM) or chronic migraine (CM) and inadequate response to 2-4 prior preventive treatment classes in the phase 3b FOCUS study....
Article
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Background New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache...
Article
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Background: Although migraine is less common in older people, preventive treatment of migraine in these individuals may be more challenging due to the presence of multiple comorbidities and polypharmacy. Additionally, evidence for migraine treatment efficacy, safety, and tolerability is limited in this population. We evaluated efficacy, safety, an...
Article
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Migraine is a disabling primary headache disorder that directly affects more than one billion people worldwide. Despite its widespread prevalence, migraine remains under-diagnosed and under-treated. To support clinical decision-making, we convened a European panel of experts to develop a ten-step approach to the diagnosis and management of migraine...
Preprint
Full-text available
Background New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache...
Article
Full-text available
Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (Erenumab) or against CGRP (Eptinezumab, Fremanezumab, Galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options, which already exist in migraine prevention. In randomized, placebo-controlled stud...
Article
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Introduction: Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, t...
Article
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Background: Hereditary transthyretin amyloidosis (hATTR) is an autosomal dominantly inherited disorder caused by an accumulation of amyloid fibrils in tissues due to mutations in the transthyretin (TTR) gene. The prevalence of hATTR is still unclear and likely underestimated in many countries. In order to apply new therapies in a targeted manner,...
Article
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ZUSAMMENFASSUNG Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (erenumab) or against CGRP (eptinezumab, fremanezumab, galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options which already exist in migraine prevention. In registration studies...
Article
Full-text available
Chronic migraine is a neurological disorder characterized by 15 or more headache days per month of which at least 8 days show typical migraine features. The process that describes the development from episodic migraine into chronic migraine is commonly referred to as migraine transformation or chronification. Ample studies have attempted to identif...
Article
Introduction. Migraine and combined hormonal contraceptives (CHCs) increase the risk of ischemic stroke in young women; however, the contribution of low-dose (<50 μg ethinylestradiol) CHCs to the risk of ischemic stroke in young women with migraine is not well defined. Areas covered. The authors performed a systematic review of observational studie...
Article
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Monoklonale Antikörper gegen den CGRP-Rezeptor (Erenumab [CGRP: „calcitonin gene-related peptide“]) oder gegen CGRP (Eptinezumab, Fremanezumab, Galcanezumab) sind neue Substanzen zur prophylaktischen Behandlung der Migräne. Sie stellen eine Erweiterung der therapeutischen Optionen in der Migräneprophylaxe dar. In Zulassungsstudien wurden die Wirksa...
Article
Full-text available
Monoclonal antibodies against the calcitonin gene-related peptide (CGRP) receptor (erenumab) or against CGRP (eptinezumab, fremanezumab, galcanezumab) are new substances for the preventive treatment of migraine. They represent an extension of the therapeutic options which already exist in migraine prevention. In registration studies, the efficacy a...
Article
Full-text available
Abstract In joint initiatives, the European Headache Federation and Lifting The Burden have described a model of structured headache services (with their basis in primary care), defined service quality in this context, and developed practical methods for its evaluation. Here, in a continuation of the service quality evaluation programme, we set out...
Article
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The global prevalence of migraine as a primary headache has been estimated as 14.4% in both sexes. Migraine headache has been ranked as the highest contributor to disability in under 50 years old population in the world. Extensive research has been conducted in order to clarify the pathological mechanisms of migraine. Although uncertainties remains...
Article
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Background and aim: Headache is very often the cause for seeking an emergency department (ED). However, less is known about the different diagnosis of headache disorders in the ED, their management and treatment. The aim of this survey is to analyse the management of headache patients in two different ED in Europe. Methods: This retrospective su...
Article
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Background and aim Migraine headache and vestibular-type vertigo co-occur in the general population about three times more often than expected by chance. Attacks of episodic vertigo (eV) are currently not recognized as migraine equivalents or variants in the International Classification of Headache Disorders, 3rd edition (ICHD III). No strong data...
Article
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In collaboration with some of the leading headache centres in Germany, Switzerland and Austria, we have established new guidelines for the treatment of migraine attacks and the prevention of migraine. A thorough literature research of the last 10 years has been the basis of the current recommendations. At the beginning, we present therapeutic novel...
Chapter
Headache disorders are of global public health, still under-diagnosed and mostly undertreated. Individualized health care for headache sufferers are rare, although headache disorders account for more disability-adjusted life years than all other neurological disorders combined. While a wide range of effective pharmacological and non-pharmacological...
Article
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Objective To find and analyze early descriptions of restless legs syndrome (RLS). Methods Databases and textbooks were searched to document the current knowledge on the history of RLS and to identify additional early descriptions of RLS. Results Two recently discovered early descriptions of RLS are presented together with a review of the current...
Article
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Background: Idiopathic Intracranial Hypertension (IIH) is characterized by an elevation of intracranial pressure (ICP no identifiable cause. The aetiology remains largely unknown, however observations made in a number of recent clinical studies are increasing the understanding of the disease and now provide the basis for evidence-based treatment s...
Article
Purpose The aim of this retrospective study was to evaluate survival outcomes in well-performing, mainly, young patients receiving a sequence of all available therapeutic options for relapsed glioblastoma, including re-irradiation. Methods We performed a retrospective analysis of 27 patients irradiated twice for glioblastoma between 2008 and 2016....
Article
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Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both mi...
Article
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Following the publication of this article [1], the authors noticed that they incorrectly reported the Absolute risk of ischemic stroke in women aged 20 to 44 years in relation to the use of hormonal contraception and migraine status due to a miscalculation. They apologize for this misreported result.
Article
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We systematically reviewed data about the effect of exogenous estrogens and progestogens on the course of migraine during reproductive age. Thereafter a consensus procedure among international experts was undertaken to develop statements to support clinical decision making, in terms of possible effects on migraine course of exogenous estrogens and...
Article
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Background: Cluster headache (CH) is a clinically well-defined primary headache disorder, approximately 20% of cluster headache sufferers experience recurrent attacks without periods of significant remission. For the treatment of chronic cluster headache (CCH) only limited therapeutic options are available. Methods: A potential refractory CCH pa...
Article
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Background Migraine is prevalent everywhere, and disabling. It is also neglected: consequently, it is under-diagnosed and undertreated. We analysed data from the Eurolight study on consultations and utilization of migraine-specific medications as indicators of adequacy of medical care in Europe. Methods Eurolight was a cross-sectional questionnaire...
Article
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Several data indicate that migraine, especially migraine with aura, is associated with an increased risk of ischemic stroke and other vascular events. Of concern is whether the risk of ischemic stroke in migraineurs is magnified by the use of hormonal contraceptives. As migraine prevalence is high in women of reproductive age, it is common to face...
Article
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The trigeminovascular system plays a key role in the pathophysiology of migraine. The activation of the trigeminovascular system causes release of various neurotransmitters and neuropeptides, including serotonin and calcitonin gene-related peptide (CGRP), which modulate pain transmission and vascular tone. Thirty years after discovery of agonists f...
Chapter
Die sozio-demographische Entwicklung bedingt, dass immer häufiger geriatrische Patienten wegen Kopfschmerzen einen Arzt aufsuchen. Nimmt man alle Altersgruppen zusammen, so leiden 75% der Männer und 80% der Frauen an Kopfschmerzen. Bekannt ist, dass die Kopfschmerzprävalenz mit dem Alter um 53–66% absinkt. Bei Patienten, die älter als 75 Jahre sind...
Article
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Background The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard). Methods Employing previously-developed instruments in 14 such...
Article
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Background Headache disorders and psychiatric disorders are both common, while evidence, mostly pertaining to migraine, suggests they are comorbid more often than might be expected by chance. There are good reasons for establishing whether they are: symptoms of comorbid illnesses may summate synergistically; comorbidities hinder management, negativ...
Article
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Background: Recurrent and especially chronic headaches are associated with psychiatric comorbidities such as depression and anxiety. Only few studies examined the impact of depression and anxiety on episodic (EH) and chronic headache (CH), and data for Austria are missing at all. Therefore, the aim of the present study was to assess the impact of...
Article
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Most primary headaches are episodic, and most estimates of the heavy disability burden attributed to headache derive from epidemiological data focused on the episodic subtypes of migraine and tension-type headache (TTH). These disorders give rise directly but intermittently to symptom burden. Nevertheless, people with these disorders may not be sym...
Article
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The diagnosis of primary headache disorders is clinical and based on the diagnostic criteria of the International Headache Society (ICHD-3-beta). However several brain conditions may mimic primary headache disorders and laboratory investigation may be needed. This necessity occurs when the treating physician doubts for the primary origin of headach...
Article
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Episodic and chronic headaches (EH, CH) are highly prevalent disorders. Severely affected patients are usually referred to headache centres. In Austria, at least one headache centre is available in seven of nine states, but detailed multicentre data are missing. Therefore we studied prevalence rates, use of medication and health care services, impa...
Article
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Whether neck pain (NP) is a prodromal migraine symptom or belongs to the migraine attack feature remains controversial. In order to prospectively record neck pain (NP) and non-headache symptoms and to evaluate the percentage of patients having NP as clear premonitory, non-headache symptom of their migraine, a specific self fulfilled questionnaire w...
Article
A 61-year-old woman was admitted to our headache outpatient center with a 6-month history of headache attacks occurring every night. She had no history of other types of headache or any other neurological diseases. There was no family history of headache. The attacks always occurred between 1 and 3 o’clock, and the duration was no longer than 120 m...
Article
A 39-year-old female was admitted to our headache outpatient center with a 1-month history of three headache attacks with nausea. She was very anxious about that because her mother died with a history of stroke a few months ago. She reported that the first attack of her headache was exploding, with a relatively sudden onset. This first attack laste...
Article
A 53-year-old male was admitted to our headache outpatient center with a 3-month history of repeated visual disturbances, in which a central scotoma was bordered by a crescent of scintillating zigzag patterns, which slowly advances to the edge of the visual field. Usually this visual phenomena march slowly across the visual field over a period of 2...
Article
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The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs and in the uncontrolled application of therapeutic techn...
Article
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Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients’ life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition for clinical and research use. The preparation of th...
Article
Metamizole (dipyrone) is a nonsteroidal compound with strong analgesic as well as antipyretic and spasmolytic properties. Based on a small number of cases of agranulocytosis, metamizole was withdrawn from the market in some countries. Other countries restricted its use. This paper discusses the safety aspects of metamizole and compares it with othe...
Article
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Background Surveys enquiring about burden of headache over a prior period of time (eg, 3 months) are subject to recall bias. To eliminate this as far as possible, we focused on presence and impact of headache on the preceding day (“headache yesterday”). Methods Adults (18-65 years) were surveyed from the general populations of Germany, Italy, Lith...
Article
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Background European data, at least from Western Europe, are relatively good on migraine prevalence but less sound for tension-type headache (TTH) and medication-overuse headache (MOH). Evidence on impact of headache disorders is very limited. Eurolight was a data-gathering exercise primarily to inform health policy in the European Union (EU). This...
Article
Combination analgesics containing acetylsalicylic acid, paracetamol and caffeine are an essential component of the self-medication of primary headache disorders. They are superior to the mono-substances acetylsalicylic acid, paracetamol and to ibuprofen and sumatriptan in terms of efficacy. The increased response rate and response probability as we...
Article
Zusammenfassung Essenzieller Bestandteil der Selbstmedikation primärer Kopfschmerzerkrankungen sind Kombinationsanalgetika, die Acetylsalicylsäure, Paracetamol und Koffein enthalten. Sie sind den Monosubstanzen Acetylsalicylsäure, Paracetamol, Ibuprofen und Sumatriptan in ihrer Wirksamkeit überlegen. Durch die Kombination mehrerer Wirkstoffe und de...
Article
Sustained treatment with effective doses of cholinesterase inhibitors or memantine is crucial to transfer treatment effects in dementia. Numerous studies, with often small samples sizes, describe low adherence rates. The purpose of current study was to examine the medical adherence of antidementia therapy in Austria. We analyzed the data of 10 Aust...
Article
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To evaluate if plasma levels of midregional pro-adrenomedullin (MR-proADM) improve prediction of functional outcome in ischemic stroke. In 168 consecutive ischemic stroke patients, plasma levels of MR-proADM were measured within 24 hours from symptom onset. Functional outcome was assessed by the modified Rankin Scale (mRS) at 90 days following stro...