摘要:

SYNOPSISBrain magnesium was measured in migraine patients and control subjects using in vivo 31‐Phosphorus Nuclear Magnetic Resonance Spectroscopy. pMg and pH were calculated from the chemical shifts between Pi, PCr and ATP signals. Magnesium levels were low during a migraine attack without changes in pH. We hypothesize that low brain magnesium is an important factor in the mechanism of the migraine attac

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907416.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe potency of dihydroergotamine (DHE) was determined at 13 neurotransmitter receptors using radioligand binding techniques. DHE is a potent agent (i.e. affinity value<100 nM) at 5‐hydroxytryptamine1A(5‐HT1A), 5‐HT1c, 5‐HT1D, 5‐HT2, dopamine2, alpha1‐ and alpha2‐adrenergic binding sites. DHE displays moderate affinity (i.e. affinity values = 100 ‐ 1000 nM) for beta‐adrenergic and dopamine1sites and is completely inactive at 5‐HT3, muscarinic and benzodiazepine receptors. These results were then compared to similar data on sumatriptan (formerly called GR 43175), a novel acute anti‐migraine agent. The only pharmacological property shared by both agents is high affinity for 5‐HT1Dand 5‐HT1Areceptors. Therefore, these data suggest that 5‐HT1Dand/or 5‐HT1Areceptors may play an important role in th

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907420.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA 29‐year‐old woman presented with acute hemicrania, trigeminal neuropathy and posterior fossa dysfunction. The admission differential diagnosis included vertebral artery dissection, posterior circulation aneurysm, vascular malformation and brainstem infarction. However, radiographic and CSF studies indicated demyelination. Acute demyelination should be in the differential diagnosis of vascular hemicrania with signs of posterior fossadysfunct

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907423.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISVerapamil is a papaverine derivative calcium channel blocking drug that has been effectively utilized in the prophylaxis of migraine. This paper reviews the clinical pharmacology as it applied to headache and the current research on the clinical use of verapamil in migraine prophylaxis. Included are three double‐blind, placebo‐controlled studies. Ten of 12 patients, eight of 14 patients, and 20 of 23 patients showed improvement, with all studies finding verapamil significantly more effective than placebo in migraine prophylaxis. Research comparing 240 mg/day with 320 mg/day dosing found 320 mg/day significantly more effective in reducing migraine frequency. Review of 133 refractory headache‐clinic patients, treated with verapamil and additional drugs reported excellent (100% improvement) or good results (>50% reduction in migraine frequency) in 5% and 40% of patients, respectively. Fair response (<50% improvement) was observed in 50% of patients, and poor response was seen in 5% of patients. Analysis of this information reveals that verapamil is a safe, well‐tolerated and effective agent for migraine prop

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907425.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISHeadache is one of the most common types of recurrent pain among children. Response to pharmacological treatment has been inconsistent, and there is caution about prolonged pharmacotherapy for headache in children. Behavioral therapies for the management of chronic headache have emerged as a significant option over the last decade. Initial studies summarized in two previous reviews of behavioral therapy for pediatric headache were favorable, but few controlled studies had been done. In the last five years, more studies, the majority with controlled comparisons, have been published. The present review summarizes and interprets the evidence from these studies. Behavioral treatment appears to be a potent alternative for the management of chronic headache in children.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907428.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWhile temperature biofeedback and related bio‐behavioral procedures have become common in the treatment of adult migraineurs, the application of these techniques to the pediatric population has lagged far behind. The current investigation was undertaken to examine various methods for delivering biofeedback with this population. Nine children participated in this single‐subject, clinical replication series in which clinic‐based therapist‐administered, home‐based child‐administered, and home‐based parent‐administered treatment formats were evaluated. Headache activity was assessed through the use of a daily headache log. Overall, results supported the utility of temperature biofeedback in the treatment of pediatric migraine. Further, it was suggested that home‐based treatments may represent an equally efficacious and more cost‐effective alternative to traditional clinic‐based treatments. Finally, treatment effects were found to be stable, with results maintaining through a one

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907434.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA survey was made of 10,506 reports to the WHO Collaboration Centre for International Drug Monitoring from five countries concerning headache, migraine, aggravated migraine and intracranial hypertension associated with drugs. The ten drugs most frequently reported to be associated with headache were indomethacin, nifedipine, cimetidine, atenolol, trimethoprim‐sulphamethoxazole, zimeldine, glyceryl trinitrate, isosorbide dinitrate, zomepirac and ranitidine. Regarding migraine, oral contraceptives were also among the most implicated drugs. Most reports of intracranial hypertension concerned tetra‐cyclines, isotretinoin and trimethoprim‐ sulphamethoxazole. Vasodilatation and salt and water retention with subsequent redistribution of intracranial fluid seem to be common mechanisms underlying drug‐related headache. For certain frequently reported drugs, however, the mechanisms of the headache are

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907441.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISOne hundred patients were enrolled in a multicenter double‐blind study to evaluate the safety and effectiveness of the Pain Suppressor Unit, a cranial electrotherapy stimulator for the symptomatic treatment of tension headaches. Treatment consisted of extremely low level, high frequency current applied transcranially. Pain scores before and after 20 minute treatments of individual headaches as well as patient and physician global evaluations were the primary efficacy variables. Following use of the active unit, patients reported an average reduction in pain intensity of approximately 35%. Placebo patients reported a reduction of approximately 18%. The difference was statistically significant (p = 0.01). The active unit was rated as moderately or highly effective in 40% by physicians, and in 36% by patients. Both physicians and patients scored the placebo unit moderately or highly effective for only 16%. The difference in ordered outcomes was statistically significant (p = 0.004). Approximately 10% of patients in each group reported at least one minor adverse experience. Cranial electrotherapy stimulation is distinct from TENS, and is safe and often effective in ameliorating the pain intensity of tension headaches. It should be considered as an alternative to the chronic usage of analgesic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907445.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe report the case of a woman with short nocturnal attacks of peri‐ and retro‐orbital pain, diplopia, ptosis, rhinorrhea and lacrimation of five months evolution. Neurological examination was normal between attacks. The latter presented with partial third nerve palsy, which finally became complete and permanent. Brain CT showed a sellar and supraseller tumor with parasellar extension to the right side. We stress the atypical clinical presentation and evolution of this case, and discuss its pathophysiol

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907451.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe describe the case of a forty‐four year old man who had typical right sided cluster headaches and an arteriovenous malformation supplied mainly by the right anterior cerebral artery. Following endovascular embolisation of this artery the AVM was supplied mainly by the left anterior cerebral artery. Subsequent headaches have always been on the left. Transcranial Doppler studies now suggested an increase of middle cerebral artery flow velocity. We suggest that the change in haemodynamics was responsible for the change in headache sid

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2907453.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY