摘要:

SYNOPSISWe have previously reported that the serotonin (5‐HT) agonist meta‐chlorophenylpiperazine (m‐CPP) induced late occurring migraine‐like headaches in a group of patients with eating disorders and controls (n=52).1In this report, we extend our analyses of these data and describe results indicating that headache responses following m‐CPP are greater in patients with bulimia nervosa than controls, regardless of the presence of anorexia nervosa or major depression. Although patients with severe migraine‐like headaches had higher peak m‐CPP levels than patients without severe headaches, these levels are not higher than other groups studied who did not get headaches. These findings suggest that post‐synaptic 5‐HT receptor sensitivity is altered in the vascular tissues of bulimic patients. Additional disturbances in 5‐HT function, perhaps presynaptic ones, may be associated with anorexia nervosa and major depression. Similar alterations in other 5‐HT pathways at or above the level of the hypothalamus may contribute to binge eating and other behavioral symptoms of bulimia nervosa. Further studies exploring the functional integrity of 5‐HT receptors and their subtypes are warranted in bulimic patients, as well as in patients with nonbulimic anorexia nervosa, minor and major depression without an eating disorder, and migraine and

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205217.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISObjective: To measure the use of prescription medication in treating migraine headache and the associations betweenmedication use and sociodemographic factors, and headache characteristics.Design: National sample survey using a mailed questionnaire to determine symptoms accompanying or preceding severe headaches; frequency, duration, and disability from severe attacks: use of medications to control pain; and medical‐care use for severe headaches.Setting: A stratified sample of United States households.Patients: A sample of 20,468 respondents, aged 12 to 80 years, who responded to a survey on “severe” headaches during the prior year.Measurements and Main Results: Overall, 20.2% of respondants reported severe headaches. Migraine was found in 17.6% of females and 5.7% of males. Of the migraineurs, 40.1% of female and 28.3% of male migraineurs reported using prescription drugs to control pain. Blacks were less likely then whites to report prescription use. Insignificant differences were seen in rates of prescription use among various income levels and regions of the country. Use of prescription medication varied considerably by symptoms and characteristics of migraine attacks. Vomiting and sensory aura were most frequently associated with medication use, as were severity and duration of attacks. Use of urgent‐care services for severe headache attacks was associated with frequent use of prescription medications. Patients who reported a physician diagnosis of migraine were more likely to use prescription medication than other migraineurs.Conclusions: Most migraineurs in the United States are not being treated with prescription medications. Many active migraine patients would benefit from appropriate treatment if care was sought and diagnos

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205223.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISGamma‐aminobutyric acid (GABA) levels in platelets were measured in 19 patients with migraine (7 males and 12 females, average age: 36.5 years) and 27 patients with chronic tension‐type headache (TH; 9 males and 18 females, average age: 48.9 years). Twenty‐one normal healthy volunteers composed the control group (11 males and 10 females, average age 34.9 years). The GABA levels in platelets were determined using high performance liquid chromatography with fluorescent detection (HPLC‐FC). The GABA levels in platelets were 30.8 $plusmn; 11.7 pmol/109platelets (mean ± S.D.) in the patients with migraine, 43.1 ± 11.8 pmol/109platelets in the patients with TH and 34.7 ± 8.1 pmol/109platelets in the healthy controls. The platelet GABA levels in the patients with TH were significantly higher than in the migraine patients end the healthy controls (p<0.05).The possible role of GABA in headache is discussed. We consider that TH may be a state of neuronal hyperexcitability similar to migraine and that GABA in the platelets of patients during TH attacks may be elevated to counterbalance it. Alternatively, we suggest that the rise of GABA levels in platelets is related to emotional factors, such as depression, in the TH patients. Further studies must be undertaken concerning the relationship between platelet GABA levels an

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205229.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISMany investigators have described olfactory dysfunction among migraineurs. Olfactory stimuli can precipitate migraine, and olfactory hallucinations can occur as auras of migraines or as part of the symptom complex. Despite many reports linking olfactory phenomena and migraine, no evaluations of the olfactory abilities of migraineurs have been documented. To begin such assessments, sixty‐seven consecutive migraine patients were given Pyridine odor threshold tests. Twelve of them (18%) scored as hyposmic or anosmic. In comparison, 1% of the general population of the U.S. is hyposmic or anosmic. Aside from possible diagnostic or methodological error, several possibilities may account for our result: migraine may induce olfactory pathology; olfactory pathology may induce migraine, or; a common pathogen may induce both olfactory dysfunction and migraine. The association of migraine with the emotional component of the limbic system has long been recognized, and our results strengthen its association with the olfactory component as well. Headache patients should be tested for olfactory loss and warned of such risks as inability to detect gas leaks and spoiled foo

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205233.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISHemicrania continua (HC) is characterized by a continuous unilateral headache of moderate severity, occurring in 2 patterns; a continuous form in which headaches persist continuously without remission for years, and a remitting form, consisting of headache phases separated by periods of pain‐free remission. The remitting form of HC must be distinguished from other cyclical headache disorders such as episodic paroxysmal hemicrania and episodic cluster headache. Characteristically, the headache of HC is unilateral and without sideshift. We now report a case of HC in which headaches alternate side

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205237.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISMartin and colleagues have described their development of a Headache‐Specific Locus of Control scale (HSLC) which contains 11 items for each of its three subscales: internal, health care professional, and chance orientations. In this replication study, we gathered data from patients who came to a Headache Clinic in a medical center (n = 151) and from a comparison sample (n = 192). Factor analysis and alpha coefficients were similar to those reported by Martin. Only small correlations were found between the subscale scores although some of them were statistically significant. This suggests that the HSLC is a psychometrically competent instrument. Additionally, mean scores of its three subscales differentiated the patient population from those whose headaches were less severe and thus did not seek he

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205239.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205242_1.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205242_2.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205251.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3205262.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY