摘要:

SYNOPSISA randomised double blind controlled trial of ‘epidural blood‐patch’ as treatment for post‐dural puncture headache is presented. The method was successful in 11 out of 12 cases on its first application, the twelfth patient being relieved by a second procedure. None of six patients reported benefit from a ‘sham’ procedure. The rationale for the use of the technique i

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910630.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThis double blind, randomized study of the calcium antagonist Nimodipine 40 mg t.i.d. vs placebo in the prophylaxis of common migraine (migraine without aura) included 192 patients. Patients with 2–8 migraine days/4 weeks, age 18–60, who had no other types of recurring headaches except up to 6 interval headaches/4 weeks were included. The study was carried out at 11 European centers. After a 4 week run‐in period, patients were randomly allocated to Nimodipine or placebo for 12 weeks (parallel groups). There were 19 drop‐outs, 12 on Nimodipine and 7 on placebo, A gradual and marked improvement was seen both with Nimodipine and with placebo amounting to approximately 60% during the last 4 weeks. Statistical analysis on all included patients (intention to treat) revealed no difference between Nimodipine and placebo for migraine days (P = 0.69) or migraine index (p = 0.91). In patients “valid for analysis of efficacy” there were also no significant differences. Due to a very marked placebo effect and use of the parallel groups design, the present trial was not very powerful despite the large number of patients and a satisfactory compliance. We cannot rule out that Nimodipine might have up to 30% effect on a single main outcome parameter, but the uniform lack of response in all tested parameters makes this unlikely. Therefore Nimodipine probably has only a small or no effect in common migraine (migraine wi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910633.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThis double‐blind, randomized study of the Nimodipine 40 mg t.i.d. vs placebo in the prophylaxis of classic migraine (migraine with aura) included 89 patients. Required migraine frequency was 2–8 migraine days/4 weeks and at least two of the attacks within the last 6 months had to be with aura. The study was carried out at 11 European centers. After a 4 week run‐in period, patients were randomly allocated to nimodipine or placebo for 12 weeks (parallel groups). There were 7 dropouts, 3 on Nimodipine, and 4 on placebo. A gradual and verymarked improvement was seen both with Nimodipine and placebo amounting to between 60 and 90 per cent during the last 4 weeks. Statistical analysis on all included patients (intention to treat) revealed no difference between Nimodipine and placebo for migraine days or migraine index. In patients “valid for analysis of efficacy” there were also no significant difference. Due to a very marked placebo effect and use of the parallel groups design, the present trial is relatively weak despite a fairly large sample size. It cannot rule out the possibility of an important effect of Nimodipine in classic migraine with a high degree of

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910639.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910643.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISOn a world‐wide basis, 84 cases of CPH were found, 59 females and 25 males: i.e., a F:M ratio of 2.36. Forty‐nine cases never exhibited a remitting stage, whereas in 35 cases a history of a remitting stage was obtained, 17 cases still remaining in the remitting stage. In other words, the ratio between the chronic and the remitting stage as of today is 67:17 =3.94. Accordingly, there seems to be a reverse relationship of the chronic versus the remitting stage, when compared to cluster headache. A maximum attack frequency even of 5–6 attacks per 24 hours seems to be consistent with a diagnosis of CPH. Nocturnal attacks occurred in 55 out of 58 cases where such information was available. An unchanging unilaterality was the rule, in that only 3 exceptions have been rep

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910648.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISPlatelet serotonin (5 hydroxytryptamine, 5‐HT) and norepinephrine (NE) were measured in common and classic migraine patients and healthy controls. Common migraine sufferers had high NE levels and a low 5‐HT/NE ratio. Classic migraine patients had a high 5‐HT level and a high 5‐HT/NE ratio. The data suggest disparate NE and 5‐HT metabolism between common and classic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910657.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISHeadaches affecting 117 insulin‐dependent diabetic patients were studied. 50 developed 3 varieties of headaches associated with clinical hypoglycaemic episodes: (1) Brief headaches, contemporaneous with cerebral and autonomic symptoms, were relieved within minutes of ingesting carbohydrates (8 patients). (2) Prolonged headaches outlasting hypoglycaemic symptoms by 1–48 (average 4.3) hours, not relieved by food, occurred in 36 patients; 12 of these also had nausea, vomiting or photophobia. (3) Migraine headache. 11 of the 117 patients were migraineurs: in 6 of the 11 their typical migraines (2 classicial and 4 common) were induced by hypoglycaemic episodes. 9 of the 50 had 2 types of headaches, easily distinguished by each subject.In the whole series of 117 patients, 9 had never had a headache in their life. The remainder had headaches associated with premenstrual tension, anxiety, alcohol or other cau

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910660.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISVarious immunological studies have revealed controversial outcomes on pathogenetic mechanisms of food‐induced migraine. In order to better define the immune status of this disease we studied 21 patients for circulating immune complexes (CIC). Six out of them were also studied for lymphocyte subpopulations, IgG 4 and anti‐IgG antibodies, before (TO), 4 hours after (T4), and 72 hours after (T72) a specific challenge with 250 ml of milk. The CIqSp assay was used to determine CIC. Lymphocyte subpopulations were defined by the following monoclonal antibodies (Mab): OKT3, OKT4, OKT8, 4F2, H366, TAC, 5E9, L.243 and DA6.231. IgG 4 subclass was assessed by using a mouse specific Mab. Anti‐IgG antibodies were determined by using HPLC.The result showed an increased incidence of CIC (28.6%) when compared to the control group (10%). Total T‐cells (OKT3 + ) showed a marked increase at T4 (p<0.01 ) and a subsequent decrease at T72 (p<0.02). Interestingly, T‐activated cells (4F2 + and TAC + ) showed a parallel trend at T4 (respectively p<0.02 and<0.01) and a subsequent decrease at T72 only for the Tac+ cells (p<0.05). Also K and NK cells (H366+) showed an early increase at T4 (p<0.05). No significant variation was observed in the study of the expression of DR anti‐gens (L.243 and DA6.231) at the three times. IgG 4 and anti‐IgG antibodies values showed no variation in their time‐course.In commenting on the outcomes of this investigation, it must be stressed that the evidence of an early lymphocyte activation after the challenge test indicates an involvement of Interleukin‐2 related receptors in food‐induced migraine. The results have reinforced the idea of an immune mechanism involvement in food‐induced migraine, but it seems to be localized at a different step from that u

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910664.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910672.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed2910673_a.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY