摘要:

SYNOPSISIn order to determine the anatomical distribution of cells concerned with relaying craniovascular nociception, local cerebral glucose utilization was determined by the 2‐deoxyglucose method in tissue autoradiographs of the a‐chloralose anesthetized cat. The superior sagittal sinus was carefully lifted from the brain by sectioning the dura laterally and the falx inferiorly and suspending the sinus across two platinum hook electrodes for stimulation. The sinus was stimulated electrically and its effect on caudal brainstem, upper cervical spinal cord and diencephalic metabolic activity determined. Stimulation of the sinus caused increased metabolic activity in the trigeminal nucleus caudalis, in the cervical dorsal horn and in a discrete area in the dorsolateral spinal cord at the second cervical segment. Metabolic activity was also increased in the ventrobasal thalamus, specifically in the ventroposteromedial (188%) nuclear group, in the medial nucleus of the posterior complex (70%) and the intralaminar complex (49%). There was no change in the surrounding thalamus, lateral geniculate nucleus or overlying cerebral cortex. These increases in 2‐deoxy‐glucose utilisation were blocked by bilateral trigeminal ganglion ablation. The dorsolateral area activated in the spinal cord corresponds to a hitherto unrecognised group of cells in or near the lateral cervical nucleus that may form an important relay for craniovascular nociception. Further electrophysiological studies with glass coated tungsten microelectrodes have characterised the cells in these regions of the thalamus to be responsible for relaying nociceptive information. An understanding of the connections and properties of the neurons that subserve craniovascular pain is an essential prerequisite to understanding the complex pathophysiology of m

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106365.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISA 27‐year‐old woman with no family or personal history of migraine presented with headache associated with unilateral paresthesias and blurred vision. This was her first, and so far only, attack of migraine with aura and led to the diagnosis of her pregnancy and to this review.Migraine can begin for the first time with pregnancy, particularly in the first trimester. Cases of migraine with aura are the most commonly reported. Preexisting migraine usually improves with pregnancy, particularly if it was associated with menstrual migraine. Headache occurs frequently in the postpartum period, particularly in known migraineurs. Migraineurs have no increased risk of complications during pregnancy and their children have no increased incidence of birth defe

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106372.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISWe report a 14‐year‐old girl who presented with yearly attacks of bilateral internal ophthalmoplegia, nausea and headache, since the age of nine.The episodic isolated bilateral mydriasis in this child is believed to be a migraine equival

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106375.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISAn EEG finding of temporo‐occipital or temporo‐parieto‐occipItal spike‐wave complexes, suppressed by eye opening, coexisting with classical migraine, was observed in 14 children; in 13 of these patients, seizures were present. Classical migraine, visual phenomena and seizures coexisted in different clinical p

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106378.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISCriteria for the diagnosis of migraine have evolved from generalized descriptions to specific rules designed to ensure the selection of homogenous groups of patients for research studies. For clinical practice, the former are insufficiently specific and the latter are too complex. For care of headache patients by primary care physicians, we propose that the diagnosis of migraine without aura (common migraine) is war‐rented if any two of the following symptoms are present: unilateral site, throbbing quality, nausea, photophobia or phonophobia. These criteria are derived from a study comparing the features of 100 patients with migraine without aura and 100 patients with chronic daily headache. The proposed criteria for the diagnosis of migraine without aura were highly sensitive and adequately specific in discriminating groups. These simple criteria should facilitate the diagnosis of migraine by primary care physician

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106384.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISFlunarizine is a non‐selective calcium antagonist. It distributes preferentially in the adipose tissue and passes the blood brain barrier. Numerous controlled clinical studies have established that flunarizine is efficacious in migraine prophylaxis, including double‐blind studies in which the drug was compared with placebo or other antimigraine drugs. To avoid side effects a special schedule or administration is necessary. Flunarizine has no myogenic effect on smooth muscle cells of the vessles. It is said to be the only calicum antagonist able to protect brain cells against hypoxic damage. In addition, the considerable body of information which shows flunarizine capable of directly influencing the central nervous system, suggests that the drug's anti‐migraine action may depend on its ability to influence centralphen

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106388.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISTo investigate whether quantification of the background EEG during a visual evoked potential (VEP) study is of value for the diagnosis of migraine we studied 8 unmedicated migraineurs between attacks, and 10 age‐matched controls. Three paradigms were used: the first two concerned pattern‐reversal VEPs with different analysis times (500 and 1500 ms), and in the third paradigm the pattern did not reverse. Power spectra were calculated for individual responses, and the delta, theta, alpha and beta areas of the averaged spectre were noted as indicators of background reactivity.Alpha and beta powers were consistently but not significantly higher in the migraine group. The difference was too small to be of value as a diagnostic test. Alpha power was (not significantly) lower in the presence of photic stimulation than in its absence. As this was the case in both groups photic stimulation does net explain the higher alpha powers in the migraine group.We conclude that EEG background activity during the VEP does not distinguish reliably between migraineurs and contr

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106392.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISArteriographic findings suggestive of inflammation are described in a 26‐year‐old woman presenting with headache and syncope. There were no clinical findings of angiitis, and a diagnosis of status migrainosus was eventually made. We present her case, as well as a review o previous cases of arterial changes in patients with headache. Most previous cases report arterial narrowing, felt to reflect spasm, whereas our patient demonstrated segmental stenoses and dilatations, perhaps implicating inflammation. The inflammatory process has been postulated as the pathogenesis of migraine pain. As most migraineurs do not undergo arteriography, the incidence of arterial change in these patients is unknown. This finding has therapeutic implications for selecting the optimal anti‐migraine

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106396.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISThe recently described “Sunct” syndrome is a rare picture of unilateral, shortlasting headache attacks accompanied by autonomic phenomena (conjunctival injection, tearing, etc.) on the symptomatic side. Heart rate and blood pressure were monitored in two elderly “Sunct” patients during and outside headache attacks. An ultrasound Doppler servo method was used for the non‐invasive, continuous, beat‐to‐beat determination of instantaneous arterial blood pressure. In a third patient, systolic and diastolic blood pressure, both outside and during pain paroxysms, were assessed using the standard Korotkoff method. Heart rate was found to be significantly decreased during pain paroxysms. Systolic blood pressure was observed to be significantly increased during attacks, when compared with the inter‐attack period, while a less consistent pattern was observed for diastolic blood pressure. Some of the changes in the cardiovascular system seemed to start prior to pain onset. Therefore, it seems unlikely that these changes were caused by pain activation of the sympathetic nervous system or the ocul

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106399.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY

摘要:

SYNOPSISWe have previously demonstrated an increase in plasma met‐enkephalin levels during the pain attacks in episodic cluster headache.2 The present study was undertaken inorderto clarify thesourceof the plasma met‐enkephalin increase.Recent evidence has shown that peripheral blood polymorphonuclear cells contain peptides derived from the proenkephalin A system, which can be released by specific stimuli. We studied neutrophil met‐enkephalin containing peptides (NMECP) in 27 episodic cluster headache patients: 24 in a cluster period (6 of them during a pain attack), and 3 in the remission period. Neutrophil met‐enkephalin containing pep‐tide levels (after sequential enzymatic digestion with trypsin and carboxypeptidase B) were determined by radioimmunoassay with specific antiserum. Neutrophil peptide concentration (pmol/mg prot) was lower (p<0.01) in patients during the pain attack (14.4 ± 0.36) than after their pain had subsided {36.7 ± 0.31) and lower than in the remission period patients (35.8 ± 0.4).We conclude that neutrophil met‐enkephalin containing pep‐tides decrease during pain in episodic cluster headache, and that they may be involved in the concomitant plasma met‐e

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1991.hed3106406.x

出版商:Blackwell Science Inc    

年代:1991

数据来源: WILEY