摘要:

The heritability of liability to self‐reported migraine and nonmigrainous headaches was examined in two large cohorts from the Swedish Twin Registry consisting of 6448 (the older cohort) and 12 884 (the younger cohort) like‐sexed twin pairs. Higher concordance rates were consistently found for lifetime migraine among the monozygotic twins than in the dizygotic twins, as well as for migraine headaches of the recurrent disabling type. In addition, a higher concordance rate was found among the monozygotic twins than in dizygotic twins in a "mixed" group of possible tension‐type or mild migraine headaches (or both). The results of structural equation model‐fitting analyses showed that genetic effects for migraine headaches were stronger for the females (estimates ranging from 49% to 58%) than for the males (39% to 44%) in the two cohorts. Unique nonshared environmental effects were greatest for the “mixed” group in both sexes (estimates ranging from 60% to 69%). The results are discussed in view of similar large‐scale twin studies examining the heritability of liabilit

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509513.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

A retrospective analysis of all patients admitted with the diagnostic codes of aseptic or viral meningitis was performed at two institutions over 3 years. Forty‐one patients with cerebrospinal fluid confirmation of aseptic meningitis (increased protein; increased white count; negative gram stain; and negative fungal, tuberculosis, and bacterial cultures) were analyzed.All the patients had headache, which was typically severe and bilateral in 39 of the 41 patients. The headache was of abrupt onset or the worst of the patient's life in 24 of the patients. The quality of the headache, when described, was usually throbbing (11 of 14). Nineteen patients had prodromal symptoms, including malaise, myalgia, gastrointestinal symptoms, and urinary tract infections. All had associated symptoms, including nausea (25), vomiting (23), photophobia (18), stiff neck (25), and back pain (11). Thirty patients were febrile. Lumbar puncture was performed forheadacheand fever unexplained by systemic illness in 30 patients, meningeal signs in 15, headache of abrupt onset or the worst headache ever in 24, neurologic signs or symptoms in 12, and for other reasons in 2. Computerized tomography, when performed, was negative in all cases. Focal neurologic findings were present in 5 patients, a decreased level of consciousness in 6, and papilledema in 1.A severe headache that worsens, is abrupt in onset, or is the worst of the patient's life could be due to aseptic meningitis, bacterial meningitis, or a subarachnoid hemorrhage. Although not universally present, meningeal signs, fever, and neurologic signs or symptoms should alert one to a possible central nervous system infectio

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509520.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

It has been suggested that patients' perceptions of the impact chronic headache has on their lives as well as perceived control of their headaches may be associated with the intensity, duration, and exacerbation of pain they experience. The present study examined associations among International Headache Society (IHS) diagnostic category, pain characteristics such as severity and duration, perceived impact and control of headaches, and adaptive response. Two hundred twenty‐five patients with migraine, tension‐type, or combined migraine and tension‐type headache served as subjects. General activity level was related to IHS diagnosis, with migraine headache patients reporting that they are more active than tension‐type headache patients (F(2, 196) = 5.69, P<.01). Headache locus of control was not significantly related to IHS diagnosis, however external headache locus of control was significantly related to headache intensity (r = .32, P<.001, r = .25, P<.001), as well as to patients' perceptions of the extent to which pain interfered with various domains of their lives (r = .33, P<.001, r = .28, P<.001), and adaptive response (F(6, 402) = 4.68, P<.001). It appeared that perceived control over headaches and perceived impact of headaches were not related to IHS diagnostic category and were not strongly related to each other, but were related to headache s

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509527.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

We have reported previously that the 25‐item Headache Disability Inventory has good internal consistency reliability, robust long‐term (2 month) test‐retest stability, and good construct validity. We conducted further investigations to evaluate the short‐term (1 week) test‐retest reliability and spouse perceptions of patients' self‐perceived headache disability. The short‐term test‐retest reliability of the Headache Disability Inventory was excellent. Additionally, the spouse and patients' perceptions of the patient's headache disability generally were congruent, although we observed instances where the differen

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509534.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

The efficacy of valproic acid in the treatment of intractable chronic daily headache, unresponsive to traditional prophylactic medications, was examined prospectively in 16 patients. Dosage of the medication was adjusted to maintain serum valproic acid levels between 50 and 100 μg/mL, provided there were no significant side effects at that level. Valproic acid prophylaxis was of some benefit in only 2 of 16 patients. One of these two patients discontinued therapy due to side effects. Eight of the 16 patients reported side effects which included nausea, diarrhea, anorexia, lethargy, sleepiness, confusion, blurred vision, and decreased libido. In conclusion, valproic acid was not effective in controlling chronic daily headache in the majority of patients in whom conventional therapy had failed, and 50% of patients reported side effects. There is a significant disparity in the reported efficacy of this drug in treating chronic daily headache. This disparity is most likely due to the poorly‐defined nature of this variety of headache. It is, therefore, recommended that more stringent definition of this disorder be developed before therapeutic regimens are evaluat

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509540.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Sixty (29%) of 205 consecutive patients with transient ischemic attacks registered in a hospital stroke data base had headache within 72 hours of onset. Headache was significantly more common in nonsmokers (odds ratio = 2.8; 95% confidence interval = 6.7 to 1.2). Headache was infrequent in patients with amaurosis fugax, and was not significantly associated with any other particular clinical presentation of transient ischemic attack. Headache was more common in vertebrobasilar (33%) than in carotid distribution (24%) episodes, and was not rare in transient ischemic attacks presenting as lacunar syndromes (29%). Headache was less frequent in patients whose computerized tomograms showed an infarct appropriate to the symptoms (odds ratio = 0.2; 95% confidence interval = 0.02 to 1.4). A diffuse headache was more common in patients with lacunar events than in patients with cortical attacks (odds ratio = 3.0; 95% confidence interval = 13 to 0.07). No other association was found between headache location and the presumed involved vascular territory. Headache in patients with transient ischemic attacks is poorly related/explained by the clinical characteristics of the ischemic event.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509544.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Piroxicam beta‐cyclodextrin has recently been observed to be equal to, or even possibly to be superior to, indomethacin (mainly with regard to side effects) in a single case of hemicrania continua. Piroxicam beta‐cyclodextrin, 20 to 40 mg per day, was, accordingly, tried in six patients with chronic paroxysmal hemicrania and six patients with hemicrania continua with a previously proven response to indomethacin. The study was conducted over a period of 3 weeks and in an open fashion. A placebo effect is considered to be negligible in these disorders. In such a comparison, piroxicam beta‐cyclodextrin seemed inferior to indomethacin, in particular in chronic paroxysmal hemic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509549.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

We have reviewed the diagnoses of 654 children aged from 7 to 14 years who attended a neurologist for headache evaluation. Headaches beginning between the age of 7 and 14 represented a higher percentage (18.3%) than the proportion of preadolescent children in our health area (12.9%). Headaches were more common in girls; although cluster, posttraumatic, benign exertional headaches, and the only case of brainstem glioma were restricted to boys. Despite the female predominance, the proportion of males with migraine was significantly higher in the preadolescents than in the over 15 age group. Migraine accounted for the majority of diagnoses (609 ‐ 93% of the total series), while tension‐type headache (27 ‐ 4%), and headache associated with sinus infection (7 ‐ 1%) were the diagnoses which followed in frequency. There were only two headaches (0.3%) associated with intracranial masses.Even though, in terms of frequency, headache is a very common reason for neurology consultation, the present results show that the majority of preadolescents consulting because of headache suffer from benign con

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509551.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Very little information exists about the physiology of pediatric headache and in particular, the role that skeletal musculature plays in the genesis of head pain. This study explored EMG levels in the neck and forehead in a group of 12 children who complained of severe headache. Comparisons were made with a matched group of 12 children who were headache‐free. Results suggested that children with headache suffer from very tense neck muscles which may reflect high levels of anxiet

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509554.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY

摘要:

Spontaneous intracranial hypotension is characterized by severe postural headache in the setting of low CSF pressure, usually attributed to a cryptic CSF leak. We report a patient whose prolonged refractory headache was characterized by the clinical symptoms of occipital neuralgia, but was also associated with the radiographic appearance of an Arnold‐Chiari malformation, type I and low CSF pressure. After extensive diagnostic evaluation, CT cisternomyelography ultimately demonstrated a CSF leak at the C2 vertebral level. Symptomatic relief was sustained only with long‐term theophylline administration. The apparent Arnold‐Chiari malformation resolved with treatment of the low CSF pre

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1995.hed3509557.x

出版商:Blackwell Science Inc    

年代:1995

数据来源: WILEY