摘要:

SYNOPSISWe conducted a randomized open‐labeled study of nifedipine versus propranolol for the initial prophylaxis of migraine. Propranolol was effective in 67% of patients (12/18) and well tolerated. Nifedipine was effective in only 30% of patients (6/20). The lack of overall efficacy of nifedipine was attributable to high incidence of side effects, including an unusual symptom complex resembling erythromelalgia. These side effects led 45% (9/20) of the nifedipine patients to withdraw from the study within two weeks. By contrast, no patient (0/18) withdrew from the study within the first 2 weeks of propranolol therapy. We conclude that nifedipine is not an agent of first choice for the prophylaxis of migrain

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904215.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe clinical efficacy of flunarizine and of propranolol for the prevention of migraine attacks was assessed in a multicenter double‐blind study lasting four months which was preceded by a single‐blind placebo period of one month. For both drugs, more than haft of the patients judged the effect to be good or very good. When considering the patients' daily logs, both drugs produced a significant reduction of the number of attacks. Propranolol furthermore significantly reduced the severity of attacks and the number of analgesics used during the attacks. In both groups no severe side effects were obser

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904219.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe reviewed the medical records of 283 cocaine users consecutively admitted to a municipal hospital and identified 37 patients (13.1%) complaining of headaches. These patients were divided into three groups. Three patients had migraine‐like headaches and transient hemiparesis associated with cocaine use. Five patients had headaches associated with cocaine withdrawal. In 29 patients headaches were not clearly associated with cocaine. Twenty‐two of the 29 had chronic daily headaches; nine of these patients were depressed. Three had focal brain lesions with chronic daily headache or acute onset global headache. The four remaining patients had other headaches. Based on these findings, we conclude that: (1) Headache is a common complaint in hospitalized cocaine users; (2) Cocaine may occasionally trigger a syndrome which resembles hemiplegic migraine. The potential mechanisms of this syndrome will be discussed; (3) Hospitalized cocaine users who present with headaches most frequently have depression with suicidal ideation, often associated with cocaine withdrawal; and (4) Structural brain disease in these patients may result from a variety of cau

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904225.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe studied one hundred patients with suspected temporomandibular joint (TMJ) arthropathy in whom 64 also complained of headache and/or facial pain, using high field surface coil magnetic resonance (MR) imaging, and found that headache and facial pain are commonly observed in association with inflammatory arthropathy of the TMJ. Each patient complained of pain and/or tenderness localized to the immediate vicinity of at least one TMJ. Pathologic joint effusion was demonstrated by MR in 88 of the painful joints studied. Significant meniscus displacement, with or without meniscus deformity and alteration of intrinsic signal intensity was present in 94 of the 100 painful joints examined. Ascial inflammation and atrophy of the ipsilateral muscles of mastication were observed occasionally with painful joints. There were no mechanical TMJ symptoms, such as joint clicking, crepitus or locking in 14 internally deranged and painful joints, 12 of which exhibited joint effusion and local inflammation. At least 80 patients described occlusal changes within 12 months of imaging. 28 of the pathologic joints in the series underwent subsequent meniscectomy, including routine histologic evaluation of surgical material. We conclude that internal derangement and inflammation of the TMJ should be considered in atients with unexplained headache and/or facial pain, even if mechanical TMJ symptoms are absent.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904229.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISEighteen patients suffering from true menstrual migraine and 12 control subjects were studied. We evaluated in different phases of the menstrual cycle and during the migraine crisis the peripheral plasma concentrations of 6‐keto‐PGF1a(the stable metabolite of PGI2), thromboxane B2(the stable metabolite of thromboxane A2), PGF2aand PGE2.The mean values of 6‐keto‐PGF1ain menstrual migraine sufferers are lower than in normal women throughout the whole cycle. The difference between the trends observed in the two groups is statistically significant (p<0.05). The plasma levels of TXB2and of PGF2aare similar in the two groups investigated, both n basal conditions and during the attack. The plasma concentrations of PGE2are slightly lower in migraineurs in basal conditions than in normals. However, during the crisis they increase significantly (plt;0.05). In conclusion, among all the parameters considered, PGE2seems to play the most important role during the pain phase of the attack.The results of the present study suggest that a deficit of PGI2, one of the most important protecting agents against ischemia, might be a typical feature of menstrual migraine and might cause in these patients a vascular hypersensitivity to different ischemic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904233.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISThe pathophysiology of migraine and its associated perceptual symptoms remains controversial. We recorded long‐latency auditory event related potentials (AEPs) in 30 unmedicated patients with common migraine, and compared them to 20 controls. 1,000 and 3,000 Hz tones were presented in an 80:20 ratio at 75 dB SL. 200 responses were recorded and replicated from Cz‐A1 +A2, with filter band‐pass of I ‐ 100 Hz, analysis time of 1,000 ms., and interstimulus interval of 1.1 second.N100, P200, and N200 ERP components did not differ in latency or amplitude between migraine patients and controls. P300 was longer in latency among those with common migraine, and P300 amplitude was significantly reduced (P>0.05). These findings suggest that migraine may have a central mechanism, and that migraineurs may have a difference in task involvement or perception which may influence their clinical course and response to

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904239.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISWe determined by radioimmunoassay plasma melatonin levels on blood samples drawn at 11 p.m. in migraine patients and control subjects. Ninety‐three cephalalgic outpatients (75 females, 18 males) were compared to a control group (24 females, 22 males) matched according to age.Patients were divided into subgroups presenting common migraine (n = 38); ophthalmic migraine (n = 12); and tension headache associated with ophthalmic or common migraine (n = 24), and associateddepressivestatus (n = 19).Statisticalanalysis revealed a decrease in plasma melatonin levels for the entire migraine population, compared to the control one, and a heterogeneity in both controls and patients; this heterogeneity was found mainly in the depressive and tension headache subgroups.When the migraine population‐from which the depressive patients were excluded‐was divided into male and female subgroups, a decrease in plasma melatonin levels was observed only for the female subgroups.Results are discussed with reference to the role of the pineal gland in the synchronization of the organism with the environmental condi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904242.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA 23‐year old woman developed headache and papilledema due to benign intracranial hypertension (BIH) while taking lithium carbonate for only seven months because of manic‐depressive disease. Having discarded other causes, drug ingestion was the most likely etiology of the syndrome since it was observed that symptoms improved upon lithium withdrawal and worsened when the treatment was restarted. This report shows that BIH may appear as a side‐effect of relatively short‐term therapy with lithium and, therefore, funduscopic exams should be performed in every patient receiving th

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904246.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.hed22904248.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY

摘要:

SYNOPSISA sample of 108 adolescent students suffering from migraine and tension headaches, treated with relaxation training and attention‐control approaches, were evaluated at 5–6 month and 3–4 year follow‐ups. Data were obtained for 69% (75) of the original subjects at the second follow‐up. The treatments administered within a school setting were contrasted with students' self‐monitoring of headache.The results indicated that students treated with relaxation training showed a good maintenance of post‐treatment headache reduction at the two follow‐up evaluations, 80% and 85%, respectively. Although treatment condition and level of pre‐treatment headache were associated with a favorable outcome at the 5–6 month follow‐up, only baseline headache severity emerged as a significant redictor at the final follow‐up. Several variables from the psychological functioning and health behavioral domains found to predict post‐treatment outcome for the adolescent headache sufferers in previous research, did not contribute significantly to

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1989.hed22904250.x

出版商:Blackwell Science Inc    

年代:1989

数据来源: WILEY