摘要:

SYNOPSISCluster headaches are rare in childhood. We identified 35 patients with cluster headaches starting at or before 18 years of age, including 7 patients with onset prior to age 10. All patients met the criteria of the International Headache Society for episodic or chronic cluster headaches. Patients experienced cluster headaches for as long as 20 years before seeking medical attention and required many medical contacts to establish the correct diagnosis. The clinical features f cluster headaches during childhood were similar to those which typically occur in adult life. Cluster headache patterns changed over 18 years of follow up.The frequency and duration of cluster periods increased in 14 subjects. The frequency of single headache attacks during cluster periods also increased in a similar number of subjects.We conclude that cluster headaches starting in childhood or adolescence closely resemble the adult form of the disease. In many patients, the frequency and duration of cluster periods and the frequency of the individual headache episodes increased over time. Cluster headache represent a treatable under‐recognized cause of severe headache in childhood and adolescenc

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206275.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISA double‐blind parallel study compared the efficacy and safety of naproxen sodium (NPX) and ergotamine tartrate (ERG) as abortive therapy for acute headache in 79 patients with classical or common migraine. The design study was of the double‐blind design. Forty‐two patients completed the study. Discontinuation of treatment was generally due to lack of efficacy or adverse reactions. NPX was significantly better than ERG in the overall efficacy of treatment rated by the patients (p<004). NPX was comparable to ERG in reducing the severity and duration of the headache and its associated symptoms. In classical migraine, NPX was better than ERG in alleviating the severity of headache. Patients in the NPX group tended to use less rescue medication. There was no significant difference in the frequency of side‐effects reported by the patients under NPX or ERG. This study demonstrates that NPX is as safe as ERG, and somewhat more effective in acute migraine attacks (although the difference is not statistically significant) and that migrainous patients tend to prefer NPX to ERG in treating their acute migraine he

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206280.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISWe investigated the role of fear of pain in headache sufferers using the Fear of Pain Questionnaire (FPQ). Seventy‐six headache sufferers and 58 controls completed the FPQ and measures of depression, anxiety, and anger. Headache sufferers also completed measures of stress‐related physical symptoms and coping with pain. We found that the FPQ has excellent internal consistency as well as good concurrent and construct validity indicated by the high correlations between the FPQ subscales and both anxiety and depression but low correlations with anger. There were marked differences between headache sufferers and controls on the FPQ; headache sufferers showed much greater fear of severe and medical pain and lower fear of minor pain. Fear of pain was generally not related to headache characteristics such as frequency, severity, or duration. On the other hand, it was related to headache impact such as disruption of pleasurable activities. These results are consistent with models of chronic pain disorders which emphasize the role of fear of pain over the nociceptive intensity of the pain stimu

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206283.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISStudies on the prevalence of MRI signal abnormalities in the brains of migraineurs have yielded controversial results. In order to provide further data on this issue we reviewed the MRI scans of 38 migraine patients without current neurologic symptoms (mean age 35.8 ± 11.9 years). In addition, we compared the findings in those 24 migraineurs under 50 years without major cerebrovascular risk factors (mean age 30.1 ± 9.0 years) to that in 14 headache and risk factor free volunteers (mean age 37.8 ± 5.3 years). Overall, focal areas of hyperintense signal were seen in 15 (39%) patients. They were present on both proton density and T2‐weighted spin‐echo sequences. Lesion prevalence varied according to the type of headache (18% in migraine without aura, 53% in migraine with typical aura, 38% in basilar migraine). The subset of migraine patients under 50 years exhibited MRI signal abnormalities more than twice as often as controls (33% vs. 14%). Punctate white matter hyperintensities were the predominant finding and were seen in 10 of 15 individuals with MRI lesions. More striking signal abnormalities consisted of symmetrical areas of hyperintensity lateral to the posterior horns in two 24 year old patients and of extensive white matter damage with lacunar infarcts in a 59 year old woman.Our findings confirm a higher prevalence of MRI lesions in a mixed group of migraineurs than in headache free individuals. Signal abnormalities are most often non‐specific, however their occurrence relates to the type of

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206287.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISFourteen female volunteers who met diagnostic criteria for migraine headache monitored their headache activity and menstrual distress symptoms for one menstrual cycle. Serum estradiol and progesterone levels, and menstrual distress measures were collected at four points of the menstrual cycle: menstrual, ovulatory, luteal and premenstrual. Results indicated that one patient (7.1%) had menstrual migraine, 10 patients (71.4%) had menstrually‐related headache and 3 (21.4%) had migraine headache unrelated to their menstrual cycle: subsequent analyses were conducted with the first two groups. Headache activity for the sample was highest during the premenstrual phase. Headache activity during the luteal and premenstrual phases was related to luteal phase progesterone levels. Menstrual distress was highest during the menstrual and premenstrual phases of the cycle, and these symptoms were related to higher estradiol levels, higher estradiol/progesterone ratios, and increased headache activity. These results indicated that for women with menstrual migraine or menstrually‐related migraine, luteal progesterone levels may be significantly associated with headache activity, and estradiol and the estradiol/progesterone ratio may be significantly related to menstrual distress during the pre‐menstrual phase of the cycle. The estradiol/progesterone ratio was not more related to headache or menstrual distress than either of these ovarian hormones alone. Suggestions for future research in this area are of

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206292.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISMigraine‐like headaches may occasionally be seen in patients with scleroderma. The mechanism of these headaches is not well established but may be secondary to central "Raynaud's phenomenon". We report a patient with such headaches that responded dramatically to the centrally acting calcium channel blocker, flunarizine. We suggest that flunarizine should be considered in the management of patients with scleroderma and migraine‐like headac

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206298.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISWe reviewed the clinical histories, examinations and results of quantitative vestibular testing in 91 patients with migraine‐associated dizziness. Nausea and vomiting, hypersensitivity to motion and postural Instability accompanied the dizziness. In the majority of patients, the temporal profile of the dizziness was more typical of the headache phase of migraine than of the aura phase. Nineteen patients (20.9%) had unilateral hypoexcitability to caloric stimulation, which represents a modestly increased risk of damage to the peripheral vestibular apparatus. We propose two separate pathophysiologic mechanisms for the production of dizziness with migraine: Short‐duration vertiginous attacks lasting minutes to 2 hours and temporally associated with headache are due to the same mechanism as other aura phenomena (spreading wave of depression and/or transient vasospasm). Longer‐duration attacks of vertigo and motion sickness lasting days, with or without headache, result from the release of neuroactive peptides into peripheral and central vestibular tructures, causing an increased baseline firing of primary afferent neurons and increased sensitivity to m

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206300.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY

摘要:

SYNOPSISThere is little dispute that a link exists between 5‐hydroxy‐tryptamine (5HT) and migraine but the exact mechanism of an attack has yet to be established.The handling of 5HT by the platelet is regarded as a simple model of the handling of 5HT by nerve terminals. If differences are seen in how the platelets from migraineurs handle 5HT compared to those from a control population, it is possible that a similar difference exists in the nerve terminal.The Haemostatometer allows the rapid and simultaneousin vitroassessment of platelet function (shear‐induced haemostasis), coagulation and thrombolysis from non anticoagulated blood samples. In this study, a baseline comparison of haemostasis was made on 20 migraineurs between attacks and 20 controls. No differences were found in the results from each of the two groups. 5μM of 5HT was then added to blood taken from 10 migraineurs and 10 controls and the recordings were repeated. Again, no differences were found between the results from the two groups. In blood taken from both migraineurs and controls, the effect of 5HT was to significantly enhance clotting time and clot lysis. No effect was seen on primary aggregation. The possible reasons for and significance of these findings is dis

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1992.hed3206305.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.hed3206312.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.hed3206314_1.x

出版商:Blackwell Science Inc    

年代:1992

数据来源: WILEY