摘要:

SYNOPSISThis study investigated the role of stress in recurrent tension headache. Although recurrent tension headache sufferers (N=117) and matched headache‐free controls (N=174) reported similar numbers and types of stressful life events, headache sufferers reported a greater number of chronic everyday stresses or daily hassles than didcontrols. Recurrent tension headache sufferers also appraised the stressful events they experienced more negatively than did controls, and employed less effective coping strategies in their efforts to manage stressful events. When the potential impact of a stressful event was ambiguous, recurrent headache sufferers appraised this event more negatively and themselves as having less control over the event than did headache‐free controls. In their coping efforts, recurrent tension headache sufferers also placed greater reliance on the relatively ineffective coping strategies of avoidance and self‐blame, and made less use of social support than did controls. These findings suggest that research on the role of stress intensionheadaches should focus not on the occurrence of major stressful life events, but on the recurrent headache sufferer's cognitive appraisals of stressful events and efforts to cope with s

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604160.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISA prospective, double‐blind, crossover study was conducted of the effectiveness of dihydroergotamine (DHE) vs. placebo in the treatment of acute migraine in the emergency department. Thirty‐seven patients were enrolled. By 60 minutes after treatment, those receiving DHE first had significantly better relief of pain than those receiving it later. Side effects were fairly common but were minor and did not necessitate terminating treatment. Eleven per cent of patients had significant relief of pain with prochlorperazine pre‐treatment alone. Only 13.5% of patients treated with this DHE regimen required narcotics at the end of the study for relief of pain, compared to 45% of migraine headache patients seen concurrently in the same emergency department who were not enrolled in the study. We conclude that treatment with intravenous prochlorperazine and DHE is a safe and effective treatment and a useful alternative to narc

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604168.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISA group of 30 patients (12 M ‐ 18 F) suffering from migraine underwent salmon calcitonin therapy for a period of one month. All patients were treated at first for 30 days with vehicle administration in a daily i.m. injection, as a control. Calcitonin effectiveness was evaluated in terms of changes in frequency, intensity and duration of the migraine attacks. The results show a significant difference between the observation period (vehicle only) and treatment phase, with improvement during the calcitonin treatmen

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604172.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISThis 34‐week, placebo‐controlled, single crossover study with a double‐blind randomized treatment sequence evaluated the effects of propranolol as a prophylactic agent in individualized doses ranging from 60–320 mg/day given to 62 patients who had common and/or classic migraine. Variables reflecting efficacy were the frequency, severity, and persistency of acute migraine attacks expressed as Headache Unit Index (HUI) and the therapeutic medication required for acute attacks during the study expressed as the Relief Medication Unit Index (RMUI). Both HUI and RMUI were significantly reduced from baseline after the six weeks of propranolol titration (p<0.0001) reflecting fewer and/or less severe headaches. During the crossover treatment periods, propranolol, in comparison with placebo, was significantly more effective in the reduction of HUI (p<0.01) and RMUI (p<0.05). Data at the end of the dose finding (titration) period were analyzed separately for patients whose final prescribed doses were 60‐240 mg or 320 mg/day propranolol. Significant reductions in HUI and RMUI (p<0.0001) were shown at this time at each dose level. At all dose levels, propranolol was well tolerated. This was the first study in which the propranolol dose for migraine extended above the usual recommended 240 mg/day, i.e., up to 320 mg/day. This higher dose was administered if the drug had been well tolerated, even if only one headache in 2 weeks occurred at lower doses. The data suggest that there is an option to prescribe propranolol at higher doses as a preventive measure, thus reducing the need for ancillary me

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604175.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISTwo patients developed generalized throbbing headaches, tenderness of the anterior neck and unilateral ptosis following whiplash injury. They were systematically evaluated for involvement of the central nervous system, carotid arteries, vagi and cervical sympathetic nerves. Biochemical study of pupils revealed bilateral postganglionic Horner's syndrome. Thermal‐induced facial sweating showed supraorbital anhidrosis. Follow‐up 18 to 54 months after injury demonstrated partial improvement in pupillary functions and headaches but persistent supraorbital anhidrosis. Pertinent literature on sympathetic dysfunction and post‐traumatic headaches is reviewed, and the reasons and implications for sympathetic involvement in hyperextension‐hyperflexion injury are di

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604183.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISIn certain refractory cases of headache, inpatient therapy in a headache treatment unit may prove beneficial. Strict criteria for admission to this unit have been developed. To ascertain the long‐term benefits of treatment, a survey was sent to 372 consecutive patients. A 41% response rate was achieved. Fifty‐four percent of the patients had a greater than 50% reduction in headache unit index at the time of the survey and 59.6% had a greater than 50% reduction in the corrected headache unit index. Approximately 10% of those responding to the survey had become and remained completely headache‐free. Medical management and non‐drug therapies such as biofeedback and dietary instruction were viewed as being the most important treatment modalities by the patients. Psychological modalities were of benefit to 72% of the patients and biofeedback was useful to 54% of the patients. These results prompt us to believe that the multidisciplinary inpatient treatment of headache is beneficial to the majority of patients whose headaches have been refractive to traditional outpatient tr

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604189.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISAcephalgic migraine is a term used interchangeably with the term migraine equivalents. These terms by definition refer to any migrainous phenomena that may occur in the absence of a migraine headache.1Perhaps 20% of migraineurs may experience acephalgic attacks of migraine at one time or another. The idea that various symptoms can occur in the absence of any headache has been noted for hundreds of years, but very little has been written about this condition recently. Some people do not believe the symptoms that are often classified as migraine equivalents are in actuality part of the migraine syndrome. Because there is as yet no specific test for migraine, there is no proof that these various symptoms are due to the same neurovascular dysfunction we know as migraine. The diagnosis of migraine is based only on the patient's history and the exclusion of other diagnoses. It is not unusual for a headache patient to see several headache “specialists” and be given different diagnoses.Some prefer the term “migraine accompaniments” for neurological or visual symptoms occurring with or without a headache.2The aura of the classic migraine attack may linger into the painful phase and thus “accompany” rather than just precede the headache. At times, symptoms typical of the aura may occur and may not be followed by a headache (acephalgic migraine). The term “complicated migraine”should probably be reserved for those neural and/or visual symptoms that outlast the headache by at least 24 hours and should not be used when referring to symptoms of shorter duration which may accompany the headache or which occur in the absence of migraine headache. Although non‐visual migraine equivalents are not nearly as common as visual symptoms, it is important to recognize the fact that migraine may account for almost any recurrent, transient, episodic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604198.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604203.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2604207.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY