摘要:

SYNOPSISTwo hundred patients who were taking daily symptomatic or immediate relief medications, often in excessive quantities, yet suffering from daily or near daily severe headaches were studied. One hundred and sixteen (58%) of them were also taking concomitant prophylactic medications and they were ineffective. Low tyramine, low caffeine dietary instructions and biofeedback training were given to all patients. The effect of continuing symptomatic medications, discontinuing symptomatic medications, and adding or changing prophylactic medi‐cations were studied in the various treatment groups. It is concluded that; 1.) Daily use of symptomatic or immediate relief medications result in chronic daily headache. 2.) Discontinuing daily symptomatic medications itself result in improvement of headache. 3.) Concomitant use of symptomatic medications nullifies the effect of prophylactic medi‐cations. 4.) Discontinuing daily symptomatic medications enhances the beneficial effect of prophylactic medicati

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010634.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISIn a double blind cross‐over study, 28 patients, 5 male and 23 female, aged 31 ± 14 years, after a run‐in period of 8 weeks, were treated for 3 months with acetylsalicylic acid and for another 3 months with metoprolol, both in a prophylactic mode. Attack frequency was reduced significantly with both therapeutic regimens (ASA p<0.001, metoprolol p<0.00005). Reduction of attacks below 50% was seen with metoprolol in 14 cases, and with ASA in three cases. Even though ASA was of statistically significant efficacy in migraine prophylaxis, it clearly is not the drug of first choice in migraine prophyl

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010639.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISAbdominal migraine is a common childhood migraine equivalent, for which diagnostic criteria have not been defined. As in other children with migraine equivalents this leads to difficulties in diagnosis and determination of prevalence. By recording the fast wave activity (beta rhythmn) in the visual evoked response (VER) to red and white flash, the pattern stimulation, 27 out of 28 children with clinically diagnosed abdominal migraine revealed significant differences compared with normal controls, outside the attack phase. Comparisons with children diagnosed as migraine with or without aura revealed, from the VER findings of higher amplitude fast wave activity and the presence of paroxysmal sharp wave activity, that abdominal migraine appears to be a specific form of childhood migraine. We found that both clinically and electrophysiologically, abdominal migraine changes with age; older children exhibiting a shorter duration of abdominal pain during attacks, and less evidence of sharp wave activity in the VER.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010642.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSIS99mTC HM‐PAO SPECT brain imaging was performed during the headache‐free period in 19 young migraineurs, affected by common migraine (CM, 10 cases), classic migraine (CLM, 6 cases) and hemiplegic migraine (HM, 3 cases). SPECT findings were negative in all 10 patients with CM, in 3 cases of CLM and in 2 cases of HM. Positive findings in the remaining 4 patients (3 cases of CLM and I of HM) showed a decreased tracer distribution in the temporo‐occipital regions (2 cases) and parietal regions (2 cases): the two with decreased temporo‐occipital perfusion reported prodromal symptoms exclusively contralateral to the areas of hypoperfusion. An impaired regional cerebral vascular autoregulation may exist even during headache‐free intervals in patients suffering from classic and hemiplegic

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010646.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISA 46 year old man with a short history of left facial pain and numbness, and subsequently headaches, had a normal physical examination and a normal CT scan of head. Lumber puncture yielded normal CSF under increased pressure. MRI showed thrombosis of the superior sagittal sinus, subsequently confirmed by angiography. MRI is a sensitive test for detecting intracranial venous thrombosis, and may be the investigation of choice when this disorder is suspected.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010650.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISWe present further evidence for a sympathetic defect of vasomotor control of the anterior cerebral artery (ACA) on the side of the headache during cluster periods. In 119 cluster headache patients, utilizing transcranial Doppler, we measured CO2reactivity of the major intracranial vessels, in and out of cluster. Reactivity was significantly lower during the cluster period, but only in the ACA on the side of the headache. Nineteen patients followed sequentially for a full cycle (ie/both in and out of a cluster period) showed the same changes. In 3 out of 6 patients in an active cluster period, we describe a lesion on Gallium single‐photon emission computerized tomography (SPECT) in the region of the cavernous sinus which fades as the patient moves out of cluster. It is felt that this lesion may represent the cavernous sinus plexus lesion postulated as the central lesion in cluster, Changes in the sympathetic outflow at this point could explain the changes we have described in ACA CO2reactivity during cluste

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010652.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISThe present study concerns the possible relationship between hypoxia and the generation of cluster headache attacks. Fifteen controls and 25 cluster headache patients were studied. The patients were allocated into two groups according to cluster headache stage, i.e. cluster or remission period. During the tests, all the subjects were asked to inhale 12% oxygen (88% N2) for 30 min, and the decreasing oxygen saturation (SaO2%) was monitored. Patients in the remission period showed nearly the same decrement ofSaO2%as controls. At the end of the test, patients in the bout showed significantly less reduction ofSaO2%than the controls. In 5 patients, the test was carried out both in and outside the cluster periods. The tendency to less decrement in oxygen saturation in the cluster phase was as marked with this comparison, but the difference between the groups was not significant, probably partly due to the low number of tests carried out. Only one patient got a typical attack. it seems that hypoxia of this magnitude per se is not the cause of attacks. The different pattern with respect toSaO2%following 12% O2inhalation in cluster headache may be due to an abnormality in central regulation and/or chemoreceptor sensitivity.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010656.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISThe effect of teacher‐presented Progressive Relaxation Training (PRT) on headaches, fear of failure and school problems was studied in school students. During ten physical education lessons, students received either PITT (n = 110) or placebo training (n=92). The effect of the training was investigated in students who indicated the presence of headaches in a pre‐training diary. No significant differences were found between both training groups regarding headache frequency, duration and intensity and the psychological variables. On the basis of these and previous findings, it is recommended to present PRT to fairly small groups of self‐selected subjects instead of complete cl

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010660.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISForty‐eight adolescents suffering from recurrent tension headache participated in a controlled trial conducted in a high school setting. During the first treatment phase self‐help relaxation training was compared with a waiting‐list group. Following this phase a pharmacological regimen consisting of a muscle relaxant (chlormezanone) and placebo was superimposed on relaxation therapy in a double‐blind crossover design. Each treatment phase encompassed a 5‐week period. In addition to the evaluation of headache complaints, psychological distress among students was measured with respect to their experience of somatic complaints, depressive, anxiety and stress symptoms. Although self‐help relaxation training significantly decreased the severity and annoyance of adolescents' headache besides their somatic complaints, the clinical improvement of headache was modest. The addition of chlormezanone did not help those who were nonresponders to self‐help relaxation training. Finally, a set of pretreatment variables consisting of baseline headache severity and annoyance, experience of anxiety and daily life stress among adolescents could predict outcome of self‐help rel

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010665.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY

摘要:

SYNOPSISThis study examined the pharmacokinetics of 300 mg of tiaprofenic acid, a NSAID belonging to the 2‐arylpropionic class, as a single oral dose, in 10 migraine patients during and out of migraine attacks. Plasma concentration of tiaprofenic acid was determined by HPLC analysis. Drug absorption appeared to be the same during and out of migraine attacks (absorption half life: during attack, 0.249±0.122 hr; out of attack, 0.249 ± 0.105 hr; maximum plasma concentration: during attack, 37.8±9.8 ug/ml; out of attack, 40.1 ± 13.2 ug/ml). The other pharmacokinetic parameters evaluated were not affected by headache attacks as well. We conclude that tiaprofenic acid absorption and metabolism are not affected by migraine attacks. Also, our data suggest that tiaprofenic acid might be useful in the treatment of mig

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1990.hed3010672.x

出版商:Blackwell Science Inc    

年代:1990

数据来源: WILEY