摘要:

SYNOPSISIn 1986–1987, a neuroepidemiologic survey was undertaken to study the prevalence of the most frequently encountered neurologic disorders, and in particular headache, in a representative sample of the population in the Haute‐Vienne Department(Limousin). A door‐to‐door survey was made using a protocol developed by the W.H.O. at the beginning of the 1980's. Thecalculated prevalences (according to Poisson's distribution) per 100,000 inhabitants were 5,059 for non migraine headache,and 4,270 for migraine headache. This disorder preferentially affected young adults and essentially involved females. It wasthe most frequently encountered disorder (50%) during the different surveys of similar meth

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310521.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISThis investigation is devoted to the study of the time‐course of a cytokines panel (IL‐4, IL‐6, IFN‐gamma,GM‐CSF) in plasma samples from migraine patients. The data obtained during challenged migraine crises was compared to the baseline values. Time‐data series analysis showed a fall after a challenge test for IL‐4 and IL‐6 plasma levels and an opposite trend for gamma‐IFN and GM‐CSF levels. The implication of this phenomenon in dietary migraine is not readily evident. There may possibly be an activation of this cytokine network together with the well‐known impairment in the neuropeptidergic system, consideringthe close links between interleukins and other cytokines and the neuro‐mediators of pain, su

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310524.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISLevels of substance P (SP) and 5‐hydroxytryptamine (5‐HT) in platelets were measured in 25 patients with migraine,31 patients with tension‐type headache (TH) and 27 healthy controls. The mean concentration of SP in platelets was 355.3 pg/10 9 platelets in patients with migraine, 290.8 pg/10 9 platelets in patients with TH and 180.8 pg/10 9 platelets in the controls. The concentrations of platelet SP in the migrainous patients and in the TH patients were significantly higher than those in the controls. The mean concentration of 5‐HT in platelets was 619.7 ng/10 9 platelets in patients with migraine, 579.3 ng/10 9 platelets in patients with TH and 811.9 ng/10 9 platelets in the controls. The concentration of platelet 5‐HT in the patients with TH was significantly lower than that in the controls. The platelet SP/5‐HT ratio in the migrainous patients and in the TH patients were significantly higher than that in the controls. There was significant negative correlation between the concentrations of platelet SP and those of platelet 5‐HT. These results may support the hypothesis that SP released from the terminals of the trigeminal nerves causes migraine either through direct actions on the vessels or by releasing 5‐HT from the platelets. The high levels of platelet SP in TH patients might reflect release of SP from the pain

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310528.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISMigraine is a hormonally sensitive episodic headache disorder which may worsen during the first trimester, but usually improves during later pregnancy. Its treatment can be difficult because of the risks of injury to the fetus and newborn. These risks include teratogenicity, embryo mortality, fetal growth abnormalities, and perinatal effect. This paper reviews the effects of drugs on the fetus and newborn, their FDA classification, and their use during both pregnancy and lactation. Specific recommendations are given.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310533.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISAcetylsalicylic acid (ASA) is one of the most commonly used substances in the treatment of headache and other pain syndromes. It is only recently that its efficacy in the treatment of acute attacks and in the prophylaxis of migraine has been proven in clinical trials. Various peripheral and central mechanisms have been proposed for the analgesic effects of acetyl‐salicylic acid and Its mode of action in migraine. The possible actions of acetylsalicylic acid in migraine include local analgesic effects, changes in cerebral serotonin turnover, modulation of antinociceptive neurons in the hypothalamus and inhibition of the release of algogenic peptides during neurogenic inflammation. In this study trigeminal somatosensory evoked potentials and single unit activity of central trigeminal neurons in the dorsolateral C2spinal cord were monitored during electrical stimulation of the superior sagittal sinus in the cat. Intravenous administration of the soluble acetylsalicylic salt (acetylsalicylic lysinate, 30mg/kg) reduced the peak‐to‐peak amplitudes of somatosensory evoked potentials from 219 ± 11mV by 18% after 45 minutes and by 26% after 60 minutes. Naloxone injection (0.5 mg/kg and 1.5 mg/kg) did not reverse the inhibition caused by ASA. The probability of trigeminal cell tiring was reduced in 63% percent of the monitored single units. The effect was not mediated through naloxone‐sensitive opioid receptors and was independent from ASA‐induced peripheral blockade of neuropeptides during neurogenic inflammation. The non‐steroidal anti‐ inflammatory agent ketorolac (0.4mg/kg, IVI) a new cyclooxygenase inhibitor, also reduced the somatosensory evoked potentials by 30% following the same time course. The data suggest that ASA exerts inhibitory effects on central trigeminal neurons, possibly mediated through inhibition of prostaglandin synthesis and that these may be responsible for its effects in the treatme

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310541.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISAutonomic nervous system function was studied in 62 patients with migraine. The Valsalva maneuver, deep breathing test, sustained handgrip test, orthostatic test and spectral analysis of heart rate variability in the supine and standing positions were performed in a group of 62 patients of both sexes, aged 21 to 50 years, and in an age‐matched control group of 45 healthy volunteers.Heart rate increase during sustained handgrip was significantly reduced in the headache group, when compared to the control group, while the results of the remaining cardiovascular tests did not significantly differ between the control and headache groups. In standing patients, the integrals of middle frequency bands of amplitude spectra were smaller in patients than in controls because the increase induced by standing was smaller in migraine patients. The results in patients with migraine with aura (21 patients) and migraine without aura (41 patients) did not differ significantly from each other. The same was true for the results of the female and male patients.It is concluded that sympathetic function is impaired in migraine patient

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310545.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISTwo female patients, one suffering from CPH in non‐remitting form, and the other from hemicrania continua, in the pre‐chronic (non‐continuous) stage are described. Both were followed through transitions to other stages: the CPH patient was followed from the non‐remitting stage to a long‐lasting remission, and lastly back to another chronic stage. Indomethacin was effective in all the symptomatic stages. The hemicrania continua patient was followed from the non‐continuous to the continuous stage. Indomethacin was effective in both stages. These observations provide further evidence that the non‐chronic and chronic (“remitting” and “non‐remitting”) stages of CPH belong together. The same seems to apply to the two stages of hemicrania continua, the “continuous” and

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310551.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISHeadaches are a common complaint after work place or environmental exposures. A striking index case led to a literature review which uncovered only limited information. We then performed a retrospective descriptive study of 50 subjects referred to University Clinics with the complaint of headaches associated with chemical exposures at their work place. Our data suggest a different headache may exist depending on whether the chemical exposure is routine and limitéd versus accidental and extensive. Low level work place chemical exposures appear to cause headaches that abate soon after cessation of the exposure. A single accidental and extensive exposure may lead to patient complaints of a new headache syndrome that may last from several months to years. The characteristics associated with the onset of a new headache syndrome from accidental chemical exposure includes: 1) An acute large quantity of exposure. 2) A short latency of onset of the heralding headache. 3) A severe intensity and long duration of the heralding headache. 4) New recurring headaches that were not experienced before the acute exposure. We suggest a possible term for this high exposure syndrome i.e. Chemical Headache Exposure Syndrome (CHES)

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310555.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISObjective: To compare the efficacy of the combination of meperidine and hydroxyzine IM, versus dihydroergotamine and metoclopramide IV in the treatment of severe migraine headaches.Design: This was a randomized double‐blind, double‐dummy study.Setting: Established patients, whose headache had failed to respond to their usual abortive agent, were invited to an out‐patient headache clinic for the study.Patients: Twenty‐eight patients, diagnosed as suffering from either migraine headache or chronic daily headache, were screened on arrival to exclude life‐threatening causes.Intervention: Group A (14 patients) received dihydroergotamine 1mg and metoclopramide 10mg IV and a placebo injection IM, and Group B (14 patients) received meperidine 75mg and hydroxyzine 75mg IM and a placebo injection IV.Main Outcome Measures: Patients rated their headaches on a scale of 0‐3 prior to treatment and again at 30 and 60 minutes.Results: Both groups experienced improvement in headache severity. (Group A P=0.001 and Group B P=0.003). Improvement in pain scale score was greater for Group A than Group B, (P=0.006). The number of patients having s mild or no headache in Group A (13/14) was significantly greater than Group B (3/14). (P<0.001)Conclusions: The combination of dihydroergotamine and metoclopramide IV should replace the standard IM narcotic and antiemetic as the parenteral treatment of choice for severe migrai

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310560.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY

摘要:

SYNOPSISThe relationships between migraine and A‐V Malformations is a subject of controversy and the arguments are mainly based on case reports and retrospective data. To clarify this subject a structured inquiry and classification of headaches in large samples of patients with intracranial vascular malformations (IVM) is essential. The authors studied the prevalence of headaches in 51 patients with IVM admitted to our Department, between 1984 and 1992. The methods used were a review of medical records followed by a self‐administered headache questionnaire and clinical interview using the IHS criteria for the diagnostic classification of headaches. The relative frequency of the different types of headaches was calculated and compared with the general population data. A correlative study of the headache characteristics with the type and location of the IVM was made. A high prevalence (47%) of migraine type headaches and a strong positive correlation (88.8%) between the site of AVM and side of the pain was found. This is highly suggestive but not conclusive of a pathophysiologic relationship between these entities. The conclusion drawn is that a prospective study of headaches by questionnaire or semi‐structured clinical interview in patients with IVM is essential to discover the effective prevalence and characteristics of headaches associated with IVM and their relation

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1993.hed3310563.x

出版商:Blackwell Science Inc    

年代:1993

数据来源: WILEY