摘要:

SYNOPSISThe early prodromal phase of a migraine attack, poorly documented yet conceivably relevant to the pathogenesisof the attack, was studied in 149 patients, mainly female, with classic or common migraine who were aware ofthese prodromal phenomena. On a questionnaire a variety of prodromes, nearly all well reproduceable, werereported. Day‐before and day‐of‐attack symptoms were noticed by 79% and 88% of the patients, respectively. Inthe other 12–21% signs were mainly observed by the partner. Some prodromes invoked the “cause orconsequence?” question as to certain trigger factors. Others bore rather striking similarities to the classic aura, sothat evolutive symptoms seemed to merge with the early part of the migraine attack. The incidence, or at least theawareness of prodromes was correlated with the occurrence of some factors aggravating the headache and withpost‐attack symptoms, was higher in women, in patients with long‐standing disease and frequent attacks, inpatients who had other types of headaches as well, and in classic mig

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602060.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSIS16 patients suffering from cluster headache (CH) were studied by recording brainstem auditory evoked potentials(BAEPs). Some subjects underwent examination in a pain‐free period, some others during an acute attack, andothers during treatment with lithium.All the data were compared with the BAEPs records of 16 normal control subjects. CH patients showed anasymmetrical interaural pattern, both in the basal condition and in a pain period, greater than the asymmetryoccurring in normal subjects.These specific neurophysiological findings may be evidence for suggesting a central pathogenesis of C

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602067.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISThe typical lateralization of pain and autonomic dysfunction in Cluster Headache has prompted severalresearches, seeking a pathogenetic interpretation of this syndrome, considering this peculiar clinical aspect.In this study, we evaluated VEPs responses in 20 CH subjects, 10 with right‐sided pain and 10 with left‐sided pain,comparing them with 20 VEPs responses in normal subjects. VEPs morphologies and latencies did not differ fromnormal controls. On the other hand, P100amplitudesare significantly lower than controls, on the pain side only.This asymmetry of the response is constant and exceeds normal variation. These data suggest a centralinvolvement in CH pathogenesis. The possible mechanisms of this involvement are discus

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602070.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISThe treatment of refractory or prolonged migraine is a difficult problem for the physician and patient. Treatment varieswith physician and location, but widely accepted is therapy with an injectable analgesic in combination with asedative/antimetic and/or ergotamine.Since prolonged migraine headache is said to be associated with cranial vascular inflammation, the addition ofcorticosteroids to treatment may enhance relief. An analysis was conducted of 162 patients who were treated with andwithout steroids for intractable migraine headache in the emergency department of a large community hospital.Patients were divided into three groups. Group I consisted of 73 patients treated with meperidine and promethazine;Group II, 32 patients treated with dihydroergotamine and meperidine; Group III, 57 patients treated with meperidine,promethazine and dexamethasone. All patients were telephoned 24 hours after treatment to determine the degree ofheadache relief. Twenty‐one patients (29%) from Group I; 12 patients (37%) from Group II; and 41 patients (72%) fromGroup III reported marked relief.From this limited study, it appears that the inclusion of dexamethasone in the treatment of intractable migraineheadache is of benefi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602074.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSIS360 Migraine and tension headache sufferers attending a specialist headache clinic completed theHeadache Scale (HS), the McGill Pain Questionnaire (MPQ) and the Pain Behaviour Checklist. Mood andpersonality were also assessed. The test‐retest reliability of the HS over a one week period was examinedand found to be adequate. Cluster analysis of the HS adjectives resulted in 5 clusters labelled tight, sharp,dull (sensory), discomfort and autonomic (affective). When the severity of headaches was partialled out, asensory and an affective cluster corresponding to the two major components of subjective pain experiencewere obtained. The concurrent validity of the HS was further demonstrated by its having an identicalpattern of association as the MPQ to the Pain Behaviour Checklist, the Wakefield Depression Inventory andthe Eysenck Personality Questionnaire. Scores of the classical and common migraineurs and tensionheadache sufferers on the HS were quantitatively but not qualitatively different. Situations in which the HSmay be used instead of the MPQ are outlined and suggestions for further examination of the validity of theHS are mad

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602076.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISThe calcium entry blocker flunarizine was compared with an antiserotonin agent, pizotifen, in the prophylaxis ofmigraine. Thirty‐five patients were treated under double‐blind conditions for four months. The number of migraineattacks gradually declined in both groups with an eventual mean reduction of 65% and 45% in the flunarizine andpizotifen groups respectively. The efficacy of the former drug developed somewhat faster but no statisticallysignificant differences between the groups were found. Weight gain was the main side effect in both groups. Otherside effects were rare.It is concluded that flunarizine is a useful alternative for the prophylactic treatment of migra

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602083.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISSixty percent of female headache sufferers have an increase paramenstrually. Although behavioraltreatment of migraine and tension headache has proven effective in controlled studies, the effect onparamenstrual increases has rarely been isolated and observed. The purpose of this study was todemonstrate the effects of two types of nonpharmacological treatment on menstrual headache: 1)relaxation with EMG and thermal biofeedback, and 2) person‐centered insight therapy, as an alternativetreatment control. The design was that of the time series method. Diagnosis was made into subtypes ofmigraine, muscle‐contraction, mixed and cluster headache. 16 women with paramenstrual headaches selfmonitored 4 times daily for a 2‐cycle baseline, then were matched on pre‐treatment pain levels into 8 pairsand randomly assigned to treatment, 12 sessions carried out over 3 cycles, with a one‐month follow‐upcycle. Post‐treatment group data analysis was by three‐way analysis of variance with 2 repeatedmeasures. There were no significant main effects of group or time, although individual clinical analysis bypercent improvement demonstrated a trend of greater improvement in the behavioral group. Resultssuggest that nonpharmacological treatment has a lesser impact on menstrually associated headachesthan on headaches not associated wi

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602086.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISA 42‐year‐old patient with a 40‐year history of paroxysmal headache associated with recurrent rightabducens palsy was treated with prednisone for three days following headache onset. Initiation ofprednisone within four hours of headache onset resulted in decreased severity and duration of theheadache and prevention or marked amelioration of the ophthalmoparesis. Therapy delayed beyondeighteen hours had a much less dramatic e

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602093.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISMTo most physicians, Thomas Willis (1621–1675) is only known for the Circle of Willis, but he achievedmuch more: he was one of the three great clinicians of 17th‐century England, and the founder of modernbrain anatomy and clinical neurology. He coined the word “neurology,” discovered reflex action, and wrotethe first textbook of clinical neurology. He made use of an imaginary neurophysiological framework whichenabled him to anticipate numerous discoveries of the 19th century.The first two chapters of the clinical part of his textbook deal with headache. Wolff's hypothesis,“complete migraine,rdquo; the slow spreading of focal symptoms, the cerebral origin of vomiting, and clusterperiodicity are found to be anticipated, at least in part. The combination of hypothetical pathophysiologyand arbitrary nosology is quite suggestive of the present situation, although the system is different.The review is based on the original Latin tex

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602095.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY

摘要:

SYNOPSISA female with multiple personality disorder (MPD) was referred for treatment of several different anddistinct headache problems. This case is presented in detail and the literature is reviewed in regard toheadaches occurring in cases of MPD.In an extensive review of 52 previously reported cases of MPD, headaches was the most frequent somaticcomplaint, occurring in over 60%. Headaches previously reported, however, have never been well definedas to etiology, type or treatment. This paper addresses these areas and the problems involved in makingsuch determinations in this unusual personality disorder.The curious clinical observations about the headaches observed in this case of MPD suggest that thisgroup of headache patients might prove to be a unique population for further study, especially in regard tosolving some of the biochemical and emotional mechanisms of headache, and their possible interactions.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1986.hed2602099.x

出版商:Blackwell Science Inc    

年代:1986

数据来源: WILEY