ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s1.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

Tension‐type headache is the term designated by the International Headache Society to describe what was previously called tension headache, muscle contraction headache, psychomyogenic headache, stress headache, ordinary headache, and psychogenic headache. The International Headache Society defines tension‐type headache more precisely, distinguishes between the episodic and the chronic varieties, and divides them into two groups, those associated with a disorder of the pericranial muscles and those not associated with this type of disorder. Most clinic‐based studies of tension‐type headache suffer from selection bias, as they include patients with more severe headaches, patients with concomitant migraine, and patients with chronic daily headache. Traditionally, episodic tension‐type headache and migraine have been considered distinct disorders, and the International Headache Society continues the separation, Some believe that both migraine and tension‐type headache are recurring benign headaches. Chronic tension‐type headache used to be called chronic daily headache, but they are not identical, Chronic tension‐type headache must be distinguished from chronic daily headache even though the International Headache Society has not done this. Chronic daily headache is a syndrome consisting of a group of disorders and can be subclassified into primary and secondary types, The primary chronic daily headache disorders include transformed migraine, chronic tension‐type headache, new daily persistent headache, and hemicrania continua. Secondary causes of chronic daily headache include post‐traumatic headache, cervical spine disorders, and headache associated with vascular disorders and nonvascular intracranial disorders. Patients with frequent headaches are prone to overuse analgesics, ergotamine, or both. Most patients with chronic daily headache overuse symptomatic medication. Treatment is most difficult for patients with chronic daily headache. These patients often have physical and emotional dependency, low frustration tolerance, a sleep disturbance, and depression. Stopping overused medication is crucial. Detoxification is difficult and frequently requires hospitalization and aggressive

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s2.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

Migraine is a very common phenomenon. Eighteen percent of women in this country and 6% of men have migraine. The old classification for headaches and diagnostic criteria were published in 1962, more than a quarter of a century ago. In 1988, the International Headache Society published a new classification and diagnostic criteria for all headache disorders, cranial neuralgias, and facial pain. The International Headache Society classification divides migraine, as it had been divided in the past, into two major categories: migraine without aura (formerly called common migraine) and migraine with aura (formerly called classical migraine). These criteria are rather complex and simpler criteria are proposed for clinical practice. The typical patient with migraine is a woman whose headaches began in adolescence or young adult life. There usually is a family history of migraine. Migraine is almost always more than just a headache. Virtually anything in the external environment and many things in the internal milieu may provoke migraine in a susceptible individual. There are many potential manifestations of the aura of migraine, but 90% are visual phenomena. Migraine in children is a little different than in adults. When the onset is below the age of puberty, the ratio of females to males is equal, but after puberty there is a striking predominance of women over men in a ratio of 3:1. Whenever the history of migraine is not typical or if something unexpected is found on examination, imaging studies are warranted.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s8.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

Migraine occurs in about 10% of the population in the United States and the United Kingdom. In the United States there seem to be more complicated patients and the expectations of the patient are higher. In the United Kingdom there is a tendency to use single rather than compound formulations, and drugs such as barbiturates cannot be prescribed for migraine. In treating migraine the first and most important thing is to get the correct diagnosis which depends on the history and the absence of abnormal physical signs. Investigations do not confirm the diagnosis of migraine, they are only necessary to exclude other causes of headaches. Most sufferers from migraine have less than four attacks a month. Attack therapy is usually all that is required, and over the past 20 years efficient attack therapy has been developed. This depends mainly on sleep, an antinauseant, analgesics, ergotamine and more recently sumatriptan.

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s13.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

ABSTRACTThe present study investigated the association between psychopathology and headache in a prospective longitudinal epidemiologic study of a cohort of 19‐ and 20‐year‐olds in Zurich, Switzerland. Prevalence rates of psychopathology by headache subtype were examined both cross‐sectionally and longitudinally. Psychiatric disorders were evaluated using a direct interview administered by experienced clinicians. Personality was assessed using the Freiburg Personality Inventory and the Symptom Checklist 90. In general, subjects with migraine had more affective and anxiety disorders and exhibited elevated rates of neuroticism and somatization compared to nonmigraine subjects. When examined by headache subtype, migraineurs with aura exhibited greater rates of psychopathology and more personality abnormalities than any of the other headache subtypes or controls. In contrast to clinical wisdom, subjects with tension‐type headache did not differ from controls in rates of psychopathology or on any of the personality or sympto

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s17.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408s23.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISThe aim of this study was to clarify the changes of inhibitory interneuronal activity in patients with chronic tension‐type headache with disorder of pericranial muscle after treatment, and the pharmacological mechanisms of tizanidine‐ an alpha2 adrenergic agonist. The effects of tizanidine on exteroceptive suppression (ES) of the temporalis muscle were examined in eighteen patients with chronic tension‐type headache with disorder of pericranial muscles, before and two weeks after the administration of tizanidine. The left mental nerve was stimulated, under the maximal voluntary contraction of the temporalis muscles. Two types of stimulation were used: weak stimulation with four times the sensory threshold, and strong stimulation with 10 times the sensory threshold. The rectified electromyographic activity was recorded from the right temporalis muscle. ES2 produced by four times the sensory threshold was lengthened after tizanidine administration. This fact suggests that tizanidine improves the inhibitory function in the central nervous system, and then relieves headache. However, ES produced by 10 times the sensory threshold did not change. This suggests that the effect of tizanidine may be relatively mild. The interneurones mediating ES2 may be modified by the alpha2 ag

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408455.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISThe pathogenetic mechanism of tension headache (TH) is still unknown. The role of pericranial muscle tension in TH is also enigmatic. To evaluate this factor in chronic TH, pericranial muscles were paralysed in 6 chronic TH patients, using botulinum toxin. All patients fulfilled the IHS criteria of chronic TH associated with involvement of the pericranial muscles, but not the current criteria for cervicogenic headache. The patients were followed‐up regularly with evaluation of the paralysis, changes in pain intensity, and pressure pain threshold measurements. We primarily only injected the temporal muscle on the one side, using the other side as a control. Contralateral muscles were in some cases injected at a later stage. In our study, we did not find any significant reduction in pain intensity, as measured by the visual analogue scale, nor any changes in pressure pain threshold, as measured by an algometer. On the basis of our observations, we conclude that muscle tension in these muscles possibly plays a minor role in the genesis of chronic TH. In our study, however, we have only treated a limited number of patients, and only one pericranial muscle has been injected systematically. Further studies of various neck/posterior head muscles ought to be performed in order to further evaluate a possible effect of tension in the pericranial musculature in producing this type of pai

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408458.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISA 25‐year‐old man, subject to bouts of left supraorbital cluster headache on an annual basis over the previous 8 years, volunteered for MRI angiography during an active period. Studies were conducted before and during a typical cluster headache attack induced by alcohol. MRI angiography failed to show dilatation of the ophthalmic artery on either the symptomatic side, or the non‐symptomatic side during headache, nor was there observed any dilatation of the anterior cerebral arteries on either

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408463.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY

摘要:

SYNOPSISWe prospectively assessed inter‐observer agreement in the diagnosis of recurrent headaches in children. Clinical letters containing information on 40 children with headaches (age 4.3 to 17.8 years, median 10.4 years) were given to four Pediatric Neurologists. One or more headache types could be checked off on a data sheet that listed the main types recognized by the International Headache Society and an additional one, “combined migraine and tension‐type headache”. There were six combinational pairs of neurologists. The six pairs yielded 240 sets of diagnoses. Percentage agreement ranged from 45% to 78%, Kappa values from 0.20 to 0.59, and weighted Kappa from 0.19 to 0.52 within the six pairs. Agreement was 76% when both neurologists in a pair assigned single headache types and 4% when one or both neurologists diagnosed multiple types. The International Headache Society suggests that patients may have multiple types of headache and recommends that all types be classified. We suggest that the option of diagnosing more than one headache type from data in clinical letters may reduce inter‐observer

ISSN:0017-8748    

DOI:10.1111/j.1526-4610.1994.hed3408467.x

出版商:Blackwell Science Inc    

年代:1994

数据来源: WILEY