bluuebunny/crossref_metadata_2025 huggingface dataset:
An Unusual Case of Migraine Accompaniments With Permanent Sequela ‐ A Case Report
Authors: Fisher C.M.
Published: June 2005

SYNOPSIS

A woman aged 44 had recurrent migrainous scintillating scotomas without headache one or more times daily beginning before the age of 7. Spells were brought on by hunger, anger and regularly by straining to have a bowel movement. At age 44, while straining, she experienced a sharp pain in the head, a buzzing sound, virtual blindness and numbness of the left side. A left homonymous hemianopia persisted. During convalesence she experienced unusually vivid hallucinations in the hemianopic field and on phenytoin sodium therapy two sets of hallucinations ran at the same time. The head pain of this type of “catastrophic migraine” may be a third type of migraine pain.
Platelet Activation and Migraine: A Study with Flunarizine
Authors: D'Andrea Giovanni , Cananzi Antonio R. , Toldo Moreno , Ferro‐Milone Francesco
Published: June 2005

SYNOPSIS

Although in common and classic migraine there is platelet activation both during painful attack and headache‐free periods, the role of platelets in migraine pathogenesis is not yet understood. Therefore, in order to investigate the relationship between platelets and migraine pathogenesis, β‐thromboglobulin (β‐TG) and platelet factor four (PF4), both platelet‐specific alpha granule proteins, were assayed in a group of patients with classic and complicated migraine before and after administration of an anti‐migraine drug, flunarizine, at a dose of 10 mg/daily. Blood samples for β‐TG and PF4 assay were collected for ten days in which the patients were headache‐free. β‐TG and PF4 plasma levels were elevated in all patients in comparison with control subjects. The patients with complicated migraine showed the highest plasma values. During flunarizine treatment β‐TG and PF4 levels persisted elevated in all patients, although a slight decrease of β‐TG plasma levels was observed. This data confirmed, as our previous works, that classic migraine is characterized by platelet activation “in vivo,” but that this may not be strictly related to migraine pathogenesis.
The Effect of Muscle Contraction Headache Chronicity on Frontal EMG
Authors: Callon Eleanor B. , Brantley Phillip J. , McAnulty David R , Waggoner Craig D. , Rappaport Neil B. , Goreczny Anthony J. , Jones Glenn N.
Published: June 2005

SYNOPSIS

The purpose of this study was to test the effect of muscle contraction headache chronicity on electromyographic (EMG) response.

Frontal EMG was measured under two stress conditions and three baselines for subjects complaining of muscle contraction headaches for (1) 3 19 years, (2) £ 10 years, and (3) subjects not complaining of headaches of any kind. There were ten subjects in each group. The three groups were equivalent in age and sex distribution. They did not differ in their ratings of the stressfulness of the experimental conditions. Neither ANOVA nor ANCOVA with frequency of headache as the covariate supported Group differences or Group X Trials interactions. The results do not support the hypothesis that changes in frontal musculature occur as a function of the number of years that an individual has had a problem with muscle contraction headaches. The results are consistent with those of other EMG investigations employing an adaptation period of 3 5 minutes. They are also supportive of the recent skepticism about frontal EMG biofeedback as a critical component in the treatment of muscle contraction headaches.
Cephalic Hyperemia During Migraine Headaches. A Prospective Study
Authors: Meyer John Stirling , Zetusky Walter , Jonsdottir Maria , Mortel Karl
Published: June 2005

SYNOPSIS

For the past 6 years, patients with headaches followed and treated by this laboratory have undergone ateach visit serial measurements of regional cephalic blood flow (rCBF) with neurological and medicalexaminations, direct interviews and completion of questionnaires regarding type, frequency, presence andseverity of head pain. Of 369 patients referred with recurrent headaches, 324 were classified classic,common, or complicated migraine, either alone or in combination with muscle contraction headaches(mixed headaches) and 45 were considered to have pure muscle contraction headaches. For purposes ofthis report, patients with cluster headaches were excluded. Forty‐two percent (136) complained ofheadaches at the time or rCBF measurements. Of these 136, 60 cases had paired CBF measurementsduring headache and when headache‐free and comprise the case material analyzed. Most headaches (61%)occurred during the initial visit. During spontaneous migraine headaches, rCBF increases (hyperemia)were present among 58% of patients classified as classic migraine, 53% classified as common migraine,25% classified as complicated and 31% classified as mixed. Cephalic blood flow values were reducedduring prodromes of classic migraine. Patchy zones of oligemia and hyperemia appeared at the onset ofheadache. Cephalic hyperemia usually returned to normal values a few days after headaches subsided.During headache, 32% of the patients showed gross dysautoregulation with paradoxical flow increasesduring 100% oxygen inhalation. Results are consonant with a vascular pathogenesis for prodromes andheadaches of migraine.
Immunological Studies in Cluster Headache and Migraine
Authors: Visintini D. , Trabattoni G. , Manzoni G.C. , Lechi A. , Bortone L. , Behan P.O.
Published: June 2005

SYNOPSIS

Serum complement component concentrations and immune complexes were studied in 47 patients withcluster headache, 32 with common migraine, 12 with classical migraine and two with possible milk‐allergicmigraine. No significant differences were found between the groups and two control populations: 63neurological patients without migraine and 30 normal healthy volunteers. The findings were similar both inand out of active periods of cluster headache and before and during migraine attacks. Bovine serumalbumin was detectable in the serum of the two cases postulated to have milk‐allergic migraine afteringestion of milk, but in neither case was an attack of migraine precipitated. Our results do not supportimplication of the complement system in either type of headache.
ATP Hyposecretion From Platelet Dense Bodies ‐‐ Evidence for the Purinergic Hypothesis and a Marker of Migraine
Authors: Joseph Rajiv , Welch K.M.A. , D'Andrea Giovanni , Levine Steven R.
Published: June 2005

SYNOPSIS

We tested the hypothesis that in migraineurs, there is hypofunction of the cerebral vasodilator purinergicsystem, which utilizes ATP and other adenine nucleotides as neurotransmitters. Besides being present inneuronal vesicles, ATP exists in a uniquely sequestered form in the dense bodies of platelets which are amodel for the study of neuronal vesicular function. Platelet ATP‐release and aggregation were measured inwhole blood by the newly developed impedance technique using collagen and epinephrine as inducingagents. Consistent with other reports, no responses were seen with epinephrine. With collagen induction,aggregation was nearly equal in controls and migraineurs. However, ATP‐release was significantly lowerin migraineurs with the higher collagen concentration. Stepwise logistic regression predicts that for each100 unit decrease in ATP‐release, the chances of being a migraineur increases by 1.89. We believe thatdecreased platelet ATP‐release is a marker of migraine reflecting hypofunction of the purinergic system,and as a result a relatively greater tendency for vasoconstriction which predisposes to migraine attacks.
Cardiovascular Reflex Responses During Migraine Attack
Authors: Havanka‐Kanniainen H
Published: June 2005

SYNOPSIS

The cardiovascular reflex responses of 10 migraine patients were recorded during both migraine attacks andheadache‐free intervals. Ten healthy subjects of similar age and sex served as a control group.When the results of the measurements for migraine patients performing an isometric work test duringmigraine attacks and during headache‐free intervals were compared, during migraine attacks a statisticallysignificant smaller increase in diastolic B.P. was encountered than interictally (p<0.05).When the results for migraine patients during migraine attack, and controls, were compared, statisticallysignificant differences were encountered in the pulse rate variation in Valsalva manoeuvre, in an orthostatictest, and in the systolic and diastolic blood pressure reactions in an isometric work test. The mean Valsalvaratio and R‐R‐interval ratio during the orthostatic test were lower in migraine patients during migraine attackthan in controls, and the mean blood pressure rise in the isometric work test was also lower in the migrainepatients group during attacks.There were no statistically significant differences between the results of the migraine patients duringheadache‐free intervals and those of the control subjects.
Differential Effects of Training in Relaxation and Stress‐Coping in Patients with Migraine
Authors: Sorbi Marjolijn , Tellegen Bert
Published: June 2005

SYNOPSIS

The effects of a psychophysiological treatment (relaxation training) and a psychological treatment(stress‐coping training) were tested in 29 patients suffering from migraine.There were significant pre‐post reductions in migraine variables and drug consumption. The effects didnot differ between the types of training, and remained stable for a medium‐term follow‐up of 8 months. Wethink, however, that stress‐coping training may in course of time be superior in maintaining training gains.Although this assumption cannot yet be tested for longer follow‐up periods, there was a non‐significanttrend for stress‐coping training to be more effective in migraine 8 months after training.There were different effects on social behavior: patients receiving relaxation training became moresocially withdrawn, while patients who underwent stress‐coping training increased their socialassertiveness. Furthermore, according to the participants, relaxation training had a stronger impact onmigraine, whereas stress‐coping training was more directed at migraine‐related stress. However, pre‐postcomparisons of the patients' coping with stress for the most part did not reveal significantly differenteffects between the two types of training.
Benign Paroxysmal Vertigo in Childhood: A Longitudinal Study
Authors: Lanzi G. , Balottin U. , Fazzi E. , Mira E. , Piacentino G.
Published: June 2005

SYNOPSIS

21 children suffering from benign paroxysmal vertigo (BPV) were submitted to complete otoneurological examination, including caloric and rotational tabyrinthine stimulation with ENG recording, and to headache provocation tests with nitroglycerin, histamine and fenfluramine. Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulo‐cerebellar pathways. Headache provocation tests were positive in 10 out of 15 children, and in 5 cases they induced a typical vertiginous attack instead of headache.

Several children had a positive family history for migraine. Sometimes headache was associated with the vertigo attack. Sometimes other signs of a “periodic syndrome” (motion sickness, cyclic vomiting, abdominal pain) occurred at times which were unrelated to vertiginous attacks. During the follow‐up period, some children responded positively to migraine treatment.

By the authors, BPV is considered a migraine equivalent or a migraine precursor, and could be due to the same pathogenetic mechanisms responsible for the migraine.
Migraine and Intercalated Seizures With Occipital EEG Paroxysms: Observations on a Family
Authors: Terzano Mario Giovanni , Pietrini Vladimiro , Parrino Liborio , Milone Francesco Ferro
Published: June 2005

SYNOPSIS

A 12‐year‐old girl presented three distinct attacks of classic migraine. In all attacks, an occipital seizure with impairment of consciousness was intercalated between the visual prodrome and the headache. A right occipital epileptogenic focus was detected by the EEG. Neurologic examination was normal. CT‐scan and laboratory work were unremarkable. Flunarizine treatment controlled both the migraine and seizure components. Periodic migraine episodes with visual phenomena occurred in three other female components of the same family. However, the attacks were never associated with epileptic manifestations. Only the 10‐year‐old sister, who suffered from common migraine, showed sporadic interictal EEG abnormalities in the right posterior leads.

The possible neurophysiologic interplay between classic migraine and epilepsy in intercalated attacks may be explained on the basis of the “spreading depression” mechanism. The intense neuronal excitation preceding the migraine aura might play a “triggering” role on the occipital epileptogenic focus.

Similarities and differences between this benign though unusual syndrome and other forms of epilepsy in childhood, are also discussed.
Migraine‐Induced Epistaxis
Authors: Sperber Ami D. , Abarbanel Jacob M.
Published: June 2005

SYNOPSIS

We report the case of a woman with recurrent episodes of throbbing head pain which culminate in epistaxis, which in turn seems to speedily end the headache. There is no evidence of intracranial or nasal pathology. References in the literature to the association between migraine and epistaxis are sparse.
Posterior Cervical‐Thoracic Thermograms: Pattern Persistence and Correlation with Chronic Headache Syndromes
Authors: Swerdlow Bernard , Dieter John Nathan
Published: June 2005

SYNOPSIS

These experiments investigate thermographic patterns in the posterior cervical/thoracic (PCT) region of 530headache patients and 30 headache/injury‐free volunteers. The study examines: The longitudinal persistence ofProximal and Distal patterns; three distinct midline patterns (PCT I, II, and III); and their correlation with diagnosis,injury, and pain.

Twenty‐four (80%) of 30 randomly selected subjects displayed unchanged Proximal patterns at the meanobservation period of 5.5 months. PCT pattern fluctuations occurred in 13/30 (43.3%) subjects. The distinctivenessof each subject's Proximal and Distal patterns was verified by blind calling of thermogram pairs. Patternpersistence was validated with alcohol spray‐Patterns were identical regardless of using a 0.5°C or 1.0°Ctemperature setting. Temperature settings of 1.0°C yielded more distinct Proximal and Distal patterns.

Chi square analysis determined that there was no significant difference in the number of PCT III patterns in theexperimental or control groups.

In conclusion, it appears that Proximal and Distal Patterns may be consistent over time and individually unique,but that PCT patterns fluctuate and, therefore, do not correlate with chronic headaches.
Personality and Behavioural Characteristics in Pediatric Migraine
Authors: Cunningham S.J. , McGrath P.J. , McGrath P.J. , McGrath P.J. , McGrath P.J. , Ferguson H.B. , Humphreys R , D'Astous J. , Latter J. , Goodman J.T. , Goodman J.T. , Goodman J.T. , Firestone R
Published: June 2005

SYNOPSIS

Personality and behavioural features in pediatric migraine were investigated in a comparison study of 20boys and girls with migraine, matched for age and sex with a “pain” control group of 20 children withmusculoskeletal pain, and with a “no‐pain” control group of 20 children. When the amount of pain experiencedby children was controlled, the only discriminating variable was that of somatic complaints which includedvomiting, nausea, and perceptual disturbances, all migraine‐related phenomena. The inclusion of the “pain” control group in this investigation yielded results which indicated that the behavioural and personality featuresthought to be characteristic of childhood migraine are common to a chronic pain disorder and in fact, themanifestation of many of these features correlate directly with the amount of pain experienced. It is suggestedthat the personality and behavioural characteristics evident in many children with migraine may result from therecurrent chronic pain episodes rather than in some way being causative of the pain.
Variations in the Leu7+ and LeuM3+ Leukocyte Subpopulations Observed in Cluster Headache are Dependent on HLA‐DR Antigens
Authors: Giacovazzo M. , Martelletti P , Valeri M. , Piazza A. , Monaco P.I. , Casciani C.U.
Published: June 2005

SYNOPSIS

The subpopulations of T‐lymphocytes and monocytes were studied in 21 Episodic Cluster Headache (ECH) patients, both in and out of the crisis. The following MoAb of the Becton‐Dickinson series were used: Leu1 (pan T cells), Leu2a (suppressor/cytotoxic cells), Leu3a (helper cells), Leu7 (NK cells) and LeuM3 (monocytes). All the subjects were typed for the HLA‐A,B,C and DR antigens of the Human Major Histocompatibility Complex. 10 patients out of 21 were DR5+. Thus, two groups could be distinguished: DR5 + patients and DR5‐ patients. We correlated the variations of the leukocyte subpopulations in and out of the crises with the two groups, since HLA‐DR antigens are related to the immune response.

A significant increase of the LeuM3 + cells during the crisis was observed in DR5‐ group (26.2 ± 7.7 vs 18.3 ± 7.1; p < 0.05). In the DR5 + group there was an increase of the Leu7 + cells during the crisis (18.1 ± 6.7 vs 12.7 ± 4.9; p < 0.05) whereas outside of the crisis the LeuM3 + subpopulation increased (21.9 ± 7.6 vs 18.3 ± 7.1; p < 0.02) in the same group. The observed values of the leukocyte subpopulations studied (difference between the data of crisis and out of it) in the two groups were not significantly different. These data confirm our previous studies on Leu7+ and LeuM3 + subsets in ECH patients. Moreover, they allow new speculation about a possible role of Class II antigens (HLA‐DR) in ECH.
Long‐Acting Propranolol in the Prophylaxis of Migraine
Authors: Diamond Seymour , Solomon Glen D. , Freitag Frederick G. , Mehta Nilesh D.
Published: June 2005

SYNOPSIS

A retrospective chart review of 200 patients with headache who had been treated with long‐acting propranolol indicated that this agent is as safe and as efficacious as regular propranoIol in the prophylaxis of migraine. Overall, 57% reported good or excellent results. Only 7% had to discontinue treatment because of side effects. Compliance was excellent with the long‐acting form.
Subchronic Cluster Headache
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

A subgroup of 33 patients were distinguished from 59 other patients with episodic cluster headache by shorterremission periods, specifically of less than six months duration. This subgroup (subchronic cluster headache)was compared to episodic cluster headache patients and an additional 29 patients with chronic cluster headache,for differences in several clinical parameters.Results of this study demonstrated that the subchronic group was clinically similar to the chronic group andsignificantly different from episodic cluster headache patients. Thus, sub‐chronic cluster headache wascharacterized by an increased frequency of treatment‐resistance, headache attacks, drug abuse, hypochondriasisand prolonged cluster periods.Results of this study suggests that subchronic cluster headache, as defined by remission duration of sixmonths or less, may be a clinically relevant class of cluster headache. Distinction of this subgroup from thebroader “episodic” category may permit more accurate prognostic and therapeutic capabilities.
On Specific Behavior of Migraine Patients in an Anger‐Provoking Situation
Authors: Grothgar Barbara , Scholz O. Berndt
Published: June 2005

SYNOPSIS

The purpose of this controlled study was to compare anger experience, anger‐relevant psychophysiological parameters, and expressive anger behavior of migraine patients, with those of pain patients and of healthy controls. Based on the probability of solving anagram tasks, we defined an anger‐provoking condition and a control condition. Data from 72 female subjects were used for analysis. Migraine patients showed a deficit in open anger behavior; their diastolic blood pressure decreased and their pulse pressure (SBP‐DBP) was higher compared to the two control groups. They did not differ with respect to their self‐reported anger experience.
The Role of MRI in the Evaluation of a Migraine Population: Preliminary Data
Authors: Kaplan Robert D. , Solomon Glen D. , Diamond Seymour , Freitag Frederick G.
Published: June 2005

SYNOPSIS

Analysis of preliminary data comparing contrast enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) in a migraine population strongly suggests that MRI is a necessary adjunct in the detection of intracerebral pathology. Additional information obtained utilizing cerebral MRI was present in approximately 33 percent of cases. Two patients demonstrated findings consistent with cerebral infarction, without comparable abnormality on CECT. Most striking was the discovery of a high signal intensity focus in the medulla of a 24 year old female with a normal CECT. This proved to be a malignant astrocytoma.
Migraine, Large Pupils, Mitral Valve Prolapse and Emotional Disturbances: An Autonomic Disorder
Authors: Herman Peter
Published: June 2005

SYNOPSIS

Thirteen young women with vascular headaches and unusually large pupils seen at the Mount Sinai Headache Clinic, were investigated for the presence of autonomic dysfunction. Two had had a significant cerebral event: one, a frontal infarct and one, a transient hemisphere deficit.

Measurement of the pupil size by pupillography showed only a small increase in size after Paredrine drops, indicating a partial saturation of iris adrenergic receptors.

Hypertension was present in three, and low blood pressure in five. Red blotching of the face, neck, and thorax was present in seven. Emotional disturbances ranging from neurosis to manic depressive episodes and schizoid features were present in all. Echocardiography performed in nine patients demonstrated a mitral valve prolapse in eight.

The severe headaches, as well as the mood swings and occasional cardiac complaints, responded well to propranolol (Inderal). This syndrome of autonomic dysfunction is thought to be a variant of “hyperdynamic ß adrenergic circulatory state” (1–2) affecting the vessels of the scalp, skin, heart, and iris.

The presence of M.V.P. places these migraine patients in a certain cardiac and neurologic risk category. Young patients with a diagnosis of ophthalmoplegic and hemiplegic migraine, should have a thorough cardiac evaluation in addition to CT Scan.
Pharmacological Treatment of Primary Headache: Analysis of Current Practice From a Drug Utilization Study
Authors: Scarani Gabriella , Beghi Ettore , Tognoni Gianni
Published: June 2005

SYNOPSIS

In a retrospective analysis of the records of 500 patients with “primary headache” (i.e. unknown etiology) it was found thattreatments prescribed by the clinic physicians varied widely, seemed not to be closely correlated with the subtype of headache (e.g. migraine, muscle contraction), and seemed not to reflect the recommendations given in controlled studies in the scientific literature. A very large number of drugs were used, often in combinations, and some had scant or no rationale for use for the indication of headache. Efficacy varied, but over time only 30% seemed to maintain a degree of effectiveness.

Many drug studies in the literature are artefactually clear cut in terms of composition of patients with “pure” headache subsets, and include a relatively short follow‐up. A more realistic appraisal of a drug's everyday efficacy could be obtained by utilizing patient populations which more accurately reflect reality, and by following them up for prolonged periods.
The Natural History of Episodic Cluster Headache
Authors: Sacquegna T. , de Carolis P. , Agati R. , de Capoa D. , Baldrati A. , Cortelli P.
Published: June 2005

SYNOPSIS

We studied the course of episodic cluster headache in 72 patients. Sixty‐two cases (86%) had a regular frequency of clusters per year. Most patients suffered from 1 bout a year. A prolonged remission (> 1 year) did not change the frequency pattern of clusters per year. Fifty patients (69%) had a fixed pattern both of frequency and duration of bouts. Thirty‐seven patients (51%) had a regular frequency of bouts per year, a fixed duration of bouts and a fixed frequency of attacks a day.

Our results show that the natural history of most cluster headache (CH) patients is characterized by a regular pattern.
Stroke in Migraine as a Consequence of Propranolol
Authors: Bardwell Avelina , Trott Justina A.
Published: June 2005

SYNOPSIS

There have been two previous case reports of complicated migraine headaches associated with the use of beta blockers. In this article we report a third case of complicated migraine in a patient with longstanding migraine headaches taking propranolol for hypertension. Visual field testing demonstrated a left homonymous hemianopsia and CT scan revealed a low density defect in the left posterior parietal‐occipital area without enhancement. A review of the literature on stroke in migraine and the mechanism of action of beta‐blockers are included. We question the appropriateness of the use of beta‐blocking agents for prophylaxis of migraines associated with or preceded by conspicuous sensory or motor deficits.
Nimodipine in Episodic Cluster Headache: Results and Methodological Considerations
Authors: de Carolis P. , Baldrati A. , Agati R. , de Capoa D. , D'Alessandro R. , Sacquegna T.
Published: June 2005

SYNOPSIS

The aim of this study was to evaluate the effect of Nimodipine on episodic cluster headache. 13 patents were studied in an open trial. The study design required that treatment be started 2 to 10 days after the beginning of cluster cycle. Nimodipine stopped clusters in 7 (53%) out of 13 patients within 10 days of treatment. We discuss the methodological aspects of drug assessment in episodic cluster headache.
Whiplash and Its Relationship to Migraine
Authors: Winston Ken R.
Published: June 2005

SYNOPSIS

Five patients with severely symptomatic cervical injury of the type commonly referred to as ‘whiplash’ were discovered to also have many migrainous features and all were successfully managed with medications. The relationship of whiplash to migraine is discussed and the argument made that whiplash is trauma‐precipitated cervical migraine.
Severe Headaches in the African: Report on 250 Cases from Sierra Leone, West Africa
Authors: Lisk Durodami Radcliffe
Published: June 2005

SYNOPSIS

The pattern of severe headaches in a clinic population of 250 indigenous Sierra Leonean Africans is studied. The sex ratio was 2.2 females to one male. The commonest cause of severe headaches was migraine, both common and classical, accounting for over 40% of cases. Next most common was tension headache. The prevalence of sinusitis of etiological importance was high at 15.6 per cent. Environmental and local cultural factors may contribute to such a high proportion. Hypertension, on the other hand, though a widespread medical problem accounted for only 4.4 percent of cases.

The prevalence of sickling positivity, though higher in the migraine groups, was not significantly higher than in the general population.

Four patients with severe headaches died mainly from tumors and hemorrhage giving a mortality of about 1.6%.

It appears as if the pattern of severe headaches in the Sierra Leonean African is basically similar to that of other racial groups.
Internal Ophthalmoplegia in Complicated Migraine: A Case Report
Authors: Bussone G. , Mantia L. La , Grazzi L. , Lamperti E. , Boiardi A.
Published: June 2005

SYNOPSIS

A 25 year old woman with a history of migraine came to our observation complaining of blurred vision and mydriasis in the right eye, starting several hours after a typical attack of common migraine had resolved. We believe this to be a case of ophthalmoplegic migraine characterized by only an isolated internal ophthalmoplegia without external third nerve involvement.

Differential diagnosis and possible pathogenetic aspects are discussed.
Seizures in Migraine: Warning of an Underlying Cerebral Infarction?
Authors: Shuaib Ashfaq , Lee Mary Anne
Published: June 2005

SYNOPSIS

Reports of an association between migraine and seizures have existed for a long time. A syndrome of basilar artery migraine, seizures and abnormal EEG's has also been published. We now report four patients with seizures and migraine in whom we feel the seizures were secondary to cerebral infarctions. Migraine was of the classical type in all patients and the auras were predominantly visual, Neurological symptoms associated with the cerebral infarctions were mild or transient and could have easily been dismissed as “complex migraine”. CT scans showed cerebral infarctions involving the occipital cortex in all four cases. Two‐dimensional echocardiography revealed mitral valve prolapse (MVP) in two cases and a bicuspid aortic valve in one case. In two cases, both with MVP, there were more than one cerebral infarctions.

Seizures may be an early warning of cerebral infarctions in patients with migraine and should alert the physician towards such a possibility.
Behavioral Research on Headaches: a Coded Bibliography
Authors: Martin Paul R. , Marie Gregory V. , Nathan Paula R.
Published: June 2005

SYNOPSIS

This coded bibliography aims to include all behavioral headache research published to date. Four hundred and forty references have been found predominantly through Psychological Abstracts and the journal Headache. Each article has been coded according to seven variables which describe the subject sample, and thirteen variables which describe the focus or topic of the study. Each reference preceded by the reference number, subject code, number of subjects in the study, and the topic code. Examples of subject codes are the types of headache the subjects were suffering from; and examples of topic codes are studies focussing on psychophysiological mechanisms, biofeedback training and personality. A table of reference numbers lists the articles pertaining to each topic starting with those including both tension headache and migraine subjects, followed by those including only tension headache subjects, then migraine only, and finally, ‘other’. Hence, this table enables rapid retrieval of references according to the focus of the study and characteristics of the subject sample.
Hypermetabolic Disorders Presenting as Headache with Anxiety and Depression
Authors: Metzer W. Steven , Lucy Dennis D.
Published: June 2005

SYNOPSIS

Patients with anxiety and depression frequently complain of headache chronically. Two cases of patients with hyper‐metabolic disorders presenting as headache with anxiety and depression are presented. One patient had a pheochromocytoma and one patient had hyperthyroidism. In addition to specific neurologic and psychiatric disorders, hypermetabolic disorders should be considered in the differential diagnosis of chronic cephalgia with anxiety and depression.
Complete External Ophthalmoplegia in a Case of Pseudotumor Cerebri
Authors: Landan Ivan , Policherla Haranath , McLaurin Jasper
Published: June 2005

SYNOPSIS

A 28 year old woman was admitted to the hospital with a 4 month history of headaches and blurred vision and a 2 week progressive loss of visual acuity. On examination she was found to have complete external ophthalmoplegia, florid papilledema and an otherwise normal neurologic examination. Cerebrospinal fluid pressure and protein supported the diagnosis of pseudotumor cerebri. A normal cerebral angiogram and “slit‐like” ventricles on brain computed tomography supported the diagnosis. She was treated with cortico‐steroids, and acetazolamide and underwent optic nerve fenestration bilaterally. This resulted in complete resolution of the ophthalmoplegia and papilledema.
Five Year Prospective Follow‐up on the Treatment of Chronic Headache with Biofeedback and/or Relaxation
Authors: Blanchard Edward B. , Appelbaum Kenneth A. , Guarnieri Patricia , Morrill Belinda , Dentinger Mark P.
Published: June 2005

SYNOPSIS

We have followed‐up, by means of 4 weeks of headache diary, 21 chronic headache patients (9 tension, 12 vascular) annually for 5 years after the successful completion of biofeedback and/or relaxation training. Results show 78% tension headache patients and 91% of vascular headache patients are still significantly improved.
Headache and Subacute Sinusiris in Children and Adolescents
Authors: Faleck Herbert , Rothner A.D. , Erenberg Gerald , Cruse Robert P.
Published: June 2005

SYNOPSIS

The medical records of 150 children and adolescents with chronic headaches seen during 1984 and 1985 were reviewed. Sinus pathology diagnosed radiographically was present in 15 patients. None had prominent respiratory symptoms. All improved with appropriate therapy directed toward the sinus pathology. The importance of including sinusitis in the differential diagnosis when seeing children and adolescents with chronic headache is emphasized.
Effectiveness of Nadolol in a Clinic Population of Migrainous Patients
Authors: Medina José L. , Medina José L.
Published: June 2005

SYNOPSIS

An uncontrolled 15‐month prospective study was conducted in a clinic population of 116 migrainous patients who received 20–240 mg. of nadolol dally (average = 46.9 mg) for 1–15 months (average = 7.0 months). The 116 patients were classified into: Group A ‐ 33 patients who partially responded to proprenolol who were switched to nadolol; Group B ‐ 48 patients with mixed migraine and muscle contraction headache who had partially responded to antidepressants; and Group C ‐ 35 new patients who were treated with nadolol. Eleven patients were lost to follow‐up. In Group A, 3 patients did equally well on both medication, 19 (61.2%) did better on nadolol, and 7 (22.5%) did worse. In Group B, 21 patients (45.7%) responded to nadolol and in Group C, 21 (75.0%). It took an average of 3 months before nadolol achieved complete control of the headaches in 17 patients. Response to nadolol could not be linked with beta blockade and the daily dose required was low (average = 39.7 mg.). This study suggests that nadolol is effective and safe in the long‐term therapy of migraine and may become more effectual with time. Its spectrum of efficacy includes simple migraine headaches, and the less responsive, intricate types of migrainous headaches of the Headache Clinic population.
Vascular Changes in Atypical Facial Pain
Authors: Drummond Peter D.
Published: June 2005

SYNOPSIS

Thermographic assessment of the facial circulation in nine patients with unilateral atypical facial pain indicated that heat loss was greater from the cheek or orbit on the side of pain in the majority of patients, The unilateral increase in facial blood flow in atypical facial pain is probably a reflex response to activity in trigeminal pain pathways, and suggests that there is an organic basis for this disorder.
Cluster Headache Patients' Responses to Dexamethasone Suppression Test
Authors: Frediani Fabio , Lamperti Elena , Leone Massimo , Boiardi Amerigo , Grazzi Licia , Bussone Gennaro
Published: June 2005

SYNOPSIS

The recurrent or cyclic time pattern is one of the most characteristic features of the Cluster Headache (CH) syndrome.

This observation has led to many studies which have proposed that the central hypothalamic system possibly plays a role in the pathogenesis of Cluster Headache attacks.

In this study we utilized the Dexamethasone Suppression Test in order to test the functioning of the hypothalamo‐pituitary axis in CH patients, in the headache‐free state.

We were able to ascertain that the hypothalamo‐pituitary axis functioned normally, while the base‐line cortisol levels of Cluster Headache patients appeared higher than the levels found in the control subjects.
Cluster Headache Due to an Impacted Superior Wisdom Tooth: Case Report
Authors: Romoli Marco , Cudia Guido
Published: June 2005

SYNOPSIS

A case of cluster headache due to an impacted superior wisdom tooth is reported. After extraction (time of observation 4 years), the patient had no more pain attacks. This case may support the role of the nervus intermedius in cluster headache.
Headache After Closed Head Injury in Children
Authors: Lanser J. B. K. , Jennekens‐Schinkel A. , Peters A. C. B.
Published: June 2005

SYNOPSIS

A random group of children (n = 129; age up to 14 years; mean 6.5 years of age) admitted with closed head injury (CHI) was followed over a number of years. It was investigated to what extent a relationship existed between headache complaints and the injury. In the first weeks after the accident significant correlations existed between headache and the female sex, and between headache and electroencephalographic (EEG)abnormalities. Subsequently, there was no clear relationship between headache and any of the injury variables, At the end of the follow‐up period, an average of 5.9 years after the accident, it appeared that in the then checked children (n = 129) there was no relationship between headache complaints and the CHI.
Prolonged Vasospasm in Migraine Detected by Noninvasive Transcranial Doppler Ultrasound
Authors: Thie Andreas , Spitzer Klaus , Lachenmayer Lutz , Kunze Klaus
Published: June 2005

SYNOPSIS

We describe three patients with different forms of migraine in whom transcranial Doppler (TCD)showed prolonged diffuse vasospasm in the basal cerebral arteries when patients were asymptomatic. Vasospasm was more severe in one patient during her attack. These findings demonstrate the usefulness of TCD in evaluating vascular changes in patients with migraine.
Effectiveness of Salmon Calcitonin Nasal Spray Preparation in Migraine Treatment
Authors: Micieli G. , Cavallini A. , Martignoni E. , Covelli V. , Facchinetti F. , Nappi G.
Published: June 2005

SYNOPSIS

A nasal spray preparation of salmon calcitonin (sCT) was administered to migrainous patients to evaluate the activity of sCT in migraine, and to better define its pharmacological profile. Twenty‐two patients with common migraine (CM) concluded a double‐blind, parallel trial versus placebo. A 30‐dayrun‐in period preceded a 3‐month period of therapy with sCT (200 UI at bed time), or with placebo. SCT was able to significantly reduce Headache Index, Pain Total Index (PTI) and analgesic consumption, from the first month of therapy. Another 10 patients suffering from migraine with interval headache (MIH) were admitted to an open study: a 10‐day run‐in period preceded a 30‐day phase of sCT (200 UI at bed time) administration. SCT induced a significant PTI reduction during the last 10‐days of treatment, while analgesic consumption improved significantly in the first ten days. Nociceptive flexion reflex threshold and plasma levels of β‐endorphin and β‐lipotropin, evaluated at the end of the run‐in and treatment periods to assess patients' antinociceptive state, did not change significantly. Our results demonstrate the effectiveness of sCT nasal spray preparation in treating migraine, and suggest a peculiar and complex pharmacological profile for sCT ranging from analgesic activity to modulation of the neuronal and neuro‐transmitter process subserving migraine attacks.
EEG Spectral Analysis and Time Domain Descriptors in Headache
Authors: Drake Miles E. , Bois Craig Du , Huber Stephen J. , Pakalnis Ann , Denio Lena S.
Published: June 2005

SYNOPSIS

We compared computerized EEG spectral measures in patients with common migraine, tension headache, complicated migraine, and normal controls. One minute summaries of 4 sec EEG epochs were recorded fromOz‐A1 + A2. Modal alpha frequency (MAF), the predominant frequency in the 8–13 Hz band, maximal alpha frequency (Mx AF), the fastest frequency in that band, and spectral edge frequency (SEF), the predominant frequency in the 13–30 Hz band, were calculated. EEG was also recorded from F3, F4, P3, P4, 01, and 02 with ear reference. Spectral mobility and first order complexity were compared in controls, migraineurs, and tension headache patients. Migraine and tension headache patients did not differ significantly, and were not different from control subjects in MAF and SEF. Complicated migraine patients had significantly lower MxAF than controls or common migraine patients (P<0.01). Patients with mixed element tension vascular headaches did not differ from controls in mobility or complexity at frontal, parietal or occipital sites. Mobility was significantly less at parietal and occipital sites in migraine patients (P<0.05). Complexity was less at both occipital electrodes(P<0.05) in the migraine group. Migraine patients had significantly lower occipital mobility and complexity scores than those with mixed element headaches (P<0.05).The findings suggest that computerized EEG analysis may help to categorize headache patients, and this may be therapeutically helpful. The time domain descriptors may be more sensitive to EEG differences than frequency or power measures. These observations suggest that migraine and mixed element headaches with amigrainous component may differ significantly in pathogenesis, and that central nervous system dysfunction may be involved in the pathogenesis of complicated migraine syndromes.
A Replicative Investigation of the Reliability of the MMPI in the Classification of Chronic Headaches
Authors: Dieter John Nathan , Swerdlow Bernard
Published: June 2005

SYNOPSISThis study attempts to replicate and synthesize previous headache/MMPI research by investigating scale differences amongst diagnoses and between a control group; re‐examining the occurrence of the conversion “V” pattern; evaluating the Kudrow‐Sutkus (1979) classification system; measuring score changes which occur with prognosis; and observing the effect that “headache items” have on scale score elevations. Several mean scale scores differed from previous studies. A number of these differences were clinically significant. Analysis of variance (ANOVA) (sex [370 males and females] and headache diagnosis) for each scale determined that males had higher L scores; the control group had higher K scores than post trauma, mixed, or vascular patients; each headache diagnosis had higher 1, 2, 3, and 7 scores than the control group (scales 1, 2, and 3 were clinically elevated in only the post trauma and mixed conditions); scale 9 scores varied between conditions; and scale 10 scores were higher for migraine, mixed, cluster, and post trauma patients. Chi‐square analysis determined that the conversion “;V” pattern occurred in a significantly greater degree in headache patients. However, the percentage of occurrence ranged from only 12.50 to 31.03 percent. The Kudrow‐Sutkus system correctly diagnosed only 40.08 percent of 90 randomly selected subjects. One‐way ANOVA determined that no significant change occurred in group scale scores in 20 headache sufferers who received treatment ranging from a multi‐disciplinary hospital program to none at all and whose prognosis ranged from excellent to poor. One‐way ANOVA determined that the removal of items which inquire about “headache symptoms” produced significant reductions on scales 1 and 3.The inability of this study to replicate previous empirical investigations raises questions of the MMPI's reliability as a diagnostic classifier in chronic headache. Certain elevations on the MMPI may be the result of symptom measurement and not psychopathology.
Effect of Prophylactic Administration of Nimodipine in Patients with Migraine
Authors: Stewart D.J. , Gelston A. , Hakim A.
Published: June 2005

SYNOPSIS

The prophylactic effect of nimodipine in the treatment of migraine headache was assessed in a prospective, placebo‐controlled, double‐blind trial. Twenty‐six patients were studied during a 3‐month experimental period (placebo vs nimodipine) following a 1‐month period during which all patients received placebo. Results were tabulated using a “headache index”. A trend in favour of a beneficial nimodipine effect on the headache index was demonstrated which achieved statistical significance during one month of the follow‐up period. A similar trend with respect to the overall number of headaches was demonstrated and achieved statistical significance during two months of the follow‐up period. We conclude that nimodipine is a potentially useful agent in the prophylaxis of migraine headache.
Hypothesis: Stress Induced Vascular Entrapment and Migraine
Authors: Gage Arthur A.
Published: June 2005

SYNOPSIS

An hypothesis: A certain vascular anatomic relationship may help explain migrainous occurrences after stressful periods.
The Relationship Between Muscle Contraction Headache and Migraine: A Multivariate Analysis Study
Authors: Takeshima Takao , Takahashi Kazuro
Published: June 2005

SYNOPSIS

Increasing evidence of the similarity between muscle contraction headache (MCH) and migraine has been reported. However, there seem to be some problems and confusion about the notion that MCH and migraine are similar. For clarification of the relationship of MCH to migraine, we carried out a series of multivariate analysis studies. One hundred and eighty headache patients (including 60 MCH patients, 60 combined headache patients and 60 migraine patients) were investigated. Clinical data of these 180 patients were analyzed using Hayashi's Quantification analysis and cluster analysis. It was possible to determine an MCH factor and a migraine factor from headache symptoms and characteristics. A diffuse and sequential distribution of patients was observed in the histogram of quantified symptoms with the purpose of discriminating headache categories. Thus, most headache patients might have both the MCH factor and the migraine factor in various proportions. We propose a slight modification of the headache severity model and add some development of the concept that MCH and migraine are a continuum. We submit a new headache model.
Prophylactic Treatment of Cluster Headache with Budipine
Authors: Krüger H. , Kohlhepp W. , Reimann G. , Przuntek H.
Published: June 2005

SYNOPSIS

For two years we have tested the prophylactic efficacy of budipine for the treatment of cluster headache. The open study was carried out on 27 men and 8 women. 23 patients suffered from episodic and 2 from chronic cluster headache. 7 patients had cluster‐migraine, and 3 chronic paroxysmal hemicrania. 20 patients were free of cluster headache attacks 2–6 days after beginning daily prophylactic budipine therapy with 15–60 mg. 14 patients showed a markedly decreased frequency of attacks and the intensity of persisting attacks was diminished. One patient reported only a slight improvement. There were no non‐responders to budipine therapy. 10 patients showed only mild budipine side effects. Budipine was found very effective for treatment of cluster headache.
The Effect of Dopamine Receptor Agonists on Prolactin Secretion in Childhood Migraine
Authors: D'Andrea Giovanni , Cananzi Antonio R. , Grigoletto Francesco , Meneghini Francesca , Cortesi Sergio , Soffiati Giuliano , Joseph Rajiv , Nordera Giampietro , Ferro‐Milone Francesco
Published: June 2005

SYNOPSIS

Recent data suggest that common migraine, particularly catamenial (menstrual), is characterized by dopaminergic (DA) receptor supersensitivity. This dopaminergic dysfunction may be related to gonadal steroidal patterns (abnormal estrogen/ progesterone ratio).

In order to distinguish between altered DA‐neurotransmission and the effect of sex hormones we studied prolactin (PRL) response to drugs considered direct and indirect DA‐agonists in a group of prepubertal children with common migraine, in whom the effect of sex hormones is minimal.

Basal PRL plasma levels were measured every 30 minutes up to 240 minutes, after oral administration of L‐DOPA, nomifensine, lisuride and placebo in headache‐free migraineurs. Results obtained show no significant differences in plasma PRL levels between migraineurs and control subjects. This suggests that in a situation of reduced interferences by sex hormones, inhibitory TIDA (tuberoinfundibular dopaminergic) function may be normal. However a drawback of our study may have been that we were inhibiting TIDA function in prepubertal subjects with already low baseline prolactin levels. It is our belief that further understanding of dopaminergic involvement in childhood migraine may come from studies utilizing substances that enhance prolactin levels through dopaminergic inhibition.