bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Muscle Contraction Headache: Micrainin(r) vs. Aspirin
Authors: Glassman Jerome M. , Soyka Joseph P. , Pollack Marcia
Published: June 2005

SYNOPSIS

Sixteen physician‐investigators participated in a double‐blind, randomized clinical study comparing the efficacy of Micrainin (meprobamate‐acetylsalicylic acid) and aspirin (acetylsalicylic acid) in the treatment of muscle contraction (tension) headache. Each patient treated one episode of moderate‐to‐severe muscle contraction headache and scored the effects for head pain, activity impairment, tension (tense/uptight feeling), muscle stiffness and overall relief using a verbal rating scale (VRS) and a visual analogue (linear) scale (VAS). In general, overall agreement occurred between the two rating scales. Patient and physician global evaluations also concurred and supported the conclusion that Micrainin was significantly more effective than aspirin in relieving the symptom complex of muscle contraction headache. Treatment emergent signs and symptoms occurred infrequently in each treatment group (£4.0%); these were not serious, were of short duration and were without sequelae.
Epilepsy, Migraine, and EEG Abnormalities in Children: A Review and Hypothesis
Authors: Jay Gary W.
Published: June 2005

SYNOPSIS

The relationship between migraine and epilepsy is reviewed. Recurrent paroxysmal episodes in children and their relationship to electroencephalographic abnormalities is discussed. Relevant literature concerning the 14 and 6/second positive spike pattern is also surveyed.

The electroencephalographic data from a group of 116 pediatric headache patients was conpared to a group of 93 children previously diagnosed with seizure disorders. In the headache group, the 14 and 6/second positive spike abnormality was seen in 40.7% of the abnormal recordings, either by itself or with other abnormalities, and in 12.2% of all EEGs performed. This pattern was found in 6.5% of all abnormal EEGs and in 4.3% of all EEGs performed in the seizure group.

It is hypothesized that the 14 and 6/second positive spike pattern is a marker for autonomic hyper‐reactivity and is most readily found in children under 16 years of age.

The use of the electroencephalogram in the pediatric headache work‐up is emphasized to differentiate the “Seizure Equivalent” headache disorder from migraine. Anticonvulsant medication is the appropriate treatment for the “Seizure Equivalent” headache disorder.
Change in Platelet Taurine and Migraine
Authors: Dhopesh V.P. , Baskin S.I.
Published: June 2005

SYNOPSIS

To establish if other neuromodulators exhibit abnormal metabolism in the platelet during migraine, we sought to analyze taurine levels, a neuromodulator known to be actively accumulated by the platelet. It was found that taurine platelet levels were greater during the headache phase (p<0.01) than the postictal phase. We propose that the metabolic platelet defect in migraine extends beyond a singular chemical species, i.e., serotonin, but may involve other substances such as taurine.
Bioavailability and Antimigraine Efficacy of Effervescent Ergotamine
Authors: Ala‐Hurula V.
Published: June 2005

SYNOPSIS

In about 20% of migraine patients treatment with enterally administrated ergotamine tartrate proves unsuccessful. One of the causes for this might be a poor systemic availability of the drug from the ordinary solid tablets. The present study aimed to investigate the bioavailability and the therapeutic value of ergotamine tartrate in effervescent form.

In twenty volunteers the plasma ergotamine levels were measured by using a radioimmunoassay after oral administration of 2.0 mg ergotamine tartrate combined with 50.0 mg caffeine in effervescent form. Measurable plasma drug levels were found in 14 (70%) of the subjects and the mean maximum plasma ergotamine level of 0.45 ng/ml was achieved at 30 minutes.

In the clinical part of the study 25 migraine patients treated their migraine attacks with effervescent ergotamine. The therapeutic value of it was considered as good by 9, moderate by 11 and poor by 5 of the patients. Among 18 of them the therapeutic effect seemed to be equal to their earlier ergotamine medications. The results indicate that the plasma pharmacokinetics of ergotamine tartrate in effervescent form is similar to and possibly faster on the absorptive phase than that reported earlier after enteral administration. In patients who do not gain benefit from the usual ergotamine tablets or suppositories, effervescent ergotamine would appear to be an alternative worth consideration.
Arteriovenous Malformation of the Brain presenting as a Cluster Headache ‐ a Case Report
Authors: Mani Srinivasan , Deeter Jane
Published: June 2005

SYNOPSIS

A patient with arteriovenous malformation (AVM) presented with cluster headache. After surgery and removal of the AVM, the headache completely resolved.
Evaluation of Oculocephalic Sympathetic Function in Vascular Headache Syndromes
Authors: Watson Craig , Vijayan N.
Published: June 2005

SYNOPSIS

Patients presenting with a unilateral ptosis and miosis offer a differential diagnostic challenge which ranges from “simple” anisocoria, a benign condition, through a variety of vascular headache syndromes, to life threatening diseases of the peripheral or central nervous system. The resolution of this dilemma often rests with the documentation of clinically questionable findings and the localization of the lesion along the oculocephalic sympathetic pathway.

In the first of our papers, we review simple bedside autonomic tests which can easily be used to document and localize lesions of the oculocephalic sympathetic pathway. We also briefly review the relevant neurotransmitter, neuroanatomical, and neurophysiological information necessary to accurately interpret the results of these tests.
Effects of Frontalis EMG Biofeedback and Diazepam in the Treatment of Tension Headache
Authors: Paiva Teresa , Nunes J. Silveira , Moreira Ana , Santos Jorge , Teixeira Jorge , Barbosa Antonio
Published: June 2005

SYNOPSIS

Frontalis EMG biofeedback and diazepam treatments were compared in tension headache patients; headache scores (intensity and frequency) and frontalis EMG were used as control parameters. The study, conducted in a double blind manner, was split in three equal observation periods (4 weeks): baseline, treatment and follow‐up. Four patient groups were chosen, two of which received placebo treatment. In both true conditions, biofeedback and diazepam, treatment effects differentiated from placebo groups; with diazepam the strongest results upon headache and frontalis EMG were observed during treatment, which, however, were lost at the follow‐up period; biofeedback although with weaker effects during treatment showed, at follow‐up, a long lasting reduction of headache scores even when frontalis activity reached baseline levels; in the false biofeedback group some decrease of EMG activity during treatment and of headache intensity at follow‐up were also observed. The data suggest that biofeedback is a complex learning situation, where several uncompletely known factors are possibly at work; it also raises the possibility of a complex relation between frontalis muscular activity and headache since a simple linear relation of both variables was not observed.
Diagnosis of Head Pain: An Idiographic Approach to Assessment and Classification
Authors: Thompson J. Kevin
Published: June 2005

SYNOPSIS

The headache literature is characterized by controversy regarding theoretical explanations, pain mediating processes and treatment efficacy. The present paper reviews past assessment and classification practices within this literature. The data suggest that inadequate adherence to the iagnostic scheme originally proposed by the Ad Hoc Committee on Classification of Headache has resulted in major nosological errors. Thus, the literature presents a confusing array of inconsistent results and inconclusive investigations. Criteria for classification of head pain are provided and the utilization of more sophisticated assessment methodology advocated. It is hypothesized that an idiosyncratic analysis of head pain parameters will eventuate in the empirical delineation of well‐defined subgroup populations of migraine, muscle‐contraction, psychogenic, and combined headache patients.
Spreading Cerebral Oligemia in Classical‐ and Normal Cerebral Blood Flow in Common Migraine
Authors: Olesen Jes , Lauritzen Martin , Tfelt‐Hansen Peer , Henriksen Leif , Larsen Bo
Published: June 2005

SYNOPSIS

Regional cerebral blood flow was studied with intra‐arterial 133Xenon technique in 254 areas of a hemisphere during the development of classical migraine attacks in seven patients. We describe a gradual spread of reduced cerebral blood flow starting at the posterior pole of the hemisphere and advancing in a mode quite similar to the spreading depression phenomenon of Leao. In three patients the oligemia was preceeded by focal or perifocal hyperemia. Functional activation by speech etc. was usually impaired or abolished during prodromes or accompaniments. Headache was found concommitantly with cerebral blood flow reduction and cannot be caused by reactive hyperemia in these patients. Similar findings were made in two patients studied with tomographic 133Xenon technique. During induced common migraine attacks repeated cerebral blood flow studies with stationary detectors (N =3) and with tomographic technique (N =4) revealed no alterations of global or cerebral blood flow. Also tomographic determination of spontaneous common migraine attacks in four patients was normal. It is concluded that the two forms of migraine are different with respect to cerebral blood flow abnormalities and that they should be studied separately in the future. Greater interest should be directed towards the phenomenon of spreading depression as a possible model of the classical migraine attack.
Platelet Membrane Lipid Composition and the Frequency of Migraine
Authors: Oxman Thomas E. , Hitzemann Robert J. , Smith Robert
Published: June 2005

SYNOPSIS

A variety of evidence associates abnormalities in platelet function with the development of migraine. Given the pivotal role of platelet membranes in these functions, it was proposed that migraine patients have abnormalities in their platelet membrane composition. To examine this hypothesis, platelet membrane lipid composition was analyzed in 16 migraine patients and 10 control subjects. The content of phosphatidylcholine, the amount of arachidonic acid in phosphatidylcholine, and the amount of unsaturated fatty acids in most phospholipids were significantly increased in patients with infrequent migraine as compared to controls or patients with frequent migraine. These results suggest that membrane lipid composition may play a role in the frequency and severity of migraine attacks.
Long‐term Study of Propranolol in the Treatment of Migraine
Authors: Diamond Seymour , Kudrow Lee , Stevens John , Shapiro David B.
Published: June 2005

SYNOPSIS

Out of 245 patients admitted to a two‐month single‐blind phase in a study with propranolol vs. placebo, 148 (72%) were propranolol responders. These responders were randomly assigned to propranolol or placebo for the following double‐blind phase. After four weeks, they opted to either (1) remain on the assigned drug for 6 to 12 months or (2) to switch to the other drug for 6 to 12 months. In either case, they then switched drugs for a final one or two months of the study.

No tolerance was found in 80 patients who remained on propranolol for at least six months.

Resurgence of migraine was analyzed in 75 patients who took propranolol for at least six months and crossed over to placebo. Thirty‐five patients (46%) continued to show the improvement achieved during propranolol therapy when it was discontinued and only 8 patients (11%) had rebound headaches. No serious complications were noted.
Single‐dose Pizotifen, 1.5 mg Nocte: A New Approach in the Prophylaxis of Migraine
Authors: Capildeo Rudy , Rose F. Clifford
Published: June 2005

SYNOPSIS

Seventeen patients have taken part in a double‐blind, controlled, randomized, cross‐over trial, completing four months, two months on each arm of the trial, in which pizotifen 0.5 mg t.d.s. has been compared with 1.5 pizotifen at night. Sixteen patients improved significantly. No significant difference was noted between patients on 0.5 mg t.d.s. compared with 1.5 mg nocte but there was a trend to suggest that initially patients may respond better to the t.d.s. dosage but then maintenance would be more easily carried out on a once nightly regime of pizotifen 1.5 mg nocte. Weight gain appeared to be related to the t.d.s. dosage regime and if this finding is confirmed in subsequent studies then the single dosage at night would certainly be preferable to a t.d.s. dosage regime. We confirm previous studies which show that pizotifen is extremely useful in the prophylaxis of migraine.
Migraine Patients Exhibit Abnormalities in the Visual Evoked Potential
Authors: Gawel M. , Connolly J.F. , Rose F. Clifford
Published: June 2005

SYNOPSIS

An experiment is described which compared visual evoked potential (VEP) amplitudes and latencies in normal subjects and migraine patients. Several VEP abnormalities were found: at vertex and to a lesser extent at temporal sites, P100‐N120 amplitudes were larger in patients; at vertex and temporal sites N120 amplitudes were larger in patients; at temporal sites patients had larger N120‐P200 amplitudes but smaller P100 amplitudes. Peak latencies of the VEP were also found to be abnormal in patients. At vertex, patients had delayed N120 peak latencies while at temporal sites delays were found in the P200 latencies. Patients were subdivided according to side of headache. Right‐sided headache patients showed larger temporal P100 amplitudes and larger left temporal P100‐N120 amplitudes than bilateral headache patients.
Biochemical Predisposition to Dietary Migraine: the Role of Phenolsulphotransferase
Authors: Glover Vivette , Littlewood Julia , Sandler Merton , Peatfield R. , Petty R. , Rose F. Clifford
Published: June 2005

SYNOPSIS

Chocolate, cheese and citrus fruit are the most frequently cited provoking factors to which patients ascribe their dietary migraine. We review here the evidence that the monoamines they contain, particularly tyramine, might be causative and conclude that the case remains open. There is no evidence that patients classifiable within this particular subgroup of the disease have a deficiency of the monoamine metabolizing enzyme, monoamine oxidase.

We report the new finding that dietary migraine patients have a relative deficiency of the enzyme, phenolsulphotransferase P, compared with non‐dietary migraine patients or controls. Phenolsulphotransferase is particularly active in the intestine where it probably serves to detoxify phenols by adding to them a sulphate group. The enzyme exists in two forms, which we have designated M and P. The M enzyme acts on monoamine phenols such as noradrenaline and tyramine. It is also somewhat reduced in dietary migraine but less significantly so than the P form. No endogenous substrate for the P enzyme has yet been identified but it acts on phenol itself and presumably also on a range of unknown phenols in chocolate, cheese and citrus fruit which are important "triggers" for dietary migraine.
Medical Evaluation of Migraineurs: Review of the Value of Laboratory and Radiologic Tests
Authors: Sargent Joseph D. , Solbach Patricia
Published: June 2005

SYNOPSIS

A total of 193 migraineurs underwent a medical screening for entry into a controlled, experimental migraine study. An isotope brain scan or a CT‐Scan, EEG, skull X‐ray, and laboratory tests, as well as a complete physical examination, were routinely done on each subject. Tests results were examined as to clinical usefulness in the screening for headache. It is the authors' conclusion that a CT‐Scan is the most effective screening test and, in most cases, the isotope brain scan, EEG, and skull X‐ray can be eliminated.
Acupuncture Treatment of Chronic Facial Pain ‐‐ a Controlled Cross‐over Trial
Authors: Hansen Per E. , Hansen John H.
Published: June 2005

SYNOPSIS

In a controlled trial the effect of traditional Chinese acupuncture versus placebo acupuncture was evaluated in 16 patients with chronic facial pain (13 atypical facial pain, 2 atypical and I typical trigeminal neuralgia). All patients suffered from daily pain, the intensity of which was recorded by the patients over a period of 16 weeks. Each patient was treated by traditional Chinese acupuncture as well as placebo acupuncture in a cross‐over design following randomization. Each period of treatment comprised 10 treatments during two weeks of hospitalization.

Traditional Chinese acupuncture was found to be significantly more pain‐relieving than placebo acupuncture according to the pain registration of the patients themselves and to their subjective preferences.
A Comparison of MMPI Personality Data and Frontalis Electromyographic Readings in Two Groups of Daily Headache Sufferers
Authors: Weeks Randall , Baskin Steven , Sheftell Fred , Rapoport Alan , Arrowsmith Fran
Published: June 2005

SYNOPSIS

Forty, daily headache patients were divided into two diagnostic categories ‐ chronic scalp muscle contraction headache alone and chronic scalp muscle contraction headache associated with analgesic rebound. Electromyographic readings from the frontalis muscle and personality data from selected scales of the MMPI served as comparison variables between the two groups.

A second part of the study divided these headache patients into a high muscle tension group (the ten patients with the highest frontalis muscle readings) and a low muscle tension group (the ten patients with the lowest frontalis reading). This division was made regardless of the original group membership. Personality data in these two groups were compared.

Results provided information regarding the relationship between the amount of medication taken by the patient, their degree of psychopathology as measured by the MMPI, and the amount of muscle tension recorded. Suggestions for future research projects were made.
Neck Musculature and EMG Biofeedback in Treatment of Muscle Contraction Headache
Authors: Hudzinski Leonard G.
Published: June 2005

SYNOPSIS

Muscle contraction headache is believed to result from sustained contraction of muscles involving the neck, scalp, and frontalis musculature. This study stresses the clinical importance of examining neck muscle activity in 16 subjects. Two questions are addressed: (1) Do subjects who in the process of treatment for headaches originating from the neck and who received EMG feedback from frontalis and neck musculature select the neck feedback site as more useful in the control of headache? (2) Is frontalis activity as measured by the EMG a measure of the level of activity in other portions of the skeletal system, namely neck musculature? Results indicate that neck involvement varies significantly among patients complaining of chronic muscle contraction headaches, and that a substantial number of subjects experience far more neck than frontalis activity and benefit from behavioral techniques applied to that area. Our findings indicate that attending specifically to neck tissue is a useful therapeutic goal. Consequently, post‐treatment results show significant reductions in neck tissue muscle activity, especially for patients reporting significant neck symptomatology and/or those with high levels of EMG neck activity who reported that behavioral techniques applied to the neck area were helpful for controlling the muscle activity related to their headaches.
The Pharmacology of Calcium Channel Antagonists: a Novel Class of Anti‐migraine Agents?
Authors: Peroutka Stephen J.
Published: June 2005

SYNOPSIS,

The calcium channel antagonists are a recently developed class of vasodilators that prevent the influx of calcium into vascular smooth muscle. The unique pharmacologic effects of these agents provide a theoretical basis for their use in the treatment of migraine. First, the calcium channel antagonists inhibit the actions of all vasoactive substances on intracerebral smooth muscle via a blockade of the "final common pathway" of cellular contraction. Secondly, the vascular effects of the calcium channel antagonists are selective for intracerebral versus peripheral vessels. Clinically, two specific calcium antagonists (flunarizine, cinnarizine) and two non‐specific antagonists (cyproheptadine, amitriptyline) are effective in the treatment of migraine. Further studies will determine whether the calcium channel antagonists, as a class of agents, are effective in the treatment of migraine and other forms of vascular headache. This novel class of vasodilators also provides a powerful tool for the critical evaluation of the vascular theory of migraine.
The Surgical Treatment of Chronic Cluster Headache
Authors: Watson C.P. , Morley T.P. , Richardson J.C. , Schutz H. , Tasker R.R.
Published: June 2005

SYNOPSIS

This article reports the results of 61 procedures performed on 20 patients and reviews the literature. The procedures consisted of 27 radiofrequency lesions, nine V root sections, five injections of local anaesthetic into the Gasserian ganglion, four greater superficial petrosal neurectomies, seven superficial temporal artery sections, six nerve avulsions and three alcohol injections. The authors conclude that:

1) No one procedure gives consistent longlasting relief.

2) Patients must have a full trial of medical therapy before considered for surgery.

3) Radiofrequency lesions and nerve avulsion are reasonable first stage procedures.

4) Both V root section and petrosal neurectomy appear to be useful as second stage procedures.
Symptoms of Vascular Headache Triggered by Intracranial Hypertension
Authors: Solomon Seymour , Wisoff Hugh , Thorpy Michael
Published: June 2005

SYNOPSIS

A 23‐year‐old male presented with features of vascular headache (unilateral throbbing pain of brief duration and ocular site). Ipsilateral tingling and hypalgesia were noted over part of the face during the headache. Papilledema was prominent. Increased intracranial pressure (ICP) and hydrocephalus were caused by aqueductal stenosis as noted in the computerized tomograms. Asymmetrical herniation of a cerebellar tonsil was noted in the angiograms. The patient's symptoms were relieved by a ventriculo‐peritoneal shunt. Although intraventricular pressure was not monitored, the brief duration of the headache and its associated symptoms are best explained by the effect of plateau waves of extreme intracranial hypertension. Asymmetrical tonsillar herniation causing traction of nociceptive vascular structures of the tentorium cerebelli and on cervical nerve roots can account for the focal nature of the headache and associated symptoms. The clinical features and theories of mechanisms of plateau waves are discussed.
Psychophysiological Reactivity in Migraine Following Biofeedback
Authors: Reading Clive
Published: June 2005

SYNOPSIS

Biofeedback training is assumed to attenuate the psychophysiological effects of cognitive stressors. This study compared the effects of four varieties of biofeedback, namely, frontalis EMG, finger temperature, skin conductance, and false EMG feedback, in the treatment of severe migraine headache. Before and after treatment there was a psychophysiological assessment during attempted relaxation and during exposure to a variety of cognitive stressors. There was a statistically and clinically significant reduction in headache activity after treatment, with the four procedures being equally effective. Frontalis EMG biofeedback was superior to finger temperature, skin conductance, and false EMG biofeedback as a means of reducing scalp muscle tension, and showed some generalization to other physiological measures. There was no evidence that the physiological effects of the cognitive stressors were modified by any of the biofeedback procedures.
Menstrual Migraine Headache: Results of a Controlled, Experimental, Outcome Study of Non‐drug Treatments
Authors: Solbach Patricia , Sargent Joseph , Coyne Lolafaye
Published: June 2005

SYNOPSIS

Female migraineurs frequently report a severe migraine headache a few days prior to, during, or immediately following a menstrual period. Menstrual migraines were identified in a study of 193 migraineurs who participatedin a controlled, experimental, outcome study of non‐drug treatments for the control of migraine headaches. Participants were required to monitor their daily headache activity and drug usage for 36 weeks and were assigned to one of four groups: (1) No Treatment; (2) Autogenic Phrases; (3) Electromyographic Feedback, and (4) Thermal Feedback. Data were reduced and analyzed using multivariate analysis of variance and covariance. There was a tendency for all groups to improve over the 36 weeks. No significant difference was found among the four groups in headache improvement.
Effect of Movement and Position in the Evaluation of Tension Headache and Nonheadache Control Subjects
Authors: Sturgis Ellie T. , Schaefer Carol A. , Ahles Tim A. , Sikora Thomas L.
Published: June 2005

SYNOPSIS

This study evaluated the effects of three positions (reclining, standing, sitting) and four movements (leftand right cervical rotation; left and right lateral tilt) on the frontalis, sternocleidomastoid, and trapeziuselectromyographic (EMG) responses of 12 muscle contraction headache and 12 non‐headache controls.While the headache group tended to show higher levels of muscle activity, position and movement effectswere much greater than headache group effects. Knowledge of kinesiology is required if one is tomeaningfully interpret muscular activity in the nonresting condition. The frontalis muscle was the musclewhich best discriminated headache and nonheadache groups. The reclining position was the position thatbest differentiated headache groups, suggesting an inability of headache subjects to relax even whenmuscle tension was not needed to maintain position. Results of the study have implications forassessments of muscular activity which deviate from the standard laboratory assessment which measuresonly frontalis EMG while the subject closes his eyes and rests in a recliner.
A Rapid Hypnotic Technique in a Case of Atypical Facial Neuralgia
Authors: Swerdlow Bernard
Published: June 2005

SYNOPSIS

A case report of a patient with a diagnosis of atypical facial neuralgia which was successfully treated with a rapid hypnotic technique is presented. After six months of intensive work up and treatment, the patient was seen and treated in one session and no longer requires any medication and reports 90% relief.

The trance capacity is measured with the Hypnotic Induction Profile (HIP). A restructuring strategy for treatment and the ramifications of this technique will be discussed.

Because the HIP rapidly predicts trance capacity, the physician is able to screen patients which may benefit from this modality in the treatment of pain.

Hypnosis may be utilized in treatment as an adjunct or independently for organic disease and therefore should be seriously considered in the armamentarium of physicians treating headaches.
The Significance of Muscle Discrimination Training in the Treatment of Chronic Muscle Contraction Headache
Authors: Hudzinski Leonard G.
Published: June 2005

SYNOPSIS

The present study was undertaken to determine if chronic muscle contraction headache subjects who received training in muscle discrimination during a headache treatment program that included the standard application of behavioral procedures would be able to relieve muscle activity more effectively than those subjects who received only the conventional program. Thirty‐eight subjects medically diagnosed as having muscle contraction headache were randomly assigned to one of the above treatment conditions or groups. Thirty subjects completed the ten‐week study and treatment program. Stimulus discrimination training, consisting of exercises involving muscles of facial expression, EMG biofeedback and differential reinforcement, was employed. Results indicated that both groups markedly improved. Although the amount of change between the two groups was not statistically significant, the direction of change improved for the experimental group who received the increased, intensified muscle discrimination training. The findings suggest that clinicians who emphasize muscle discrimination training with this type of headache will most likely achieve better results in the way of treatment outcome than without that emphasis.
Differential Efficacy of Biofeedback in Headache
Authors: Billings R.F. , Thomas M.R. , Rapp M.S. , Reyes E. , Leith M.
Published: June 2005

SYNOPSIS

This paper presents a retrospective study of 84 headache patients seen in the Behavioural Medicine Unit of Sunnybrook Medical Centre, of whom 53 were treated with biofeedback.

Of the 84 patients assessed, half were tension headache and half were migraine. Both groups were treated in one of three ways:

1. Frontal EMG FB only.

2. Hand skin temperature (HST) only.

3. EMG FB followed by HST FB.

Assessment results showed the migraine group to have longer headache histories and more severe headaches than the tension group. The tension group had significantly higher frontal muscle tension than the migraine group, while the migraine group had significantly colder peripheral hand temperature. No differences were found in psychometric assessment data.

EMG feedback results showed significant decreases in frontal EMG for both headache groups. Both groups showed a moderate improvement in headache at the end of treatment.

HST feedback treatment results showed significant increases in peripheral temperature and a significant improvement in headache for those migraine patients who achieved a pre‐determined criterion level of performance. Non‐significant increases in skin temperature occurred for the tension headache group. HST feedback after EMG feedback did not provide further improvement for the tension group. The results are discussed in the context of the differential effects of treatment and highlight the importance of a “trials to criterion” training paradigm.
A Screening Procedure for Differentiating Temporomandibular Joint Related Headache
Authors: Ahlin Jeffrey H. , Atkins George
Published: June 2005

Synopsis

Headache and facial pain are common complaints of patients seeking medical advice. Recurrent headache and temporomandibular joint related muscle spasms are frequent sources of patient cranial pain. This study suggests a procedure for differentiating temporomandibular joint related head pain from other forms of head pain and a mode of treatment that may be effective for TMJ related head pain.

The results of a two year investigation indicate both vascular and muscle tension headache may be improved by orthopedic repositioning of the mandible. Although the study was not able to demonstrate a clear‐cut method for differentiating vascular from muscle tension head pain, differentiation from more serious organic pathology and/or underlying structural lesion may be effective.

Forty‐two consecutive patients that complained of hemicrania were given a soft flexible plastic mouthguard to wear while sleeping. Those patients that reported fewer or less severe headaches after one to two weeks (40 out of 42) were then given an orthopedic appliance to reposition the mandible forward and increase the vertical interocclusal dimension.
Atypical Odontalgia: a Localized Form of Atypical Facial Pain
Authors: Reik Louis
Published: June 2005

SYNOPSIS

Eight patients with atypical odontalgia, a condition which causes long‐lasting throbbing pain localized to clinically and radiologically normal teeth and unrelieved by extensive dental treatment, are described. Atypical odontalgia is often accompanied by depression, appears to be related to both atypical facial neuralgia and migraine, and responds in most cases to antidepressant drug therapy and in others to treatment with vasoconstrictors. The importance of recognizing the condition in avoiding unnecessary dental treatment is stressed.
Tension Headaches: Muscle Overactivity or Psychogenic Pain
Authors: Haber Joel D. , Kuczmierczyk Andrzej R. , Adams Henry E.
Published: June 2005

SYNOPSIS

In two exploratory studies it was attempted to develop psychophysiological and self‐report criteria for differentiating MCH and psychogenic headache. Subjects diagnosed as having muscle contraction headaches were assigned to low and high EMG groups following measurement of the frontalis muscle in a headache state. It was hypothesized that the low EMG group would display characteristics of psychogenic pain disorders. In the first study, nine subjects with high EMG, nine subjects with low EMG and nine control subjects participated. The results show that basal levels in a non‐headache and headache state for the high EMG group were significantly different than the low EMG group, which were similar to control subjects. The low EMG group's self‐report data were consistent with the hypothesis of a psychogenic disorder. The second study determined if changes in EMG activity across headache and pain‐free states was a reliable effect by assessing frontalis EMG in three independent groups in two headache and two non‐headache states. The results showed systematic changes in EMG in headache and non‐headache states only for the high EMG group. These results suggest that accurate classification of headache disorders may alleviate some of the contradictory data in the headache literature.
Atypical Facial Pain: A Reappraisal
Authors: Reik Louis
Published: June 2005

SYNOPSIS

Atypical facial pain is a syndrome of chronic facial pain affecting mainly young women who are often emotionally disturbed. Current opinion favors a psychogenic cause for it, but no causal relationship has been established: not all those affected are emotionally disturbed and no single psychiatric disorder predominates among those who are. Early reports of the syndrome in fact described a migraine‐like disorder in which either episodic facial pain or episodic exacerbations of chronic pain were associated with arterial tenderness, a variety of autonomic symptoms and signs and sometimes a response to treatment with vasoconstrictors. Painful dilation of craniofacial arteries may cause atypical facial pain.
Endorphin Levels in Headache Syndromes
Authors: Fettes Ivy , Gawel Marek , Kuzniak Sandy , Edmeads John
Published: June 2005

SYNOPSIS

Plasma levels of immunoreactive b‐endorphin were found to be lower in patients with classical migraine than in patients with common migraine or chronic daily vascular headache or the control group. A role for b‐endorphin in the mechanism of the neurological dysfunction in classical migraine is suggested.
Extracranial Vascular Responses to Sublingual Nitroglycerin and Oxygen Inhalation in Cluster Headache Patients
Authors: Drummond P.D. , Anthony M.
Published: June 2005

SYNOPSIS

Photoplethysmography was used to record pulsations from the superficial temporal artery and supraorbital region in 23 patients suffering from cluster headaches, in 10 patients between bouts of headache, and in 10 control subjects. Pulsations were measured before and after the administration of 0.9 mg nitroglycerin sublingually, at the onset and height of cluster attacks and after inhalation of 100% oxygen for 10 minutes. Following nitroglycerin administration, increases in superficial temporal artery pulsations were greater on the symptomatic than on the nonsymptomatic side in patients who later developed headache. This persisted during cluster headache. By contrast, the increase in superficial temporal artery pulsations was greater on the nonsymptomatic side in patients who did not develop headache. The cause of this paradoxical response is unclear. Inhalation of oxygen produced significantly greater reduction of supraorbital pulsations on the symptomatic side in patients with headache. Decreases in both arterial territories following oxygen inhalation were significantly greater during cluster headache than between bouts or than in control subjects.
The Influence of Pain State on Physiological Reactivity of Tension Headache Sufferers
Authors: Hursey Karl G. , Holroyd Kenneth A. , Penzien Donald B. , Holm Jeffrey E.
Published: June 2005

SYNOPSIS

This study compared physiological reactivity to stress of subjects who frequently experience tension headaches and subjects who rarely get headaches. Physiological measures were Frontal and Trapezius muscle tension and Heart Rate. Subjects prone to headaches and subjects not prone to headaches did not differ on any variable, although there was a trend for subjects who were prone to headaches to have the highest Frontal muscle tension levels. For further analyses, subjects prone to headaches were separated into two groups: Subjects with headache during the psychophysiological assessment and subjects who were headache‐free during the assessment. Only subjects who were prone to tension headaches and who were actually experiencing a headache at the assessment had significantly higher Frontal muscle tension than controls who were not prone to headaches. These results suggest greater attention needs to be paid to the subjects' current headache state in research on the psychophysiology of headache.
Epidemiology of Headache in Elderly Correlations With Life Conditions and Socio‐professional Environment
Authors: Serratrice G. , Serbanesco F. , Sambuc R.
Published: June 2005

SYNOPSIS

The decreased frequency of headache in the aged is generally acknowledged. Thus in a general population, Waters (1975) reported 74% men and 92% women suffering from headaches and ranging between 21 and 34 years, while in a group aged 75 years or more, he reported only 21% men and 55% women. Likewise Newland et al (1978) mentioned 88% men and 96.7% women ranging between 21 and 34 years suffering from headaches and only 45.5% men and 52.7% women aged 75 years or more. Our previous study18 dealed with a group of 1990 headache sufferers (H.S.), who consulted for isolated headache among whom we noticed a low percentage (about 5%) of individuals over 65.This decrease of headaches in aged people is difficult to explain and there are few studies concerning headaches in the elderly. Prospective studies were carried out in poorly homogeneous groups examined by written questionnaires,3,4,5,6. less accurate than a direct examination. Conversely, this present study deals with a group of hospitalized patients, more homogeneous as regards the age, examined and followed up very closely. There are still no studies tending to compare H.S. and non‐headache sufferers (N.H.) and dealing with the difference or relationship between them. The aim of this work is an epidemiological and clinical analysis within a group of old people and then a comparison between this group and another of N.S. to determine if the life conditions and the socio‐professional environment have any influence on the occurrence of headaches.
Corneal Sensitivity in Cluster Headache
Authors: Vijayan N. , Watson Craig
Published: June 2005

SYNOPSIS

Cluster headache pain is thought to arise from vasodilatation, but a neural origin of the pain has never been completely excluded. Some patients with cluster headache have complained of subjective diminution of sensation over the ipsilateral forehead. This is hard to quantitate and is often variable. Besides, ablation of trigeminal sensory pathways has been re sorted to for relief of pain in some intractable cases.

The present study was undertaken to quantitatively assess the sensitivity of the cornea in cluster patients. Fifteen cluster headache patients were the subjects of this study. Measurement of the corneal sensitivity was undertaken using a Cochet‐Bonnet Aesthesiometer. There was no difference between the affected and the unaffected eye. There was no difference in the sensitivity when testing was done during the cluster period and later on when the patients were in remission. It is concluded from this study that there is no objective evidence for involvement of trigeminal sensory pathways in patients with cluster headache.
Medical Diagnoses and Problems in Individuals With Recurrent Idiopathic Headaches
Authors: Featherstone Harvey J.
Published: June 2005

SYNOPSIS

Two hundred cases with recurrent idiopathic headache and 200 age‐ and sex‐matched controls without headaches were compared for the occurrence of medical problems and diagnoses according to their primary physicians. Hypertension, vertigo and dizziness, peptic ulcer, gastroesophageal reflux and depression and/or anxiety were among diagnoses seen more frequently in the headache cases, while nephrolithiasis, excessive ethanol use and abdominal pain in women were more common in the controls. There were no significant differences between the two groups in the diagnosis of cardiac disease, including mitral valve prolapse and ischemic heart disease, and occlusive cerebrovascular disease. Possible underlying mechanisms are discussed. These findings need confirmation and further investigation.
The Prevalence of Headache in a Small New Zealand Town
Authors: Paulin Judith M. , Waal‐Manning Hendrika J. , Simpson F. Olaf , Knight Robert G.
Published: June 2005

SYNOPSIS

Information on the prevalence, characteristic features and possible causative factors of headache was collected from 1138 adults who participated in a multiphasic health survey in Milton in May 1981.

Thirty‐nine percent of men and 60% of women experienced headaches in the year preceding the survey. Total prevalence of headache peaked in men 30–39 years and in women aged 20–29 years and thereafter decreased with increasing age.

The most commonly reported positions for headache were at the forehead unilaterally and bilaterally. The most common precipitating factors were ‘too much’ alcohol (men only), tiredness, mental stress and eye strain. Chocolate was the food most commonly blamed for the headache.

No association was found between headache frequency and blood pressure or smoking habit. However the psychometric scores for anger, anxiety and depression were positively related to frequency of headache.
An Approach to the Nature of Tension Headache
Authors: Chun Wang Xing
Published: June 2005

SYNOPSIS

Clinical, EMG and therapeutic studies were used to explore the nature of tension headache. The EMG data indicated that muscle contraction was not important in the genesis of these headaches. In our 402 patients, tiredness, sleepiness, and hypomnesia were very common and, with the headaches, were improved following administration of the CNS stimulant caffeine sodium benzoate. It is suggested that inhibitory mechanisms in the CNS may be important in producing tension headaches.
Migraine and Muscle Contraction Headaches: a Continuum
Authors: Featherstone Harvey J.
Published: June 2005

SYNOPSIS

There is increasing evidence that migraine and muscle contraction headaches are similar; rather than being different entities, they may vary in symptom quantities instead of having qualitative differences. Analysis of elements of the headache history in 50 consecutive idiopathic headache patients failed to show evidence for distinct headache types. Quantitation of symptoms and characteristics showed a unipolar distribution; reported pain severity was directly related to the symptom quantitation score. These two statements were true for three different history scoring systems, from the simplest (quantitation of nausea, unilaterality and aura) to the most detailed (quantitation of nausea, unilaterality, aura, photophobia, throbbing pain, headache location, family history and clustering). Headache scores were lower for patients previously diagnosed as “tension” headache patients compared to those diagnosed previously as having “migraine”. Joint occurrence of the major migraine symptoms of nausea, aura and unilaterality was by chance. These data support the headache severity model described by others, and do not support the existence of separate, distinct idiopathic headache entities.
Migraine ‐ Cluster Headache Syndrome
Authors: Solomon Seymour , Karfunkel Perry , Guglielmo Karen M.
Published: June 2005

SYNOPSIS

The migraine‐cluster headache syndrome is defined as headaches that are predominately of one type but with at least one major timing factor plus three lesser features of the other or five lesser features of the other (no more than one of the opposing features is a weak differential feature). The most important factors distinguishing migraine (M) from cluster headache (CH) are the timing of attacks (random occurrence versus clustering, frequency, duration, hour of onset) and the prodromal phenomena which occur with classical M, but are rarely seen with CH. Somewhat less significant differentiating characteristics are the associated symptoms of ipsilateral eye redness and tearing, nasal congestion and secretion, and partial Horner's syndrome which often accompany CH, in contrast to the symptoms of nausea and vomiting commonly associated with M. Also helpful in establishing the diagnosis are the quality, site and recurrent laterality of the pain, as well as its aggravating and ameliorating factors. Weak features in the differential diagnosis of M and CH are age of onset, sex, family history, and response to therapy.

Patients with M or CH seen at the Headache Unit of Montefiore Medical Center during the past two years were evaluated for the occurrence of the migraine‐cluster headache syndrome. Nine (1.0%) of 923 patients with M had 4 or more features of CH and 5 (3.2%) of 154 patients with CH had 4 or 5 characteristics of M. In 4 patients symptoms of M and CH were blended in such a way neither headache predominated.
Complicated Migraine and Cerebral Angiography: a Report of an Unusual Adverse Reaction
Authors: Kwentus Joseph , Kattah Jorge , Koppicar Mohesh , Potolicchio Samuel J.
Published: June 2005

SYNOPSIS

Adverse reactions have been previously reported when cerebral angiography is performed on patients with complicated migraine. We report a case of complicated migraine in which cerebral angiography produced come and prolonged suppression of EEG rhythms. Possible mechanisms are discussed.
Plasma Methionine Enkephalin Levels — A Biological Marker for Migraine?
Authors: Mosnaim Aron D. , Wolf Marion E. , Chevesich Jorge , Callaghan Owen H. , Diamond Seymour
Published: June 2005

SYNOPSIS

Migraine patients, either during an attack or when pain‐free, have significantly higher platelet‐rich and platelet‐poor plasma methionine‐enkephalin levels than healthy race‐ and sex‐matched and age‐comparable controls. Although we did not observe differences in the platelet‐rich samples between the patients subgroups, platelet‐poor samples had higher peptide levels during a pain‐free period than the values obtained for the patients during a migraine episode. Similarly, platelet‐rich samples obtained from controls and patients during an attack had higher methionine‐enkephalin levels than their corresponding platelet‐poor plasma samples. These results provide new evidence supporting the involvement of the endogenous peptides in the etiology of migraine headache and suggest that plasma methionine‐enkephalin levels could serve as a biological marker for this condition.
Migraine and Cluster Headache Treatment With Calcium Antagonists Supports a Vascular Pathogenesis
Authors: Meyer John Stirling , Nance Matthew , Walker Mary , Zetusky Walter J. , Dowell Richard E.
Published: June 2005

SYNOPSIS

Clinical research during the past four years in this and other laboratories has demonstrated therapeutic effectiveness of three different calcium channel blockers in the prophylaxis of migraine and cluster headaches. The drugs are nimodipine, nifedipine and verapamil. Clinical observations and cephalic hemodynamic responses correlated before and during treatment with nimodipine show extremely low incidences for development of tolerance and/or side effects plus normal glucose tolerance and calcium dependent insulin secretion before and during nimodipine therapy. The results confirm potent and highly selective calcium entry blockade of cephalic smooth muscle receptors by nimodipine. Nifedipine and verapamil showed less therapeutic effectiveness in controlling headaches, higher incidence for development of tolerance and side‐effects with less consistent cephalic hemodynamic changes. Taken together these observations during treatment of migraine and cluster with calcium antagonist support Wolff's theory of vascular head pain.