bluuebunny/crossref_metadata_2025 huggingface dataset:
Migraine Prophylaxis with Lisuride Hydrogen Maleate‐A Double Blind Study of Lisuride Versus Placebo
Authors: Somerville Brian W. , Herrmann Werner M.
Published: June 2005

SYNOPSIS

This paper reports the results of a double‐blind clinical trial of the antiserotonin compound Lisuride hydrogen maleate (LHM) in the prophylaxis of frequent and severe migraine. The study was conducted over a minimum period of three months. When judged according to reduction in frequency of attacks, LHM emerged significantly superior to placebo (p<0.05), though a higher rate of side effects was noted in the active treatment group. A high rate of placebo response (in keeping with other similar trials) was observed.It is concluded that LHM is significantly superior to placebo as a migraine prophylactic and its relative freedom from serious side effects suggests a useful role for the drug as an alternative to methysergide.
Physical Characteristics and Allergic History In Young Men with Migraine and Other Headaches
Authors: Schéle Rickard , Ahlborg Björn , Ekbom Karl
Published: June 2005

SYNOPSIS

Physical characteristics and allergic history have been studied in 436 men 18 years of age with migraine and non‐migrainous headache (NMH) and compared to those of controls. Body height was on average 11 and 8 mm less in the migraine and NMH groups than in the controls (p<0.02 and p<0.05 respectively). Isometric muscle strength in knee extension was on average 4% less among the migraine subjects than among the controls (p<0.01). The average strength of the NMH subjects was for all three muscle tests significantly below that of the controls (p<0.05). Physical working capacity measured on a bicycle ergometer was lower for both migraine and NMH subjects as compared to the controls (p<0.001). Body weight and femoral condylar breadth did not differ significantly between the groups, nor did mean values for hematocrit, sedimentation rate, resting blood pressure, or the results from tests of visual acuity, color vision or hearing capacity. It can be concluded that unselected young men with migraine and NMH are significantly shorter and have lower muscle strength and physical working capacity than controls, although the differences are small. The small group of subjects with cluster headache tended to be taller and heavier and to have higher physical working capacity and lower blood pressure than subjects with migraine and NMH. Allergy to food was more frequently reported by migraineurs than by subjects with non‐migrainous headache (p<0.01) or without headache (p<0.01). Allergy to pollens as well as asthma were present in about the same proportions in all groups (p>0.80).
Headache in a Hospitalized Military Population
Authors: Packard Russell C. , Brannon William
Published: June 2005

SYNOPSIS

The problem of headache is ubiquitous in the medical profession, and is a very frequent complaint at military sick calls. In 1969 a retrospective study of 196 patients hospitalized at the Philadelphia Naval Hospital offered the opinion that “all patients had symptoms and signs of vascular headaches of the migraine type.”Our study was done in a prospective manner to analyze the headache syndromes of 100 patients requiring admission to the Neurology Service at the National Naval Medical Center, Bethesda, Maryland. Only 33% of cases could be classified as vascular headache of the migraine type in this study, utilizing the criteria proposed by the Ad Hoc Committee on Classification of Headache. The other types varied considerably. Findings related to age, sex, circumstances of admission, expectations of hospitalization, history of headache in a primary relative, head trauma, neurologic examination, and laboratory studies are discussed.
The Five Hour Glucose Tolerance Test and Effect of Low Sucrose Diet in Migraine
Authors: Dexter James D. , Roberts John , Byer John A.
Published: June 2005

SYNOPSIS

Seventy‐four patients were evaluated who suffered from migraine and associated their attacks to the mid‐morning or mid‐afternoon fasting state. These seventy‐four patients underwent a standard five hour, 100 gram glucose tolerance test. The glucose tolerance curves of six of the patients were classified diabetic and fifty‐six patients exhibited a curve consistent with degrees of reactive hypoglycemia, i.e., serum glucose of less than 65 mg% or a drop of 75 mg% within one hour. Following dietary therapy with a low sucrose, six meal regimen, all patients who demonstrated a diabetic glucose tolerance curve showed an improvement of greater than 75%, and three have been headache free. Of the fifty‐six patients who showed reactive hypoglycemia curves, forty‐three returned for follow‐up after dietary instruction. Of those forty‐three patients 27, (63%) showed greater than 75% improvement, 17 (40%) showed 50 to 75% improvement and 4 (9%) showed 25 to 50% improvement.
Toxic Effects of Ergotamine Used for Migraine
Authors: Hokkanen E. , Waltimo O. , Kallanranta T.
Published: June 2005

SYNOPSIS

Forty‐three patients (6 males and 37 females) who had used ergotamine tartrate 10 mg or more per week continuously over six months were studied. Twenty (47%) of the patients had symptoms and signs compatible with ergotism. This group had not used more ergotamine tartrate than the group, free of symptoms. Of the patients with symptoms, 13 had cardiovascular symptoms and 5 had clinical signs of peripheral neuropathy. Forty‐three per cent of the patients examined had a normal electroencephalogram and the remainder relatively slight abnormalities. Eight patients had signs of peripheral neuropathy in their electroneuromyographic examination., The neurophthalmological examinations were all normal. Eighteen of 23 patients examined psychologically and psychiatrically were characterized as neurotic. Concomitant diseases were more often seen in the group with symptoms of ergotism; it is especially notable that all patients with collagen or diabetic disorders belonged to this group.
Chronic Paroxysmal Hemicrania: A Case Report
Authors: Russell D. , Christoffersen B. , Hörven I.
Published: June 2005

SYNOPSIS

Corneal indentation pulse amplitudes and intraocular pressures were obtained from a 51‐year‐old Danish woman‐diagnosed as having chronic paroxysmal hemicrania. During headache attacks, values for both procedures were found to be markedly increased, especially on the symptomatic side. Complete relief of symptoms was obtained by indomethacin, prophylactically.
Psychophysiological Studies of Headache: Is There Similarity Between Migraine and Muscle Contraction Headaches?
Authors: Cohen Michael J.
Published: June 2005

SYNOPSIS

Typically migraine and muscle contraction headaches are thought to be different disorders. Recently some investigators have argued that these headache categories are quantitatively, but not qualitatively distinct. Studies of vasomotor and electromyographic (EMG) reflexes and treatments for these headaches were reviewed to elucidate similarities and differences. Similarities include for both types of headaches high levels of tension in the muscles of the head and neck, a vasoconstrictive component, a responsiveness to treatment by relaxation or reduction of frontalis muscle tension. Differences between migraine and muscle contraction headaches relate to the status of the temporal artery between and during headaches and the standard medical treatments used for each. Systematic research is needed to establish if fundamental differences exist between these two major categories of headache.
Is Volitional Manipulation of Hemodynamics a Valid Rationale for Biofeedback Therapy of Migraine?
Authors: Sovak M. , Kunzel M. , Sternbach R.A. , Dalessio D.J.
Published: June 2005

SYNOPSIS

Responses of supraorbital (SA), superficial temporal (TA), and digital (F) arterial beds and the heart rate were studied in 5 normal subjects and 10 migraineurs, when their hand temperature was increased by volition and/or by heat. In normal subjects, volitional digital arterial dilation coincided with vasoconstriction in SA and TA. In migraineurs the response varied. Bradycardia resulted in most subjects except in unimproved migraineurs. Heat induced hand vasodilation led to dilation in SA and TA and to tachycardia. In those 8 migraineurs who improved clinically the finger temperature feedback training apparently did not result in conditioning of a single autonomic response (i.e. digital vasodilation), but in a general decrease of the sympathetic tonic outflow.
Skin Temperature Self‐Regulation and Non‐Invasive Regional Cerebral Blood Flow
Authors: Largen John W. , Mathew Roy J. , Dobbins Ken , Meyer John S. , Claghorn James L.
Published: June 2005

SYNOPSIS

Theoretical notions concerning the mechanism of migraine alleviation via “hand‐warming” techniques remain unclear and are somewhat hampered by a lack of knowledge as to what effect skin temperature self‐regulation has on intracerebral blood flow. Twelve normal female subjects were trained either to increase or to decrease the skin temperature of their hands. Following extensive training, subjects were given one measure of non‐invasive regional cerebral blood flow (rCBF) during a relaxation run and another measure while self‐regulating their skin temperature. The skin temperatures of the hand‐warming and hand‐cooling groups changed in significantly opposite directions. However the rCBF of either the left or right hemispheres showed no such concomitant differentiation. The present study contributes physiological confirmation of existing clinical indications that skin temperature manipulation per se may not be the major factor responsible for the therapeutic gains seen in migraine therapy.
Peripheral Temperatures of Migraineurs Undergoing Relaxation Training
Authors: Werbach Melvyn R. , Sandweiss Jack H.
Published: June 2005

SYNOPSIS

Forty‐five migraine patients entered a program of biofeedback‐assisted relaxation training. Their mean finger temperature prior to training was found to be significantly lower than that of patients with either non‐migrainous headaches, tinnitus or hypertension. Furthermore, while the other three patient groups warmed their hands several degrees during the first session, the migraine patients were unable to do so.

Of the thirty‐seven patients who completed ten training sessions, twenty‐seven were rated as improved. A significant inverse correlation was found between the ability to warm hands during the first session and treatment success. Although patients that improved showed increased hand temperatures across training sessions, the gain scores were not significant. Age was the second best predictor of outcome with the youngest patients showing the most improvement.
Psychological Correlates of Frontalis EMG and Pain in Tension Headache
Authors: Harper Robert G. , Steger Jeffery C.
Published: June 2005

SYNOPSIS

Frontalis EMG, headache pain ratings, and psychological measures of personality and physical‐emotional symptom complaints were obtained from female tension headache patients. Whereas there was no relationship between EMG and headache pain measures, personality factors were significantly associated with patient pain ratings. Physical‐emotional symptom complaints were significantly related to frontalis EMG, consistent with the notion of a psychological component to tension headache.
Prednisone Therapy for Cluster Headache
Authors: Couch James R. , Ziegler Dewey K.
Published: June 2005

SYNOPSIS

Prednisone in peak doses of 10‐80 mg/day was employed for therapy in 19 patients with cluster headache. Overall, 14 of the 19 patients (73%) had greater than 50% relief and 11 (58%) had 100% relief from headache. The remaining 5 patients had less than 50% improvement. Of the subjects who were greater than 50% improved, 12 received peak doses of prednisone of 40 mg. or more, one received 30 mg. and one received 10 mg. The subjects with less than 50% improvement received peak prednisone doses of 10, 30, 40, 60 and 80 mg. Recurrence of cluster headache was noted in 79% of patients when the prednisone dose was tapered below 10–20 mg./d. Prednisone appears effective in relief of cluster headache but recurrence can be expected as the dose is reduced.
Transient Cortical Blindness Following Vertebral Angiography
Authors: Prendes J.L.
Published: June 2005

SYNOPSIS

A 32‐year‐old migrainous woman suffered an episode of transient cortical blindness during evaluation by angiography of her neurological complaints. EEG documentation was obtained to correlate with her deficit and recovery.
Divascan(r) in Migraine Prophylaxis. Open Trial with Three Different Doses
Authors: Osterman P.O.
Published: June 2005

SYNOPSIS

In an open trial 26 patients with severe migraine were treated with 3 different doses of Divascan (1‐isopropyl‐noradrenochrome‐5‐monosemicarbazone) ‐ 15, 30 and 40 mg a day. During treatment with Divascan there was a significant reduction in the number of migraine attacks and in the headache index compared with a preceding control period. The prophylactic effect of 30 and 40 mg Divascan a day seemed better than that of 15 mg a day. The headache frequency was significantly lower with 40 mg a day than with 15 mg a day. A good or very good effect of the treatment was reported by 24 per cent of the patients on 15 mg a day, by 48 per cent on 30 mg a day and by 57 per cent on 40 mg a day. No serious side‐effects were noted. Divascan seems to be a promising drug in the prophylactic treatment of migraine but further studies are needed to establish what doses are optimal in migraine prophylaxis.
Pericarotid Syndrome
Authors: Vijayan N. , Watson Craig
Published: June 2005

SYNOPSIS

Six patients with a syndrome characterized by oculosympathetic paralysis, ipsilateral head pain, and anhidrosis over the forehead with otherwise intact facial sweating are described. Thirty‐one similar cases have been collected from literature which have been designated in the past as either “paratrigeminal” or “Raeder's” syndrome. These cases, however, do not resemble very much the five original cases described by Raeder nor is the location of oculosympathetic paralysis “paratrigeminal.” Clinical evidences from a detailed study of these thirty‐seven cases, animal and human experimental evidences, and observations from our own dissections are presented to establish the fact that the site of lesion of the oculosympathetic fibers in these patients is “pericarotid” and not “paratrigeminal.” This clinico‐anatomical study also helps to better understand the exact course taken by the oculosympathetic fibers from the superior cervical ganglion to reach the various structures in the orbit. Probable pathogenesis and causative factors of this syndrome are also discussed.
Complement and Immune Complex Studies in Migraine
Authors: Lord G.D.A. , Duckworth J.W.
Published: June 2005

SYNOPSIS

Serum complement component levels were measured in sera from those migraineurs who experience premonitory focal neurological symptoms (prodromal) and immune complexes were sought in sera from both prodromal and non‐prodromal migraineurs. Comparison was made between headache‐free, onset and late headache samples in these determinations.

Serum complement component levels were shown not to change with migraine, in prodromal migraineurs. This contrasts with non‐prodromal migraineurs in whom we have previously reported complement activation via the classical pathway at the onset of headache.

Classical pathway activation of complement is most commonly initiated by immune complexes and these were sought using a CIq precipitation technique. Circulating immune complexes were only detected in sera from non‐prodromal migraineurs. In this group of patients there was a significant correlation between the presence of immune complexes and the onset of headache.

These results indicate the occurrence of an immune reaction at the headache onset in non‐prodromal migraineurs but not in prodromal migraineurs. An immune complex mediated immune response could account for many of the reported phenomena in migraine including platelet aggregation and 5‐HT release and basophil and mast cell degranulation. The timing and transient nature of the immune reaction argues for its having a causative role in the attacks of migraineurs without prodromes.
Controlled Trials of Cimetidine in Migraine and Cluster Headache
Authors: Anthony M. , Lord G.D.A. , Lance J.W.
Published: June 2005

SYNOPSIS

Controlled double‐blind trials of the histamine H2‐receptor antagonist, cimetidine, alone and in combination with the histamine H1‐receptor antagonist, chlorpheniramine, in 24 patients with migraine and 20 patients with cluster headache, showed that these agents were ineffective in prophylaxis. The reason for this may lie in the fact that induced intracellular histamine does not act via receptors and does not necessarily negate the hypothesis that histamine plays a role in the pathogenesis of vascular headaches.
Testosterone Levels in Cluster and Non‐Cluster Migrainous Headache Patients
Authors: Nelson Robert F.
Published: June 2005

SYNOPSIS

In a study of 30 cluster headache sufferers compared with 30 men suffering from classical migraine, no significant difference in plasma testosterone levels could be detected. On examination of individual patients it is noted that three patients suffering from chronic cluster headache did have values below the normal range. However, an equal number of sufferers from classical migraine also had low values. All of four female patients suffering from cluster headache had elevated male hormone levels. Speculations are offered as to why hormone variations may be found in these conditions. Further studies will be undertaken in an effort to better understand the underlying mechanisms of this distressing disorder.
Some Clinical Features of the Acute Migraine Attack. An Analysis of 750 Patients
Authors: Olesen Jes
Published: June 2005

SYNOPSIS

Clinical features of 750 patients seen with an acute migraine attack at the Copenhagen Acute Headache Clinic were analyzed. In 47% pain quality was pulsating, in 42% pressing and in 11% other types. Unilateral pain was seen in 56% and bilateral in 44%. Half the patients had interictal headaches. In patients with severe pain the quality was significantly more often pulsating. Patients with bioccipital headache had significantly less visual disturbances than patients with other pain locations. On the basis of these findings the currently accepted definitions of migraine are criticized and a new and more precise definition is proposed. Considerable amounts of tenderness was found in the chewing and neck muscles. The location of tenderness corresponded largely to the location of the pain. Patients with associated symptoms and with pulsating pain quality had significantly more tenderness. There was no correlation between the duration of the attacks and the amount of muscle tenderness. Based on these data and other clinical evidence it is proposed that the muscle tenderness during a migraine attack is not secondary to migrainous pain but rather yet another manifestation of the attack and probably responsible for the pain.
Cluster Headache ‐ Pneumoencephalographic and Cerebral Computerized Axial Tomography Findings
Authors: Russell D. , Nakstad P. , Sjaastad O.
Published: June 2005

SYNOPSIS

Twenty‐eight cluster headache patients have been examined by CT scanning (Delta scan 25), during symptomatic cluster periods. Prior to the introduction of CT scanning, 14 of these patients had been examined by pneumoencephalography, the interval between the two investigations varying between two and six years.

Borderline enlargement of the ventricles was assessed as being present in three of the pneumoencephalographic examinations, but in only one of the CT scan examinations. One other patient showed slight cortical atrophy on both pneumoencephalography and CT scanning. None of the 28 patients examined by CT scanning showed cerebral parenchymal low densitometric areas, similar to those previously described on CT scan examination of some patients with severe migraine.
Accessory Nerve Palsy ‐ A Painful Cranial Neuropathy: Surgical Cure
Authors: Cherington Michael , Hendee Robert , Roland Ralph
Published: June 2005

SYNOPSIS

The accessory nerve can be inadvertently traumatized at the time of lymph node biopsy. The resulting shoulder and occipital pain is severe and disabling. The pain from damage to the Eleventh Cranial nerve can be as agonizing as the painful syndromes relating to the trigeminal and glossopharyngeal nerves. In addition to the severe pain, patients suffer from motor disability and cosmetic deformity associated with a drooping shoulder.
Iris Adrenergic Impairment in Idiopathic Headache
Authors: Fanciullacci Marcello
Published: June 2005

SYNOPSIS

Adrenergic iris neurons were pharmacologically studied in 30 migraineurs, 11 cluster headaches and 30 controls.

The pupillary diameter was measured by photographic technique. When compared with controls, migraineurs showed minor fenfluramine mydriasis and greater, more prolonged guanethidine miosis. No significant differences between the affected and unaffected side were observed by testing with guanethidine in unilateral migraineurs.

A poor concentration and synthesis of noradrenaline in the pupil terminals is hypothesized. Moreover, increased mydriasis observed with phenylephrine suggests alpha adrenoceptor supersensitivity from a defect of neuronal transmitter.

In cluster headaches, only a minor tyramine mydriasis was found in the affected pupil. This suggests low availability of neuronal transmitter or a defect of the synaptic tyramine re‐uptake in the affected cluster pupil. A disorder of the iris adrenergic neurons could mirror an impairment in the central aminergic systems of idiopathic headaches.
Platelet Serotonin (5‐HT) and 5‐HT Releasing Factor in Plasma of Migrainous Patients
Authors: Mück‐Šeler Dorotea , Deanovic Zivan , Dupelj Milivoj
Published: June 2005

SYNOPSIS

The mean platelet 5‐HT concentration in 24 migrainous patients during headache‐free intervals (580 ± 53.3 ng109 platelets, M ± SEM) was similar to that found in 25 healthy persons (550 ± 48.1). A significant fall in platelet 5‐HT level (about 15% p<0.05) was found during migraine attacks as compared with headache‐free intervals. When platelets from blood collected during headache‐free intervals were incubated with platelet‐poor plasma taken from another migrainous patient in attack, the 5‐HT content diminished by 22%. On the other hand, plasma taken in the headache‐free period did not produce a considerable release of platelet 5‐HT. Moreover, plasma from migrainous sufferers in the attack did not elicit 5‐HT release from platelets of healthy persons. These results lend support to the hypothesis that a 5‐HT releasing factor appears in plasma during the migraine attack, and that some platelet abnormality is present in these patients.
MMPI Pattern Specificity in Primary Headache Disorders
Authors: Kudrow Lee , Sutkus Bruce J.
Published: June 2005

SYNOPSIS

MMPI' were obtained from 258 untreated headache patients, of whom 113 were males and 145 females. The diagnostic headache categories included: 1. Migraine alone; 2. Chronic scalp muscle contraction headache (SMC); 3. Combination headache (migraine and SMC); 4. Cluster headache; 5. Post‐traumatic cephalgia (P‐T); 6. conversion cephalgia.

Mean scores of the validity and clinical scales were calculated and compared between diagnostic categories; males considered separately from females. As a result of this comparison, three significantly distinct groups, two categories per group, were obtained; Group A, migraine and cluster; Group B, SMC and combination headaches; Group C, P‐T and conversion cephalgia. This grouping applied to women and men similarly.

In a spectrum of from most normal to most neurotic patterns, Group A was followed by Groups B and C respectively. Significant "conversion v" patterns were found in women with SMC, P‐T, and conversion cephalgia, and in men with combination headache.

In an effort to determine the predictability of correct diagnoses from MMPI patterns, selective criteria were generated and tested in a blind fashion using an additional 83 coded MMPI'. The accuracy of predictability exceeded the .001 level.
Sex Hormones, Prolactin Levels, Osmolarity and Electrolyte Patterns in Menstrual Migraine‐Relationship with Fluid Retention
Authors: Nattero G. , Bisbocci D. , Ceresa F.
Published: June 2005

SYNOPSIS

In order to evaluate a possible connection between fluid retention and menstrual crisis, sex hormones, prolactin levels, osmolarity and electrolyte patterns were investigated in a carefully selected group of migrainous women with regular menses and chronological pre‐menstrual attacks. These include: a) osmolarity, in the span between the two menstrual cycles; b) estradiol, progesterone, prolactin and electrolytes in the follicular and luteal stage, and again immediately before the menstrual attack; c) aldosterone rhythm in the follicular and luteal stages, and again immediately before and during the migraine crisis.

Higher plasma levels of estradiol and progesterone were found in the migraine patients group when compared with the control group. Also prolactin levels appeared to be slightly higher in the migraine group, but no statistical significance had been obtained. In migraine sufferers, osmolarity values fell during the menstrual attack.

Our findings regarding aldosterone changes, as we had previously shown, may explain fluid retention in menstrual migraine sufferers. However a causal relationship is still open to question.
Chronic Paroxysmal Hemicranial: Mechanical Precipitation of Attacks
Authors: Sjaastad O. , Egge K. , Hørven I. , Kayed K. , Lund‐Roland L. , Russell D. , Conradi I. SIørdahl
Published: June 2005

SYNOPSIS,

Chronic paroxysmal hemicrania (CPH) is a cluster headache variant, characterized by daily, frequent, unilateral, excruciatingly severe but rather short lasting headache attacks, which will not surface during chronic indomethacin medication. Three of five patients with an established diagnosis of CPH were able to precipitate attacks by head flexion (or rotation), whereas this ability was not detected in any of 40 patients with regular cluster headache. Attacks with associated unilateral tearing, conjunctival injection, slight miosis, ptosis and headache may start 4–15 second after beginning of head flexion. Precipitated and spontaneous attacks seem identical both clinically and as far as the immediate increment in corneal indentation pulse (CIP) amplitudes and intraocular pressure are concerned.

There are various alternative explanations for the underlying mechanism, the most plausible of which concerns sympathetic nerve involvement.
A Retrospective Assessment of Emergency Department Patients with Complaint of Headache
Authors: Dhopesh Vasant , Anwar Rebecca , Herring Christina
Published: June 2005

SYNOPSIS

A one year retrospective assessment of emergency department patient charts with the chief complaint of headache revealed two major categories: (1) general infections; (2) tension headaches. Although somewhat small, a number of cases were categorized as post‐traumatic, migraine, and hypertension‐related headaches. Only 11 patients out of 872 or 1.2 per cent had serious neurological conditions. It is concluded that the vast majority of headaches seen in the emergency department are benign in nature.
Painful Ophthalmoplegia: Oculomotor Nerve Palsy Without Mydriasis Due to Compression by Aneurysm
Authors: Román‐Campos Gustavo , Edwards Keith R.
Published: June 2005

SYNOPSIS

A patient with a previously diagnosed left Horner's syndrome suddenly developed severe pain in the left eye and diplopia. Ipsilateral third cranial nerve palsy was present, but the pupil remained small and minimally reactive. A carotid angiogram showed a large aneurysm of the left internal carotid‐posterior communicating junction. Pain was only relieved after successful clipping of the aneurysm and liberation of the third nerve. The effects of combined sympathetic and parasympathetic denervation of the pupil and the mechanism of their development in regard to the differential diagnosis of painful ophthalmoplegia are discussed.
Visual Evoked Potentials in Menstrual Migraine
Authors: Lehtonen J. , Hyyppä M. T. , Kaihola H‐L. , Kangasniemi P. , Lang A. H.
Published: June 2005

SYNOPSIS

Visual evoked potentials (VEP) were recorded and plasma estrogen, progesterone, FSH and LH hormones were determined in a group of patients with menstrual migraine and in healthy controls. Consistent differences from controls were found in the VEPs of migraine patients, justifying the use of VEP recording as a method of investigating the neurophysiology of migraine. The VEPs were not dependent on the hormonal cycle, except for responses to flashes 10/sec which in healthy persons were higher in the luteal phase. This was less clear in migraine patients. Some of the patients showed strong asymmetrical VEP distortion, which was always transient; follow‐up revealed later normalisation. The transient and asymmetrical VEP distortion seemed to relate to the asymmetrical symptoms of migraine, but a direct connection between the two was not established.
HLA Antigens in Migraine
Authors: O'Neill Brian P. , Kapur Janet J. , Good Armin E.
Published: June 2005

SYNOPSIS

Fifty consecutive patients with migraine headaches were evaluated for the presence of 10 HLA‐A and 14 HLA‐B antigens by means of the microlymphocytotoxicity assay. Comparisons were made between classical and common migraine, and between patients with and without a family history of migraine. All groups of patients showed an association with B8 and B27, which failed to reach clinical significance. This data suggests that the multifactorial inheritance postulated for migraine probably does not require the participation of the HLA‐A or B locus of the major histocompatibility complex.
Headache and Its Treatment: A Random Sample Survey
Authors: Turner Dan B. , Stone Alan J.
Published: June 2005

SYNOPSIS

Headache characteristics, diagnosis, current treatments, and treatment efficacy of a random sample of the general population were examined as a result of a verbally‐administered questionnaire. The factors of prevalence, frequency, intensity, and duration of the average headache were found to be similar to the findings of earlier studies. Original data on diagnosis, prescribed treatment, and its effectiveness is provided. The findings suggest that further research attention should focus on investigating more effective methods of treatment.
Tranquilizers and Mood Elevators in the Treatment of Migraine: An Analysis of the Migraine Foundation Questionnaire
Authors: Parnell Penny , Cooperstock Ruth
Published: June 2005

SYNOPSIS

A sample of 1,500 self‐report mailed questionnaires distributed by the Migraine Foundation was analyzed To provide basic information on a large number of migraine sufferers in Canada, and more specifically to examine the extent of use and the perceived efficacy of tranquilizers and mood elevators by migraine sufferers.

Data were presented on family history, headache history and type of migraine, triggers, physicians/specialist contacts, the extent and efficacy of both drug and non‐drug treatments, and suspected addiction. For each of these topics, the limitations of this data, unique or interesting findings and areas deserving further investigation were discussed.

The analysis of the data on tranquilizers and mood elevators indicated that these drugs had been used by approximately 41% of migraine sufferers at some time. In general, the type of migraine did not appear to determine who received the tranquilizing and mood elevating agents. Females were more prone to both migraine and to the use of any of the classes of medication. Tranquilizers and mood elevators, considered to be moderately efficacious, ranked below the prescription pain killers, many of the special migraine medications and many of the non‐drug treatments.
The Value of Biofeedback in the Treatment of Chronic Headache: A Five‐Year Retrospective Study
Authors: Diamond Seymour , Medina Jose , Diamond‐Falk Judi , DeVeno Theresa
Published: June 2005

SYNOPSIS

A five‐year retrospective study was conducted with patients who had completed training with thermal and electromyograph feedback and muscle relaxation exercises. The purpose was to examine the long‐term effects of biofeedback training on headache problems. A questionnaire was mailed to all 556 patients who had completed training between September, 1972 and January, 1977. Patients were asked to measure the effects of biofeedback training on their headache problems, i.e., no improvement, transient improvement, or long‐term improvement. 407 questionnaires were completed and returned. The role of such variables as age at time of training, sex, the presence of a habituation problem prior to training, and time elapsed since training were analysed and found to significantly influence the success of biofeedback training. A trend was seen within the diagnosis variable. The most successful biofeedback candidate was found to be a female under 30 years of age who was not habituated to medication and without depressive symptoms, diagnosed as suffering from vascular headaches. It can be concluded from the results that biofeedback training is a successful form of therapy in treating headache problems.
Reliability of Headache Questionnaire Data
Authors: Thompson J. Kevin , Collins Frank L.
Published: June 2005

Synopsis

The self‐report questionnaire is the most common data collection procedure used in normative headache investigations. However, reliability data for such an instrument is notably lacking in the headache literature. In the present study, the reliability of questions commonly used in headache questionnaire assessment was evaluated. One hundred and one college students were given a headache questionnaire twice, with three months separating the administrations. As a group, the subjects were very reliable as indicated by highly significant (p <.001) correlations. However, differences were noted when the subject population was divided into “problem headache” and “non‐problem headache” groups on the basis of reported headache frequency and severity. There was a tendency for the “problem headache” group to be less reliable reporters of headache severity and accompanying symptoms. Results are discussed with regard to the need for more research into symptom reliability and its facilitative effect on the development of a standard headache assessment instrument.
Is the Cluster Headache Local Mastocytic Diaethesis?
Authors: Prusinski A. , Liberski P.O.
Published: June 2005

SYNOPSIS

Mast cell counts from the skin over painful regions were obtained in cluster patients and compared to those from controls. A significantly higher count was found in the cluster group, and suggests a possible causal relationship.
Vasospasm and Vascular Headaches: Selective Vasoconstriction in the Carotid Vascular System Measured by the Doppler Ophthalmic Method in Migraineurs
Authors: Otis S. M. , Smith R. A. , Kroll A. D. , Krasny S. E. , Seltzer K. A. , Dalessio D. J.
Published: June 2005

SYNOPSIS

With the finding of significant extracranial cerebral vascular disease in 60–70% of patients with transient ischemic attacks (TIA), increased emphasis has been placed on the early detection of extracranial vascular lesions by noninvasive methods. The Doppler Ophthalmic Test (DOT), introduced in 1970 is one such technique. DOT's are abnormal in a significant percentage of patients (5‐12%) found not to have extracranial vascular disease by angiography. Three thousand DOT's performed in a 3 12 year period at the Hospital of Scripps Clinic were re‐examined. 37.2% of the positive sonograms occurred in patients with severe vascular headaches. Since migrainous patients have altered vasomotor function, it is suggested that the abnormal DOT represents a significant degree of vasoconstriction in the internal carotid or ophthalmic arteries. It is suggested further that persistence of vasoconstriction is related to complicated migraine and may, in part, be responsible for the increased occurrence of stroke in migraine patients.
Thermographic and Doppler Flow Asymmetry in Cluster Headache
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

Bilateral examination of supraorbital and frontal arteries in 26 patients were examined by the Doppler flow technique. In 70% of the patients, ipsilateral flow was diminished when compared to contralateral flow, during interim periods. An additional 5 patients were tested during the cluster attack and in 10 to 15 minute intervals, for I hour, following administration of sublingual ergotamine tartrate. Measurements of blood flow velocity revealed: ipsilateral decrese during the attack; marked increase 10 to 15 minutes following ergot administration; and a slow decline toward baseline by one hour. Doppler flow examination was supplemented by facial thermography in an additional 20 patients, of whom 7 had not used medication, 6 had been treated prophylactically without success, and 7 successfully treated. The results indicated that when treatment was successful, velocity values were higher on the ipsilateral side in most patients (p<.01), as were thermographic values (p<.001). Most patients, either untreated or unsuccessfully treated had lower Doppler and thermographic values ipsilaterally (p<.001), in agreement with data obtained earlier in this study. Although the results of this study clearly challenges the suggestion that the cluster attack is due to vasodilatation, it does not provide an explanation for pain nor establishes the presence of absolute vasoconstriction. It does suggest that extracranial vasodilatation and increased CBF observed during attacks, may be compensatory responses to internal carotid artery spasm.
In Vitro Response of Animal Arteries to Serum of Migraineurs
Authors: Nattero G. , Franzone J. , Croce F. , Bisbocci D. , Genazzani E.
Published: June 2005

SYNOPSIS

Vasoactive substances have long been suspected to be of importance in the genesis of migraine. In vitro experiments carried out by us and partially published, resulted in significant data concerning the contracting activity of migraineiurs' sere on various isolated organs. In the present study, extracranial animal arteries were tested by means of blood samples taken under identical conditions. No contracting activity from sere taken both in the headache‐free period and during the migraine crisis was observed in animal arteries. By contrast, each serum taken after the onset of the migraine crisis, showed a synergic effect on the action of histamine, serotonin and bradykinin. This synergic effect increases with the worsening of the attack, while it decreases as soon as the attack wears off.The experiments on human specimens provided data which cannot be evaluated yet. It seems likely that, on the occasion of the migraine attack, vasoactive substances which enable isolated organs to contract In vitro are released or activated. They synergistically increase the activity of serotonin and histamine.
Effects of Headache on Working Ability: A Survey of an Urban and a Rural Population in Northern Finland
Authors: Nikiforow Rita , Hokkanen E.
Published: June 2005

SYNOPSISIn a headache survey in which a self‐administered questionnaire was used, the respondents were asked to estimate work absence frequency, effect on daily activities and disability due to headache. Work absence was not a common occurrence. Only 2632018 respondents (13%) who suffered from headaches were absent from work one or more days during the previous year. Of these, absence was estimated at 1–3 daysyear in 41%, and 7 days or less, in 55%. 28% stated that they had been absent but were unable to estimate the number of days. Self‐employed persons had a higher percentage of absence than other employed categories, and the rural self‐employed and rural housewives had the highest percentage of absence. 22% stated that headache did not affect their work, 26% were able to carry on by easing their pace of work, and 47% were forced to rest or lie down during an attack. In a random sample of 154 personally examined headache sufferers, vascular headaches were more incapacitating, but did not cause more frequent absence from work.
Placebo, 1‐Isopropylnoradrenochrome‐5‐Monosemicarbazono and Pizotifen in Migraine Prophylaxis
Authors: Kangasniemi P.
Published: June 2005

SYNOPSIS

A new agent to be used in the prophylaxis of migraine has been developed. In addition to its antiserotonin effect it reduces vascular permeability. This preparation, 1‐isopropyl‐3‐hydroxy‐5‐semicarbazono‐6‐oxo‐2.3.5.6‐tetrahydroindol, was compared to pizotifen and to placebo by double‐blind cross‐over design. The doses were 15 mg respectively. 34 patients with severe and chronic migraine completed the study. The effects did not differ very much from each other. Pizotifen seemed to be more effective, but the semicarbozone derivative caused fewer side‐effects. 14 patients reported no benefit from either preparation.
The Copenhagen Acute Headache Clinic: Organization, Patient Material and Treatment Results
Authors: Olesen Jes , Aebelholt Anette , Veilis Bent
Published: June 2005

SYNOPSIS

The Copenhagen Acute Headache Clinic is part of the neurological department of the University Hospital. Patients with acute attacks of headache are treated day or night by the neurological nursing staff and residents. A standard history and examination is used.

88% of all headache patients had migraine. They were treated with metoclopramide 10 mg. i.m. for nausea vomiting and to speed up gastric emptying. Mild analgesics (acetylsalicylic acid 1 gm. or acetaminophen 1 gm. p.o.) and a tranquilizer (diazepam 5 mg. p.o.) were also given.

67% left symptom‐free. 25% left with only mild headache and the remainder left with moderate pain or unimproved. Median time in hospital was four hours. There was no correlation between the length of the attack at the time of arrival and the treatment result. Patients with frequent, severe migraine, (judged by the number of previous house calls) responded as well as others. Patients who had previously used morphine‐like drugs, also responded well to our standard treatment. It is concluded that treatment of migraine patients in‐hospital is worthwhile and economically acceptable when combined with research and teaching.
HLA Antigens in Cluster Headache
Authors: Cuypers J. , Altenkirch H.
Published: June 2005

SYNOPSIS

HLA typing was performed in 42 cluster headache patients. In the total group, no significant deviation in HLA antigen frequencies could be found. This result was also true for the subgroup of the episodic type (37 patients). However, all 5 patients with the chronic form of cluster headache carried the HLA‐A1 antigen. The results are discussed.
Abnormal Cerebrovascular Reactivity in Patients with Migraine and Cluster Headache
Authors: Sakai Fumihiko , Meyer John Stirling
Published: June 2005

SYNOPSIS

Cerebral vasomotor responsiveness to 5% CO 2 or 100% 0 2 inhalation or hyperventilation was tested in groups of patients with either migraine or cluster headache. Regional cerebral blood flow was measured by the 133 Xe inhalation method before and during hypercapnia, hypocapnia or hyperoxia. A series of 79 headache patients were tested (18 classic, I complicated, 37 common, 16 cluster and 7 muscle contraction). For purposes of comparison, cerebral vasomotor responsiveness was likewise tested in 48 age and sex matched healthy volunteers. CO 2 responsiveness was expressed as D%Fg (gray matter blood flow) per mmHg PECO 2 (end‐tidal CO 2 tension). Normal response was 3.6 ± 0.8% during 5% CO 2 inhalation and 3.0 ± 0.9% during hyperventilation. Inhalation of 100% O 2 inhalation reduced mean hemispheric Fg by 9.4 ± 5.4%. During the prodrome of migraine (N = 1) there was bilateral impairment of hemispheric CO 2 responsiveness. During the headache phase of migraine (N = 5) CO 2 responsiveness was impaired throughout both hemispheres but recovery occurred 24 hours after headache had subsided. During the headache‐free interval of migraine (N = 21) there was excessive cerebrovascular CO 2 responsiveness (5.1 ± 2.2%). The cerebral hemisphere on the side of predominant head pain showed significantly greater excessive CO 2 response than the “non‐headache” hemisphere. During cluster headache (N = 2) hemispheric CO 2 responsiveness was similarly impaired, but returned to normal immediately after the headache subsided. Unlike migraineurs, during cluster headache the cerebral vasoconstrictive response to 100% O 2 was excessive with marked reduction of Fg (33 ± 11%), with relief of headache. Two different types of abnormality in cerebral vascular receptor sites are hypothesized, which make it possible to differentiate migraine from cluster headache.
Serotonin: Change in Plasma‐free Level and Urinary Excretion after LM 5008 and Reserpine
Authors: Uzan A. , Kabouche M. , Imbault F. , Fur G. Le
Published: June 2005

SYNOPSIS

LM 5008, a potent 5‐HT uptake inhibitor, induced an increase in plasma‐free 5‐HT level in a higher proportion than its metabolite 5‐HIAA. In contrast, reserpine provoked a greater rise in 5‐HIAA than in 5‐HT, indicating stimulation of 5‐HT turnover. LM 5008 potentiated the effects of reserpine on bound and free 5‐HT and 5‐HIAA levels but potentiated more the plasma‐free 5‐HT (4 times) than 5‐HIAA (2.5 times), over reserpine‐induced increases. Moreover, the rise in urinary excretion of 5‐HT induced by reserpine was potentiated by LM 5008, whereas 5‐HIAA was decreased. The differences between these two drugs implies that they do not act on the same platelet site. Since migraine has been proposed as a “low 5‐HT syndrome,” LM 5008 may be useful as an anti‐migrainous agent.
Disturbed Liver Function in Migraine Patients
Authors: Capel Ifor D. , Grant Ellen C.G. , Dorrell Helen M. , Pinnock Marisa H. , Rose F. Clifford , Williams Donald C.
Published: June 2005

SYNOPSIS

Hepatic function as estimated from the plasma kinetics of antipyrine has been determined in 32 migraine patients. A high proportion of patients exhibited abnormal plasma half‐life and metabolic clearance rates for this drug. The serum levels of copper and zinc were also estimated in these patients; the ratio copper:zinc was uniformly higher than that of controls.
Reserpine ‐ Headache and PRL Release in Migraine
Authors: Nappi G. , Savoldi F. , Bono G. , Martignoni E.
Published: June 2005

SYNOPSIS

In the light of Sicuteri's central theory of migraine, reserpine‐induced attacks have been related to a central depletion of monoamine stores, 5HT and DA in particular. Reserpine is known to increase serum prolactin (PRL) levels. The PRL response to reserpine, before and after treatment with drugs affecting DA and 5HT pathways, has been used as a tool to clarify the role of central neurotransmitters in migraine pathogenesis. Twenty‐nine migraine patients and a control group underwent i.v. reserpine tests under control of PRL levels. A retest was performed after thirty days of treatment with bromocriptine, DL‐5HTP or methysergide.

The reserpine‐induced PRL increase was similar for migraine and control groups during the first 5 hours, with no relationship to occurrence and severity of headache. Only the control males, however, had returned to basal PRL levels after 24 hours. At the retest, only bromocriptine could prevent the PRL increase by reserpine and the onset of headache in nine out of ten patients. The value of the pharmacodynamic PRL secretions tests is emphasized in order to clarify the central mechanisms of various trigger factors in headache, and drug effectiveness in the management of migraine.