bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Effectiveness of Calcium Entry Blockers in Prophylactic Treatment of Migraine and Cluster Headaches
Authors: Meyer John Stirling , Hardenberg Jeffrey
Published: June 2005

SYNOPSIS

Since Wolff's original proposal regarding the vascular etiology of cyclic head pain, evidence has accumulated that the prodromes of migraine are due to cerebral vasoconstriction and headaches of both cluster and migraine are due to painful dilatation. Theories regarding their pathogenesis include cyclic release of vasoactive substances from platelets and/or other sources (such as serotonin, catecholamines, histamine, acetyl choline, prostaglandins, substance P, endogenous opiates). These substances influence vasomotor receptors bringing about abnormal constriction and/or dilatation. Drugs which modify receptors (such as methysergide, alpha and beta blockers, antihistaminics, anticholinergics, steroids and non‐steriodal anti‐inflammatory agents) have had some therapeutic success in migraine but provide little benefit for cluster patients. Ca2+ entry blockers (including nimodipine, nifedipine, verapamil) theoretically should diminish cephalic vasoconstriction and ‐dilatation no matter what their cause. To test this, 35 headache patients with classic (N = 13), common (N = 14) migraine or cluster (N=8) were evaluated by double‐blind, cross‐over, randomized assignment to high or low dose nimodipine therapy. Within 10 days migraine prodromes became infrequent and after 2–4 weeks headache frequency was significantly reduced for migraine and within 4–6 weeks for cluster. CBF measurements during oxygen inhalation showed reduced cerebral vasoconstrictive responses after high dose nimodipine. Associated muscular contraction headaches were not altered. Nifedipine and verapamil provided equivalent relief for cluster but produced more side effects, and were less effective, than nimodipine in control of migraine.
Cluster Headache Developing Following Ipsilateral Orbital Exenteration
Authors: McKinney Alexander S.
Published: June 2005

SYNOPSIS

A patient developed cluster headache after exenteration of the ipsilateral orbit. This case illustrates that the prominent eye findings in cluster headache are epiphenomena, and not critical to the development of the pain itself.
The Effects of Propranolol and Amitriptyline on Vascular and EMG Biofeedback Training
Authors: Jay Gary W. , Renelli Dona , Mead Travis
Published: June 2005

SYNOPSIS

Biofeedback training for vascular and neuromuscular (EMG) control has been used for the treatment of migraine, chronic muscle contraction headaches, and myofascial pain syndromes. Many patients undergoing this training are concurrently taking propranolol, a beta blocker, and/or amitriptyline, a tricyclic antidepressant which inhibits re‐uptake of serotonin. There is an extreme paucity of information delineating the effects and interactions of these medications in patients learning autonomically mediated vascular control through biofeedback. In this pilot study we examined the ability of patients to learnvascular control and neuromuscular control. Four groups of patients were used: those taking no medication, those taking propranolol or amitriptyline alone, and patients using both medications. Results indicate the use of propranolol in patients learning vascular control produces a markedly increased variability in the ability of patients to control physiological parameters; this difficulty is also manifested in EMG training of patients taking only amitriptyline. Those within group variances were found to be negated by the use of both medications together. In spite of these findings, all groups did reach training criterion. In some patients the inability to easily control baseline physiological parameters may induce enough frustration to cause premature termination of training. It is postulated that the effectiveness of biofeedback training might be enhanced in patients not concurrently taking medications with autonomic effects.
A Computerized Behavioral Assessment for Children With Headaches
Authors: Leviton Alan , Slack Warner V. , Masek Bruce , Bana Dhirendra , R.Graham John
Published: June 2005

SYNOPSIS

We have developed a computerized interview program suitable for school‐age children with headaches. Behavioral assessment questions have been included. Between 18 and 39% of children and teenagers acknowledge that something happens to influence their headache either the day before, or the day of the headache. Some of the more frequent antecedents included “an especially hard day at work/school/home,” skipping a meal, worrying a lot, and unexpected excitement or pressure. The older the child or adolescent, the more likely he/she acknowledged that an “unpleasant emotional situation” preceded the headache. Chocolate was the only food or beverage identified as a headache antecedent. Heat and sun glare were reported most frequently as weather concomitants of headache. Approximately 30% of the children and teenagers were concerned about headaches interfering with their activities, and between 22 and 46% wanted to control their headaches without medications. Our experience indicates that children who read can complete a computer‐based interview containing behavioral assessment questions, and that an appreciable number of children brought to medical attention for their headaches are receptive to behavioral therapies.
Mood and Migraine ‐ a Preliminary Prospective Study
Authors: Harvey P.G. , Hay K.M.
Published: June 2005

SYNOPSIS

Ten migraineurs assessed their moods daily for 30 consecutive days on both a general and a specific mood rating scale in a preliminary prospective study. Results from the eight subjects who successfully completed the task indicate an overall improvement in mood on pre‐headache days and a worsening on days when they had headaches. The mood change seemed to reflect both reduction in depression and increasing general alertness.
Treatment of Headache by Transcutaneous Electrical Stimulation
Authors: Solomon Seymour , Guglielmo Karen M.
Published: June 2005

SYNOPSIS

Transcutaneous electrical stimulation (TENS) has been used extensively for many types of pain but only rarely for headache. The object of this study was to judge the efficacy of TENS against placebo. Contrary to popular use, TENS (and placebo) were applied in a rigid manner, probably prejudicial to maximum effectiveness.

62 patients with migraine or muscle contraction headache, or both, were studied using TENS equipment of low amperage and high frequency. One of three modalities was chosen at random for each patient: TENS just above the patient's ability to perceive the stimuli (perceived stimuli), TENS just below the perception threshold (subliminal stimuli), and electrodes applied without electrical stimulation (placebo). Degree of improvement was judged by the patient using a scale of pain from 1 to 10. Following treatment with TENS perceived by the patient, 55% of patients noted improvement as compared to 18% after application of placebo; a significant difference (p < .025 chi‐square test). Subliminal TENS was not statistically better than placebo.
A Distinctive Facial Thermographic Pattern in Cluster Headache the “Chai” Sign
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

To ascertain the diagnostic value of thermography in cluster headache, a large group of cluster patients was studied and compared to non‐cluster headache groups, The latter groups included classical, hemiplegic and common migraine. Unexpectedly, a distinctive thermographic pattern pathognomic of cluster headache was revealed.

An asymmetric ipsilaterally decreased supraorbital temperature distribution was found in 67% to 75% of patients with cluster headache, classical migraine and hemiplegic migraine. This finding occurred with significantly less frequency in the common migraine group.

Thirty‐two out of 130 (25%) of cluster patients and eight out of 58 (14%) of classical and hemiplegic migraine groups displayed a specific facial temperature pattern best described as a “chai” pattern, the Hebrew word for “life.” Doppler blood flow velocity examination confirmed the vascular nature of this pattern as formed by supraorbital and superficial temporal arteries and their anastomotic vessels. The chai pattern was not evident in any of the 462 common migraine patients.

The chai pattern was designated a “chai” sign when occurring contralaterally, and as such, was found to occur with significantly greater frequency in the cluster headache group when compared to the combined classical and hemiplegic migraine groups.
Autonomic Nervous System Dysfunction in Common Migraine
Authors: Rubin Leonard S. , Graham Dennis , Pasker Roy , Calhoun William
Published: June 2005

SYNOPSIS

Common migraine has been related to both dysfunction of the autonomic nervous system (A.N.S.) in the regulation of cerebral vasomotor tonicity and to neurotic and depressive tendencies. In the present study 86 normal healthy controls and 50 patients with common migraine were studied in order to determine whether tonic or phasic central autonomic nervous system dysfunction was concomitant with migraine during a headache‐free, medication‐free interval. pupillometry was employed to measure relevant parameters of sympathetic and parasympathetic activity at rest and during the cold pressor test. Concomitantly, measurements of neuroticism, anxiety and depression were also obtained.

Migraineurs were not identifiably different from controls with respect to tonic sympathetic or parasympathetic activity nor were they distinguishable on measures of supranuclear inhibition. However, 70% of migraineurs manifested phasic hyposympathetic activity in response to the cold pressor test. These migraineurs also demonstrated more neurotic and depressive tendencies. The physiological dysfunction was shown to differentiate the groups of migraineurs after personality variables were statistically controlled by a covariance multiple regression analysis.

Results of the study are discussed in relationship to cerebral blood flow and permeability of the cerebral vasculature.
Clomipramine and Metoprolol in Migraine Prophylaxis — A Double‐blind Crossover Study
Authors: Langohr H.D. , Gerber W.D. , Koletzki E. , Mayer K. , Schroth G.
Published: June 2005

SYNOPSIS

Clomipramine, metoprolol, or placebo was administered to 36 migraine patients in a double‐blind crossover study. The patients were randomly assigned to one of the following five treatment groups: group 1 (clomipramine followed by placebo), group 2 (placebo followed by clomipramine), group 3 (metoprolol followed by placebo), group 4 (placebo followed by metoprolol), and group 5 (clomipramine followed by metoprolol). Dosage form was the same in all groups. The study de sign consisted of a 6‐week baseline period, administration of first drug for 4 weeks, a 4‐week washout period, administration of second drug for 4 weeks, and a 6‐week followup period. Headache variables such as attack frequency as well as headache intensity and duration were recorded daily in diaries. The data were evaluated by time series analysis (ARIMA). Only metoprolol significantly reduced attack frequency and headache duration. Adverse reactions to clomipramine were severe. Our results showed metoprolol to be an effective antimigraine drug.
Cluster‐Tic Syndrome
Authors: Watson Peter , Evans Ramon
Published: June 2005

SYNOPSIS

This paper reports five instances of the association of cluster headache and tic douloureux (trigeminal neuralgia) and reviews the literature.
Proquazone for Tension Headache‐A Multicenter Trial
Authors: DiSerio Frank J. , Friedman Arnold P. , Parno Jeffrey , Singer Jack M.
Published: June 2005

SYNOPSIS

The efficacy and safety of proquazone 150 mg and proquazone 75 mg was compared to placebo in a double‐blind, randomized, parallel, multi‐investigator study in the acute treatment of muscle contraction (tension) headache.

Of the 122 patients entered into the study, 5 were subsequently discontinued, and 117 patients (39 in each of the three treatment groups) were included in the efficacy analyses.

The effects of proquazone 150 mg on all of the symptoms associated with the muscle contraction (tension) headache symptom complex, namely pain, psychic tension and muscle stiffness of the head, neck and shoulders, were significantly superior to both proquazone 75 mg and placebo. These results were consistent using both a patient self‐rating form and a physician's global evaluation of patient response to study medication. For the pain parameters, proquazone 75 mg also showed significant superiority to placebo indicating a dose related clinical effect of proquazone. Only four patients reported transient adverse effects after taking the study medication, which were considered to be mild in nature, and none required therapeutic intervention.
Cluster Headache in a Patient Without an Ipsilateral Eye
Authors: Prusinski Antoni , Liberski Pawel R , Szulc‐Kuberska Janina
Published: June 2005

SYNOPSIS

Typical cluster headaches occurred in a patient who had had the ipsilateral eye removed eighteen years previously. This case, and similar ones in the literature, eliminate the eye as an important link in the pathogenesis of cluster headache.
Effectiveness of Methysergide in Relation to Clinical Features of Migraine
Authors: Drummond P.D.
Published: June 2005

SYNOPSIS

Clinical data collected during a comparative trial of serotonin antagonists1 was reanalysed to determine whether particular migrainous features were associated with a good response to methysergide. Patients with the fewest number of headache days per month and those with symptoms of cerebral disturbance before or during migraine had the best outcome.
Headache in the Rural Village of Quiroga, Ecuador
Authors: Sachs Howard , Sevilla Francisco , Barberis Patricia , Bolls Liana , Schoenberg Bruce , Cruz Marcelo
Published: June 2005

SYNOPSIS

Epidemiologic studies on headache among the Mestizo population in the rural village of Quiroga, Ecuador, was carried out as part of a neuroepidemiologic project under sponsorship of the World Health Organization. The distribution and prevalence of headache according to age and sex taken from a sample of 1113 persons is reported. Of the total number of headache sufferers, 35% gave a history of only occasional headache; these were equally divided among males and females. The remainder or 65% regarded their headaches as severe or disabling; 81% were female. Of these, 43% described migrainous headaches. Among the males the headache classification was 77% tension‐type and 23% migrainous. The overall prevalence of migraine (both common and classical) was 11/1000 for males and 61.5/1000 for females. In a preliminary investigation of the association of headache and depression, 63% of 19 female sufferers scored clearly in the depressed range.
Headache as the Leading Symptom of the Thoracic Outlet Syndrome
Authors: Raskin Neil H. , Howard Mark W. , Ehrenfeld William K.
Published: June 2005

SYNOPSIS

Intractable headache is a common presenting symptom of the thoracic outlet syndrome (TOS). We followed thirty patients for at least six months after transaxillary first rib resection. Prior to surgery, twenty‐six reported recurring headache before the appearance of neck and shoulder pain; headache was lateralized in 21 and continual in 14. In 11, intensification of TOS symptoms accompanied headache. After surgery, 11 previously disabled patients returned to work; 13 became head‐ache‐free. Eleven others reported benefit from vaso‐active drugs that had been ineffective pre‐operatively.
Are Classical and Common Migraine Different Entities?
Authors: Wilkinson Marcia , Blau J.N.
Published: June 2005

SYNOPSIS

Classical migraine has been described as a familial disorder characterized by recurrent; attacks of headache widely variable in intensity, frequency and duration.1 Attacks are commonly unilateral and are usually associated with anorexia, nausea and vomiting. In classical migraine the headache is preceded or accompanied by transient focal neurological phenomena e.g. visual, sensory or speech disturbances. Nonclassical or common migraine is not associated with sharply defined focal neurological disturbances and occurs more frequently.

Are these two conditions the same or do they differ in some fundamental way? The evidence for and against their being a single entity is discussed. The conclusion reached is that common and classical migraine are probably different aspects of the same disorder.
The Efficacy and Cost‐effectiveness of Minimal‐therapist‐contact, Non‐drug Treatments of Chronic Migraine and Tension Headache
Authors: Blanchard Edward B. , Andrasik Frank , Appelbaum Kenneth A. , Evans Donald D. , Jurish Susan E. , Teders Steven J. , Rodichok Lawrence D. , Barron Kevin D.
Published: June 2005

SYNOPSIS

Two studies, one involving 53 tension headache patients and the other involving 87 vascular (both migraine and combined migraine and tension headaches) headache patients, are presented in which a largely home‐based, self‐administered non‐drug treatment for headache was compared to a comparable clinic‐based, therapist‐administered treatment regimen. The home‐based treatment programs were equal in effectiveness to the clinic‐based programs and significantly more cost effective for both types of headache patients.
Neck Tongue Syndrome
Authors: Fortin Claude Jean , Biller José
Published: June 2005

SYNOPSIS

The neck tongue syndrome is a rare clinical entity not well appreciated. In general, it has a good prognosis. We present two patients with this syndrome, both with novel additional symptoms. Existing clinicoanatomical and physiological correlates are discussed.
Maprotiline in Chronic Tension Headache: a Double‐blind Cross‐over Study
Authors: Fogelholm R. , Murros K.
Published: June 2005

SYNOPSIS

In a double‐blind cross‐over study maprotiline was compared with placebo in the treatment of chronic tension headache in 30 women aged 16 to 52 years with a history of headache for 1.5 to 20 years. The treatment periods were 6 weeks long and the daily dose of maprotiline increased in two weeks from 25 mg to 75 mg nocte. The effects of the treatment ware measured by visual linear analogue scale, verbal rating scale, number of days without headache, number of days needing additional analgesics, and the patients' global impression of the treatment periods. In all these parameters maprotiline was superior to placebo and the difference was statistically highly significant. Beck Depression Inventory scores improved slightly during both placebo and maprotiline but the improvements wars without statistical significance. Patients not or only slightly depressed according to BDI responded better to maprotiline than those more severely depressed. Side‐effects ware frequent but mild and did not necessitate stopping the treatment.

The results suggest that maprotiline is effective and useful in the treatment of chronic tension headache.
Trigeminal Cistern Glycerol Injections for Facial Pain
Authors: Waltz Thomas A. , Dalessio Donald J. , Ott Kenneth H. , Copeland Brian , Abbott Gaye
Published: June 2005

SYNOPSIS

The treatment of paroxysmal facial pain is often easily accomplished. At times, however, the converse occurs; the pain becomes more refractory, and unresponsive to therapy. This is especially the case when trigeminal neuralgia, cluster headache, and atypical facial pain become chronic. This report will summarize our experience with injection of glycerol into the region of the trigeminal cistern for intractable facial pain in 71 patients; 58 with trigeminal neuralgia, 5 with chronic cluster headache, and 8 with atypical facial pain.
Biofeedback Behavioral Treatment of Headache With Locus of Control Pain Analysis: a 20‐month Retrospective Study
Authors: Hudzinski Leonard G. , Levenson Hanna
Published: June 2005

SYNOPSIS

Muscle contraction headache is associated with sustained contraction of skeletal muscles. Approximately 80 percent of headache sufferers have this form of headache. Behavioral approaches offer a powerful treatment alternative to the use of medication. Studies on the long‐term outcome of effectiveness of biofeedback‐behavioral programs, however, are scarce. The purposes of this paper were twofold: to assess through a survey method long‐term patient progress on headache control 20 months after a specific biofeedback‐behavioral program; and to examine how a personality variable (i.e., expectations of control) might be related to success in headache self‐regulation. Specifically it was hypothesized that patients with an internal locus of control would be more likely to exercise self‐control and rate the biofeedback‐behavioral program higher than externally oriented individuals. A self‐re‐port evaluation questionnaire inquired into the patient's perception of the headache program's effectiveness and the consequent increase or decrease of headache activity. A pain locus of control scale was used as a means to assess the personality variable theses.

Of 114 potential subjects contacted, 74 (65%) completed questionnaires for this study. Most 82% of these chronic patients achieved and maintained a significant decrease in overall headache intensity, severity, and duration 20 months after biofeedback‐behavioral treatment. Of variables analyzed, sex, number of sessions attended, age at time of treatment program participation, and locus of control were found significant in influencing the effectiveness of training in reducing headache activity. Chronic patients benefiting most were under 40 years of age and had an internal locus of control. We concluded biofeedback behavioral training is an effective form of therapy in treating chronic muscle contraction headache. The pain locus of control scale appears useful for predicting and possibly selecting patients most likely to succeed in biofeedback‐behavioral headache treatment programs.
Cluster Headache and the Nervus Intermedius
Authors: Solomon Seymour
Published: June 2005

SYNOPSIS

The nervus intermedius (NI) appears to be the main conduit of cluster headache (CH). Parasympatheticimpulses via the NI account for the associated symptoms of ipsilateral tearing and redness of the eye,congestion of the nose and rhinorrhea. Vasodilatory stimuli to the internal carotid artery may result inpartial Horner's syndrome and set off a cascade of events causing pain, similar to the changes in theexternal carotid arterial tree during migraine. The pain of CH may also be carried by afferent impulsesaccompanying motor fibers of the deep facial muscles.The central nervous system (CNS) mechanisms responsible for the circannual recurrence of CH may beexcitatory with parasympathetic impulses channeled through the NI. Conversely, inhibitory CNSmechanisms may be invoked to explain long remissions, if CH were to be due to hypersensitivity of the NIas caused by the subtle injury of a cross compressing blood vessel.
Migraine Prophylaxis with Salmon Calcitonin: a Cross‐over Double‐blind, Placebo‐controlled Study
Authors: Gennari Carlo , Chierichetti M. Silvio , Gonnelli Stefano , Vibelli Claudio , Montagnani Mario , Piolini Marco
Published: June 2005

SYNOPSIS

Ten women with histories of migraine attacks and with diagnosis of classic or common migraineconcluded a double‐blind, placebo controlled, cross‐over study to assess the effectiveness of syntheticsalmon calcitonin 100 MRC U. i.m. a day in preventing migraine attacks. After a two‐month run‐in phase thewomen were randomly allocated to one of the following two‐month sequences: placebo‐calcitonin orcalcitonin‐placebo. The patients filled in every day a standard card with number, duration and severity ofattacks. The mean migraine frequency per month on calcitonin was 3.7±0.7 (s.e.m.) and on placebo 7.7±1.3(r<0.01). The ratio of total score of headache intensity to the number of days of observation on calcitoninwas 0.18±0.03 and on placebo was 0.30±0.04 (r<0.01). It is concluded that calcitonin is effective forprophylactic treatment of migraine and should be useful when other first‐choice treatments arecontraindicated.
Brainstem Auditory Evoked Potential (BAEPs) in Cluster Headache (CH): New Aspects for a Central Theory
Authors: Bussone G. , Sinatra M.G. , Boiardi A. , Frediani F. , Mantia L. La , Lamperti E. , Peccarisi C.
Published: June 2005

SYNOPSIS

16 patients suffering from cluster headache (CH) were studied by recording brainstem auditory evoked potentials(BAEPs). Some subjects underwent examination in a pain‐free period, some others during an acute attack, andothers during treatment with lithium.All the data were compared with the BAEPs records of 16 normal control subjects. CH patients showed anasymmetrical interaural pattern, both in the basal condition and in a pain period, greater than the asymmetryoccurring in normal subjects.These specific neurophysiological findings may be evidence for suggesting a central pathogenesis of CH.
Nonpharmacological Treatment of Menstrual Headache: Relaxation‐Biofeedback Behavior Therapy and Person‐Centered Insight Therapy
Authors: Szekely Barbara , Botwin David , Eidelman Benjamin H. , Becker Margaret , Elman Nancy , Schemm Robert
Published: June 2005

SYNOPSIS

Sixty percent of female headache sufferers have an increase paramenstrually. Although behavioraltreatment of migraine and tension headache has proven effective in controlled studies, the effect onparamenstrual increases has rarely been isolated and observed. The purpose of this study was todemonstrate the effects of two types of nonpharmacological treatment on menstrual headache: 1)relaxation with EMG and thermal biofeedback, and 2) person‐centered insight therapy, as an alternativetreatment control. The design was that of the time series method. Diagnosis was made into subtypes ofmigraine, muscle‐contraction, mixed and cluster headache. 16 women with paramenstrual headaches selfmonitored 4 times daily for a 2‐cycle baseline, then were matched on pre‐treatment pain levels into 8 pairsand randomly assigned to treatment, 12 sessions carried out over 3 cycles, with a one‐month follow‐upcycle. Post‐treatment group data analysis was by three‐way analysis of variance with 2 repeatedmeasures. There were no significant main effects of group or time, although individual clinical analysis bypercent improvement demonstrated a trend of greater improvement in the behavioral group. Resultssuggest that nonpharmacological treatment has a lesser impact on menstrually associated headachesthan on headaches not associated with menstruation.
Headache Clinics: Their Role in Health Care Systems and Science
Authors: Rose F. Clifford
Published: June 2005

SYNOPSIS

There is often opposition to the establishment of special clinics. In spite of this, the last fifty years hasseen a gradual increase in the number of clinics serving specifically patients with headaches. While thereare wide variations, there can be little doubt that they provide the basic clinical material for research andwill, by the accumulating experience and expertise, best serve to help patients with headache disorders.
Clinical Features of Stroke in Migraine: A Review
Authors: Featherstone Harvey J.
Published: June 2005

SYNOPSIS

High resolution CT scanning in patients with post‐traumatic head pain is superior to conventional radiography for detecting fractures and other lesions of the facial structures. This is an important consideration, since such lesions may be responsible for the post‐traumatic pain. Direct axial and coronal scanning is adequate for diagnosis in most cases; multiplanar reconstructions can be done to obtain sagittal and other views. The radiation dose and cost of CT are comparable to those of conventional tomography.
A Correlative Study of Immunoglobulin Isotype Expression in Common Migraine
Authors: Rubin Leonard S. , Boyer Jere
Published: June 2005

SYNOPSIS

Recent studies have hypothesized that late‐onset immune response may be mediated through Immunoglobulin G (IgG) and Immunoglobulin A (IgA) in common migraine. In the present study, measurements of serum concentrations IgD, IgA, IgE, IgM and IgG were obtained on samples of healthy controls and common migraineurs. No significant differences in concentration of any of the isotypes were found between groups. Correlational analysis between isotypes within groups demonstrated that whereas the relationships between IgD and IgG, IgD and IgA, and IgG and IgE were positive in the control group, the correlations between these variables in the migraineurs were negative (inverse). Moreover, the application of semi‐partial correlational techniques to these relationships generated divergent models of regulatory process underlying isotype expression. In control subjects, IgD is involved in the expression of IgA and IgE, which are reciprocally related to each other and in turn affect the concentration of IgG. Common migraineurs were found to be characterized by a dysfunctional regulatory process as manifested in their pattern of isotype expression. IgD is involved in the independent expression of IgA, IgE or IgG, but IgA and IgE are not involved in the expression of IgG and there is no reciprocal relationship between IgA and IgE.
Migraine, Mitral Valve Prolapse and Platelet Function in the Pediatric Age Group
Authors: Lanzi Giovanni , Grandi Anna Maria , Gamba Gabriella , Balottin Umberto , Barzizza Franco , Longoni Patrizia , Fazzi Elisa , Venco Achille
Published: June 2005

SYNOPSIS

We evaluated 58 pediatric patients (39 females) suffering from various kinds of migraine in order to assess the prevalence of mitral valve prolapse, using echocardiography, and platelet function, using standard platelet aggregation tests. The patients were grouped as follows: 14 subjects with muscle contraction headache, 9 subjects with common migraine, 13 subjects with classic migraine, 22 subjects with complicated migraine. We examined as a control group 30 normal subjects matched for age and sex with the patients. Prevalence of MVP in subjects with complicated migraine (59%) was significantly higher as compared to the other groups of patients ( r <0.005) and to the control group ( r <0.0005). The prevalence of MVP in subjects with classic and common migraine (13.6%) was slightly, but not significantly higher than in the control group (6.7%). No significant differences in platelet aggregation tests were observed either between groups of migraine sufferers and controls, or between subjects with and without MVP. We suggest that the association between MVP and complicated migraine is not coincidence, and that follow‐up studies are needed to assess its clinical significance.
The Role of Stress in Recurrent Tension Headache
Authors: Holm Jeffrey E. , Holroyd Kenneth A. , Hursey Karl G. , Penzien Donald B.
Published: June 2005

SYNOPSIS

This study investigated the role of stress in recurrent tension headache. Although recurrent tension headache sufferers (N=117) and matched headache‐free controls (N=174) reported similar numbers and types of stressful life events, headache sufferers reported a greater number of chronic everyday stresses or daily hassles than did controls. Recurrent tension headache sufferers also appraised the stressful events they experienced more negatively than did controls, and employed less effective coping strategies in their efforts to manage stressful events. When the potential impact of a stressful event was ambiguous, recurrent headache sufferers appraised this event more negatively and themselves as having less control over the event than did headache‐free controls. In their coping efforts, recurrent tension headache sufferers also placed greater reliance on the relatively ineffective coping strategies of avoidance and self‐blame, and made less use of social support than did controls. These findings suggest that research on the role of stress in tensionheadaches should focus not on the occurrence of major stressful life events, but on the recurrent headache sufferer's cognitive appraisals of stressful events and efforts to cope with stress.
A Controlled Study of Dihydroergotamine in the Treatment of Acute Migraine Headache
Authors: Callaham Michael , Raskin Neil
Published: June 2005

SYNOPSIS

A prospective, double‐blind, crossover study was conducted of the effectiveness of dihydroergotamine (DHE) vs. placebo in the treatment of acute migraine in the emergency department. Thirty‐seven patients were enrolled. By 60 minutes after treatment, those receiving DHE first had significantly better relief of pain than those receiving it later. Side effects were fairly common but were minor and did not necessitate terminating treatment. Eleven per cent of patients had significant relief of pain with prochlorperazine pre‐treatment alone. Only 13.5% of patients treated with this DHE regimen required narcotics at the end of the study for relief of pain, compared to 45% of migraine headache patients seen concurrently in the same emergency department who were not enrolled in the study. We conclude that treatment with intravenous prochlorperazine and DHE is a safe and effective treatment and a useful alternative to narcotics.
Prophylaxis of Migraine: A Comparison Between Naproxen Sodium and Pizotifen
Authors: Behan P.O. , Connelly K.
Published: June 2005

SYNOPSIS

Seventy‐four migraine sufferers were entered into a randomized, single‐blind study to compare the prophylactic effects of naproxen sodium and pizotifen. 550 mg naproxen sodium twice daily or 0.5 mg pizotifen three times daily were given for up to three months. Response to treatment was determined by monthly clinical assessments and daily patient self‐assessment.

Both groups showed a significant decline in both the severity of migraine (p=0.001) and in the frequency of attacks (p = 0.02). No significant differences were detected between groups.

Tolerance to both treatments was good. The most common adverse experience reported by the naproxen sodium treated patients was nausea (6 patients), whereas pizotifen gave rise to weight gain in five patients.

The study has shown that naproxen sodium is a useful prophylactic agent for migraine.
Differential Responsivity of the Vasomotor Response System to a “Novel” Stressor
Authors: McCaffrey Robert J. , Goetsch Virginia L. , Robinson James , Isaac Walter
Published: June 2005

SYNOPSIS

Bilateral blood volume pulse (BVP) recordings from the frontotemporal artery were obtained from a migraineur and eight non‐migraineurs prior to and following the presentation of a novel laboratory stressor ‐ the consumption of ice water. The results revealed a markedly different pattern of BVP activity in the migraineur compared to the non‐migraineurs. The implications of these findings for assessing the disregulation of the vasomotor response system are noted. In addition, the novel stressor used in this study may be used for inducing migraine attacks in controlled laboratory environment.
Post‐Traumatic Headache Patients I: Demographics, Injuries, Headache and Health Status
Authors: Barnat Michael R.
Published: June 2005

SYNOPSIS

While research has recently focused on the perceptions of general headache patients of their disorders, little attention has been paid to post‐traumatic headache patients, their perceptions of their disorder and of its course, and their perception of the health care system in which they have become participants. The present study was designed to provide data on these aspects. The respondents were new and return post‐traumatic headache patients in a headache treatment center. A survey form was employed and, in a twelve month sampling effort, the opinions of one hundred seventeen patients were obtained. This report describes demographic characteristics of the sample, the patients' premorbid and postmorbid health status, the status of headache and associated symptoms, and descriptions of injuries and of post‐traumatic amnesia. Patients and their families are often demoralized by both the symptoms and their slow resolution. They lack information around which to build long term coping strategies. The data in this report can be helpful in tailoring treatment programs and guiding patients with respect to prognosis.
Plasma Methionine Enkephalin. Increased Levels During a Migraine Episode
Authors: Mosnaim Aron D. , Chevesich Jorge , Wolf Marion E. , Freitag Frederick G. , Diamond Seymour
Published: June 2005

SYNOPSIS

Plasma methionine‐enkephalin (MET) levels in migraine patients, either during an attack or when pain‐free, are statistically significantly higher than in matched controls; this is also true when comparing the classical and nonclassical migraine subpopulations with the control group. Individual patients consistently presented lower MET plasma concentrations in the pain‐free period than during the acute headache, with some subjects showing values falling within the range of controls. Platelet neuropeptide content was similar in patients and controls, irrespective of plasma MET levels. These results indicate that increased plasma MET concentrations are associated with the occurrence of a migraine episode and suggests that they are not a constant characteristic of migraineurs.
Migraine and Platelet Aggregation in Patients Treated With Low Dose Acetylsalicylic Acid
Authors: Hosman‐Benjaminse S.L. , Bolhuis P.A.
Published: June 2005

SYNOPSIS

To discriminate between the general analgesic effect of acetylsalicylic acid (a.s.a.) and a specific effect by inhibition of platelets we treated 27 migraine patients with low doses of acetylsalicylic acid. In a double‐blind randomized cross‐over study a small change in number of migraine attacks was found which however must be ascribed to a period effect. Severity of attacks as judged by the patients was similar in the placebo and drug periods. The frequency of attacks and the effect of a.s.a. were not significantly different in patients with platelets relatively sensitive to ADP and those with a slow response to ADP. No correlation was found between number of attacks and inhibition of the ADP aggregation obtained by administration of a.s.a. We concluded that low doses of a.s.a. are not useful to reduce the number or the severity of migraine attacks, and that no correlation exists between migraine attacks and a.s.a. effects on ADP‐induced platelet aggregation. High doses of a.s.a. appear to be beneficial in migraine only by a general analgesic effect.
Predictors of Outcome in Headache Patients Presenting to Family Physicians ‐ a One Year Prospective Study
Authors:   The Headache Study Group of The University of Western Ontario
Published: June 2005

SYNOPSIS

Two hundred and seventy‐two patients presenting to family physicians with a new complaint of headache were enrolled in a one year prospective study. Data was collected from patients and doctors at the first visit. Patients were interviewed at home six weeks after the first visit, and follow‐up data was obtained by mailed questionnaire or telephone interview at six months and one year. Patients were diagnosed by three of the investigators, using conventional diagnostic categories. Fifty‐six patients (21.1%) had headache of organic origin. Of the 209 with non‐organic headache, the majority were diagnosed as muscle contraction headache (MCH) possible (38.8%), common migraine possible (28.6%) and MCH definite (21.8%). The distinction between common migraine possible and MCH had no value in predicting outcome. There was a gradient of increasing severity across the spectrum of nonorganic headache, from MCH to classical migraine, a finding which we believe supports the “severity model”. The factors independently associated with a good outcome at one year (p<0.05) were the patient's assessment at six weeks that he had had the opportunity to discuss his problem fully at the first visit, an organic diagnosis, and no report of visual symptoms accompanying the headaches. More severe pain and warning vomiting were strongly associated with a poor outcome. Since the distinction has no predictive value, we suggest that headaches without definite features of migraine or cluster headache be categorized as recurrent non‐specific headache (R.N.S.H.).
Unusual Angiographic Appearance During Attack of Hemiplegic Migraine
Authors: Jensen Ivan W.
Published: June 2005

SYNOPSIS

Transfemoral carotid angiography was performed in a 23‐year‐old man twelve hours after the abrupt onset of hemiplegic migraine. An unusual appearance of the internal carotid artery contralateral to the hemiplegia was noted. Possibly this appearance represented spasm.
Marital Conflicts and Exacerbation of Headache: Some Clinical Observations
Authors: Roy Ranjan
Published: June 2005

SYNOPSIS

The purpose of this paper is to highlight the association between deteriorating family situations and conflicts, and exacerbation of head pain. Many headache sufferers seen at a university‐based headache clinic reveal complex family‐related problems which may have had a negative effect on their head pain. It is argued that family assessment and treatment, if indicated, has considerable therapeutic value both for the patient's headache as well as overall functioning of the family.
Cardiovascular Reflexes in Young Migraine Patients
Authors: Havanka‐Kanniainen H , Tolonen U , Myllylä V.V
Published: June 2005

SYNOPSIS

The autonomic nervous system functions of 49 young migraine patients, aged from 11 to 22 years, wereinvestigated during headache‐free intervals by utilizing a number of cardiovascular reflexes as indices.Twenty‐five healthy subjects of similar age served as a control group. The pulse rate (R‐R‐interval)variation was registered in normal and deep breathing, during the Valsalva manoeuvre, and in anorthostatic test (a tilt table was used); and the blood pressure measurements were performed in anorthostatic test and during an isometric work test. There were no significant differences between the groupof young migraine patients and the control group. Furthermore, all numeric mean values were in thenormal limits given in the literature; only incidental abnormal values were encountered, and even then inboth groups. Moreover, the cardiovascular reflex responses of various subgroups of migraine patients(common‐classic, frequent ‐infrequent attacks, patients with or without autonomic nervous systemdysfunction signs during attacks, normal‐abnormal EEGs), did not significantly differ from each otherduring this interictal recording period. The results suggest intact autonomic nervous system functions inyoung migraine patients during headache free intervals.
Headache and Cervical Spine Disorders: Classification and Treatment with Transcutaneous Electrical Nerve Stimulation
Authors: Farina Stefano , Granella Franco , Malferrari Giovanni , Manzoni Gian Camillo
Published: June 2005

SYNOPSIS

A clearer definition of the relationship between headache and disorders of the cervical spine appearsnecessary not only for classification purposes but also for a more rational approach to the management ofsuch conditions. The classification proposed here would distinguish headaches etiologically related to cervicalspine disorders from those in which these disorders might represent just one of several triggering orcomplicating factors. The first group includes cervicogenic headache, occipital neuralgia, auriculotemporalneuralgia, cervicalgia and cervicobrachialgia; the second group includes muscle‐contraction headache andmixed headache. Treatment with transcutaneous electrical nerve stimulation (TENS) was applied in 10 patientswith cervicogenic headache, 15 patients with occipital neuralgia, and 35 patients with muscle‐contraction ormixed headache. Good results, i.e. HI improvement >60% in 70–80% of cases, were obtained in all three groupsof patients, with no significant differences between them.
The Economic Burden of Headache: An Epidemiological Study in the Republic of San Marino
Authors: Benassi G. , D'Alessandro R. , Lenzi P.L. , Manzaroli D. , Baldrati A. , Lugaresi E.
Published: June 2005

SYNOPSIS

We examined the socio‐economic consequences of headache in a random sample of 514 working people living inthe Republic of San Marino. Our results show that, in the preceding year, 255 out of 514 (49.6%) suffered fromheadache; 31.9% (164/514) reported decreased efficiency as a consequence of headache; 9.3% (48/514) reportedthat head pain is always severe; 7.4% (38/514) were absent from work because of headache for a total of 338working days lost; 8.4% of all working days lost to illness were due to headache.We estimated that in the Republic of San Marino (21,792 inhabitants), headache causes a loss of at least 5,000working days every year. Since the cost of a working day in the Republic of San Marino is about 100,000 italianlire, the economic burden in this area amounts to 500 millions of lire in a year. This shows that headache is amajor socio‐medical problem.
Nadolol and Propranolol in Migraine Management
Authors: Olerud Bengt , Gustavsson Carl‐Lennart , Furberg Bengt
Published: June 2005

SYNOPSIS

The prophylactic effects of nadolol once daily and propranolol b.i.d. were studied in 28 patients with common or classic migraine. Following screening procedures, the subjects entered a 28‐ to 120‐day placebo period, which was followed by a 24‐week randomized, double‐blind treatment period. The prophylactic effects were evaluated by frequency of migraine attacks, consumption of acute migraine‐relief tablets, duration of attacks, ratings of headache and nausea severity, and duration of incapacitation. Compared to placebo, both beta blockers brought about a highly significant (p < 0.01 ) reduction in attack frequency and consumption of acute migraine‐relief tablets, while no significant changes were found with regard to the other variables. No significant differences were found between the two beta blockers. The results indicate that nadolol once daily is as effective as propranolol b.i.d. in migraine management and that the main effect of beta blockers in migraine is in preventing attacks from breaking out, while the capacity for reducing the intensity or duration of unsuppressed attacks is less prominent.
Migrainous Olfactory Hallucinations
Authors: Schreiber Andrew O. , Calvert Preston C.
Published: June 2005

SYNOPSIS

Olfactory hallucinations have been reported in association with numerous neurologic and psychiatric disorders. We present four cases of olfactory hallucinations accompanying migraine headache. Each patient had a normal neurologic examination, normal cranial CT, and normal EEG. All patients experienced relief of olfactory hallucinations and headaches with propranolol therapy. The specific subjective features of olfactory hallucinations associated with various neurologic and psychiatric disorders are reviewed, and a classification of these sensory phenomena along well‐defined axes is presented. Olfactory hallucinations associated with migraine are usually perceived as extrinsic, real and unpleasant, features which are also common in such hallucinations associated with other neurologic diseases. Psychiatric olfactory hallucinations are most often perceived as intrinsic, unreal, or both. These subjective aspects of the hallucinations are helpful in differential diagnosis, but careful evaluation is necessary to exclude other neurologic disorders.
Auditory Brainstem Evoked Potentials in Patients with Migraine
Authors: Podoshin Ludwig , Ben‐David Jacob , Pratt Hillel , Fradis Milo , Sharf Benjamin , Weller Boaz , Wajsbort Jerzy , Zellinger Michael
Published: June 2005

SYNOPSIS

Auditory brainstem evoked potentials (ABEP's) using the routine 10 per second click rate, and also a 55 persecond stimulus rate, were studied in 17 migraine patients between and during attacks, and in 20 normal subjects.Only in the "migraine during attack" group did the increased stimulus rate change the ABEP's. Similar changeswith increased stimulus rates may be seen in situations of ischemic synaptic dysfunction. Thus, our data supporta vascular pathogenesis of migraine.
Impairment of Consciousness and Memory in Migraine: A Review
Authors: Sacquegna Tommaso , Cortelli Pietro , Baldrati Anna , De Carolis Piero , Tinuper Paolo
Published: June 2005

SYNOPSIS

Four distinctive patterns of consciousness and memory impairment can be recognized during amigraine attack: 1. syncope, 2. transient global amnesia, 3. confusional state, 4. epileptic seizure.We discuss old and new views concerning the mechanisms responsible for these differentdisturbances of consciousness.