bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual Contrast Gain Control in Migraine: Measures of Visual Cortical Excitability and Inhibition
Authors: McColl SL , Wilkinson F
Published: March 2003

The present study examined the extent to which migraineurs demonstrate interictal visual cortical hyperexcitability as a result of poor inhibitory control in the visual system. We employed a well-established psychophysical measure of inhibition, visual contrast gain control. The task involved detecting a briefly presented target that was superimposed on a highly excitable high contrast masking pattern. The strength of inhibition was assessed by comparing target detection thresholds with and without the operation of gain controls. Migraineurs with and without aura ( n = 25, n = 22, respectively) were compared with those with no history of migraine ( n = 25). Our results do not indicate a loss of inhibition in migraine; the strength of inhibitory feedback contrast gain controls was similar between migraineurs and controls. We did however, find a statistically greater masking effect in migraineurs compared with controls in the zero delay condition, suggesting cortical hyperexcitability in migraine. Possible mechanisms of cortical hyperexcitability are discussed in light of the results.
SUNCT Syndrome Responsive to Gabapentin (Neurontin)
Authors: Graff-Radford SB
Published: March 2003

A 48-year-old male suffering with SUNCT (severe unilateral neuralgiform headache with conjunctival injection and tearing, rhinorrhea and sub-clinical sweating) presented in 1996 after a 10-year history of multiple failed therapies. The symptoms included strictly left-sided ocular, as well as facial and temple pain. The pain attacks were burning, sharp, shooting and occurred 25 times daily, lasting 2 to 3 minutes with tearing and conjunctival injection. There was no associated nausea or vomiting, but there was photophobia. No other autonomic changes were reported and the pain was not triggerable. Initially Indocin (indomethacin) was tried without significant benefit. Gabapentin (Neurontin) was then started with improvement at 1800 mg per day. The patient was then lost to follow-up for 3 years, as he moved from the Los Angeles area. He returned in 1999 having stopped the gabapentin after his prescription ran out in 1996, reporting the pain returned immediately. Again gabapentin was prescribed and at 900 mg three times daily he has been pain free for 12 months.
The Long-Term Effects of Homeopathic Treatment of Chronic Headaches: 1 Year Follow Up
Authors: Walach H , Lowes T , Mussbach D , Schamell U , Springer W , Stritzl G , Haag G
Published: March 2003

Little is known about the long-term effects of homeopathic treatment. Following a double-blind, placebo-controlled trial of classical homeopathy in chronic headaches, we conducted a complete follow-up study of all trial participants. All patients enrolled in the double-blind study were sent a 6-week headache diary, a follow-up questionnaire. Eighty-seven of the original 98 patients enrolled returned questionnaires, 81 returned diaries. There was no additional change from the end of the trial to the 1-year follow up. The improvement seen at the end of the 12-week trial was stable after 1 year. No differential effects according to treatment after the trial could be seen. Patients with no treatment following the trial had the most improvement after 1 year. Approximately 30% of patients in homeopathic treatment will benefit after 1 year of treatment. There is no indication of a specific, or of a delayed effect of homeopathy.
Release of Calcitonin Gene-Related Peptide (CGRP) from Guinea Pig Dura Mater in vitro is Inhibited by Sumatriptan But Unaffected by Nitric Oxide
Authors: Eltorp CT , Jansen-Olesen I , Hansen AJ
Published: March 2003

Migraine attacks can be provoked by administration of nitroglycerin, suggesting a role for nitric oxide (NO). The fact that release of the neuropeptide CGRP from trigeminal sensory nerves occurs during the pain phase of migraine and that NO can augment transmitter release prompted us to study CGRP release from the in situ dura mater in guinea pig skulls. Release of CGRP by capsaicin or by high potassium concentration was concentration-dependent and counteracted in calcium-free medium. The anti-migraine compound, sumatriptan, inhibited CGRP release via the 5-HT1-receptor. The NO donors, nitroglycerin, sodium nitroprusside and S-nitroso-N-acetylpenicillamine did not influence CGRP release, alone or together with the stimulants. We concluded that the skull preparation is well suited for scrutinizing CGRP release from dura mater. The fact that sumatriptan inhibits CGRP release as in migraine patients suggests a use for the present preparation in headache research.
The Prevalence of Migraine in Women Aged 40–74 Years: A Population-Based Study
Authors: Mattsson P , Svärdsudd K , Lundberg Po , Westerberg C-E
Published: March 2003

The objective of this study was to investigate the age-dependence of the prevalence and characteristics of migraine headache and migraine visual aura. A neurologist interviewed 728 women attending a mammography screening programme. International Headache Society (IHS) criteria were used. The lifetime prevalence of migraine headache was 31.5% and the 1-year prevalence 18.0%. The magnitude of the decline of the prevalence of active (one or more attacks in the previous year) migraine headache was estimated to 50% per decade. The prevalence of active migraine visual aura was 3.8%. This did not vary by age. Except for the pain intensity and the presence of nausea, other characteristics and concomitant symptoms did not change with age. Active migraine headache and migraine visual aura in middle-aged and older women are common and modified differently by age. We suggest that the decline of prevalence of active migraine headache with age is caused by a decrease in pain intensity.
Nitric Oxide Metabolites, Prostaglandins and Trigeminal Vasoactive Peptides in Internal Jugular Vein Blood During Spontaneous Migraine Attacks
Authors: Sarchielli P , Alberti A , Codini M , Floridi A , Gallai V
Published: March 2003

Despite evidence emerging from the experimental model of nitroglycerin-induced headache, the endogenous increase in nitric oxide (NO) production during migraine attacks is only speculative. It has been hypothesized that there is a close relationship between activation of the l-arginine/NO pathway and production of certain vasoactive and algogenic prostaglandins during spontaneous migraine attacks, but this suggestion also needs to be confirmed. In the present study the levels of nitrites, the stable metabolites of NO, were determined with high performance liquid chromatography (HPLC) in the internal jugular venous blood of five patients affected by migraine without aura examined ictally. These samples were taken within 30 min, 1, 2, and 4 h from the onset of the attack and at the end of the ictal period. At the same time, the plasma levels of calcitonin gene-related peptide (CGRP), neurokinin A (NKA), prostaglandin E2 (PGE2) and 6 keto PGF1α, the stable product of PGI2, were assessed with radioimmunoassay (RIA) kits in the same samples. The levels of the intracellular messengers, cGMP and cAMP, were also measured with the RIA method. Nitrite, cGMP, CGRP and NKA levels reached their highest values at the first hour, then they tended to decrease progressively and returned, after the end of attacks, to values similar or below those detected at the time of catheter insertion (anova, statistical significance: P < 0.001; P < 0.002; P < 0.002; P < 0.003, respectively). PGE2 and 6 keto PGF1α, as well as cAMP levels also significantly increased at the first hour but reached a peak at the 2nd hour and remained in the same range until the 4th and 6th hours. Then their values tended to decrease after the end of attacks, becoming lower than those measured immediately after catheter positioning for internal jugular venous blood drawing (anova: P < 0.002, P < 0.004, P < 0.001, respectively). Our results support early activation of the l-arginine/NO pathway which accompanies the release of vasoactive peptides from trigeminal endings and a late rise in the synthesis of prostanoids with algogenic and vasoactive properties which may intervene in maintaining the headache phase.
Lanepitant, an NK-1 Antagonist, in Migraine Prevention
Authors: Goldstein DJ , Offen WW , Klein EG , Phebus LA , Hipskind P , Johnson KW , Ryan RE
Published: March 2003

Lanepitant, a potent non-peptide neurokinin-1 receptor antagonist, inhibits neurogenic dural inflammation, and may have a role in migraine therapy. This study evaluated the effect of lanepitant taken daily for migraine prevention. Patients with migraine headaches with and without aura by International Headache Society classification criteria were enrolled in a 12-week double-blind, parallel design study comparing the effect of 200 mg qd lanepitant ( n = 42) and placebo ( n = 42) on reduction of migraine frequency. The primary outcome measure was response rate, i.e. the proportion of patients with a 50% reduction in days of headache. Of the 84 patients enrolled, 90.5% were female. The endpoint response rate for lanepitant-treated patients (41.0%) was not statistically significantly ( P = 0.065) greater than that for placebo-treated patients (22.0%). No efficacy variables differed significantly between treatments, except for response rates at month 3 ( P = 0.045). Higher plasma concentrations were no more effective than lower concentrations. In this study lanepitant was not effective in preventing migraine, but was well tolerated. These results do not support a role for NK-1 antagonism in migraine prevention.
A Comparative Study Of Oral Acetylsalicyclic Acid and Metoprolol for the Prophylactic Treatment of Migraine. A Randomized, Controlled, Double-Blind, Parallel Group Phase III Study
Authors: Diener HC , Hartung E , Chrubasik J , Evers S , Schoenen J , Eikermann A , Latta G , Hauke W ,   The Study Group
Published: March 2003

This study was a multinational, multicentre, double-blind, active controlled phase III trial designed to investigate efficacy and safety of 300 mg acetylsalicyclic acid (ASA) ( n = 135) vs. 200 mg metoprolol ( n = 135) in the prophylaxis of migraine. In total 270 (51 male and 219 female) patients, aged 18–65 years, suffering between two and six migraine attacks per month were recruited. The main objective was to show equivalence with respect to efficacy, defined as a 50% reduction in the rate of migraine attacks. A run-in phase was carried out with placebo for 4 weeks, followed by a 16-week drug phase. In both treatment groups the median frequency of migraine attacks improved during the study period, from three to two in the ASA group and from three to one in the metoprolol group; 45.2% of all metoprolol patients were responders compared with 29.6% with ASA. Medication-related adverse events were less frequent in the ASA group (37) than in the metoprolol group (73). The findings from this trial show that metoprolol is superior to ASA for migraine prophylaxis but has more side-effects. Acetylsalicylic acid is better tolerated than metoprolol. Using a strict responder criterion ASA showed a responder rate comparable with the placebo rate in the literature.
Needle Acupuncture in Tension-Type Headache: A Randomized, Placebo-Controlled Study
Authors: Karst M , Reinhard M , Thum P , Wiese B , Rollnik J , Fink M
Published: March 2003

A study with needle acupuncture was performed in tension-type headache employing a new placebo acupuncture method. Sixty-nine patients (mean age 48.1 years, sd = 14.1) fulfilling the International Headache Society criteria for tension-type headache were randomly assigned to verum or placebo condition. No significant differences between placebo and verum with respect to visual analogue scale and frequency of headache attacks could be observed immediately, 6 weeks and 5 months after the end of treatment. There was a significant but weak improvement in quality of life parameters (clinical global impressions, Nottingham Health Profile) after verum treatment. In decision tree analyses, the changes in clinical global impressions and headache frequency depended significantly on primary headache frequency with a limit value of 24.5 days headache per month. High values in the von Zerssen Depression Score resulted in high mean visual analogue scale values.
Migraine and Haemostasis
Authors: Crassard I , Conard J , Bousser M-G
Published: March 2003

Migraine is a risk factor for cerebral infarction in young women. The nature of the connection between these diseases remains however essentially unknown. Abnormalities of haemostasis leading to an increased thrombotic risk would provide a logical link. Platelets, antiphospholipid antibodies and more recently congenital thrombophilia have thus successively been implicated. The different studies concerning these topics have been reviewed. Because of the conflicting results obtained and because of the numerous methodological shortcomings of many of these studies, no definite conclusion can be reached. It is possible that these 3 factors play a role in the ischemic risk of migraine, but it is as likely or even more likely that other factors (inside or outside the hemostatic system) play a more important role. Further studies are thus deeply needed.
Nitric Oxide Potentiates Response of Trigeminal Neurones to Dural or Facial Stimulation in the Rat
Authors: Jones MG , Lever I , Bingham S , Read S , McMahon SB , Parsons A
Published: March 2003

Infusing glyceryl trinitrate as a donor molecule, we have used electrophysiological and c-fos immunostaining techniques to study the effects of nitric oxide on neurones in the nucleus trigeminalis caudalis. Following infusion of glyceryl trinitrate, responses of neurones to electrical stimulation of periorbital cutaneous afferents were potentiated and threshold for activation of neurones by stimulation of dural afferents was reduced. Expression of c-fos was unchanged by glyceryl trinitrate compared to saline controls. Intradermal injection of capsaicin in the periorbital area increased c-fos expression in nucleus trigeminalis caudalis; this was significantly potentiated by glyceryl trinitrate. These results suggest that, in the anaesthetized rat, glyceryl trinitrate alone may not acutely activate the trigeminovascular system to a significant degree at doses that cause headache and later trigger migraine headache in migraineurs. Nevertheless, it is susceptible to exogenous nitric oxide in that activation of trigeminal neurones through cutaneous or dural pathways is potentiated. This may in some measure underlie the pathogenesis of migraine headache.
Cluster Headache Sine Headache: Two New Cases in One Family
Authors: Leone M , Rigamonti A , Bussone G
Published: March 2003

We report two cases of cluster headache sine headache occurring in a family of cluster headache sufferers. A 54-year-old female, suffered for 15 years from short-lasting, right-sided attacks of eye reddening, lacrimation, rhinorrea, palpebral oedema and miosis, seven to eight times per day, in periods of 20-30 days. She did not experience headache, either with or without these phenomena. Her son suffers from periorbital, short-lasting, right-sided painful attacks accompanied by eye reddening, lacrimation, rhinorrea and nasal stiffnesss, occurring in periods of 30-35 days. Soon after the end of the current cluster period he still had daily attacks lasting 10-15 min, with the oculo-nasal autonomic phenomena only. The occurrence of cluster headache sine headache and cluster headache in the same family strongly suggests that the first condition is related to the cluster headache syndrome. Cluster headache sine headache should be considered as a subtype of the cluster headache syndrome.
Migraine and the Extrapyramidal System
Authors: Barbanti P , Fabbrini G
Published: March 2003

This review explores a large series of observations from clinical and experimental studies on the interactions between migraine and the extrapyramidal system (EPS). A critical appraisal of these data suggests that the EPS is somehow involved in migraine. However, primary involvement of the EPS in the pathophysiology of migraine, as hinted at by the apparent concomitance of migraine, extrapyramidal symptoms and diseases, as well as by the common involvement of neurotransmitters and pathways, cannot as yet be proven. On the other hand, the involvement of EPS in migraine may reflect its more general role in the processing of nociceptive information and/or may be part of the complex behavioural adaptive response that characterizes migraine.
Zolmitriptan Orally Disintegrating Tablet is Effective in the Acute Treatment of Migraine
Authors: Dowson AJ , MacGregor EA , Purdy RA , Becker WJ , Green J , Levy SL
Published: March 2003

A new formulation of zolmitriptan has been developed that dissolves on the tongue without the need for additional fluid intake. In this double-blind, parallel study, 471 patients were randomized to receive the zolmitriptan orally disintegrating tablet 2.5 mg( n=231) or matching placebo ( n=240) to treat a single moderate or severe migraine. Headache relief following zolmitriptan 2.5 mg (63%) was significantly greater than with placebo (22%) at 2 h post-dose (primary endpoint; P < 0.0001). The zolmitriptan orally disintegrating tablet was also significantly more effective than placebo for 1-, 2- and 4-h pain-free response (8% vs. 3%, P =0.0207, 27% vs. 7%, P < 0.0001, and 37% vs. 11%, P < 0.0001, respectively). Of those patients stating a preference, 70% of patients preferred the orally disintegrating tablet to a conventional tablet. Zolmitriptan orally disintegrating tablets are an effective and convenient alternative to a conventional tablet, allowing migraine attacks to be treated anytime a migraine strikes, which can facilitate earlier treatment.
Lack of Age-Dependent Development of the Contingent Negative Variation (Cnv) in Migraine Children?
Authors: Bender S , Weisbrod M , Just U , Pfüller U , Parzer P , Resch F , Oelkers-Ax R
Published: March 2003

Increased negativity of contingent negative variation (CNV) in adult migraineurs is thought to reflect cortical hyperexcitability. CNV amplitude changes with age in healthy adults. Recently, evidence emerged that this might not be the case for migraineurs. Our study investigates age-dependency of CNV during childhood age. Seventy-six healthy controls and 61 children with migraine without aura (IHS code 1.1) between 6 and 18 years were examined using an acoustic S1-S2-CNV-paradigm with a 3-s inter-stimulus interval. The amplitude of the late component of CNV, as well as total CNV at the vertex (Cz according to the international 10-20 system), were significantly higher in migraineurs without aura than in controls. Healthy controls showed increasing amplitudes of CNV with age, whereas in migraine children without aura amplitudes did not change. Thus group differences were reduced during adolescence. Increased CNV negativity might reflect a biological vulnerability to migraine, rather than being a result of chronification. Migraineurs seem to lack age-dependent development of CNV also during early age, which supports the hypothesis of migraine as a maturation disorder.
Two Cases of Medically and Surgically Intractable Sunct: A Reason for Caution and an Argument for A Central Mechanism
Authors: Black DF , Dodick DW
Published: March 2003

We report two cases of SUNCT that demonstrate the medically and surgically refractory nature of this disorder and support the hypothesis that the causative ‘lesion’ lies within the central nervous system. After both patients had failed medical therapies, the first underwent a glycerol rhizotomy, gammaknife radiosurgery and microvascular decompression of the trigeminal nerve. The second patient underwent gammaknife radiosurgery of the trigeminal root exit zone and two microvascular decompression surgeries. Neither patient benefited from these procedures. Currently, the first patient suffers from anaesthesia dolorosa and the second patient from unilateral deafness, chronic vertigo and dysequilibrium as a result of surgical trauma. These cases of SUNCT highlight the uncertainty regarding the role of surgery given the potential for significant morbidity. These cases also suggest that SUNCT originates and may be maintained from within the CNS and this central locus explains why SUNCT is not typically amenable to interventions aimed at the peripheral portion of the trigeminal nerve.
Helicobacter Pylori Infection and Migraine
Authors: Ciancarelli I , Di Massimo C , Tozzi-Ciancarelli MG , De Matteis G , Marini C , Carolei A
Published: March 2003

The study is aimed to ascertain whether the Helicobacter pylori ( Hp) infection is responsible for the vulnerability to oxidative stress observed in migraineurs. Hp sero-logical positivity was assessed by ELISA evaluation of specific IgA and IgG antibodies in 30 subjects (11 males and 19 females) suffering from migraine without aura during the headache-free period. The Hp infection was detected in 16.7% of migraineurs. Plasma accumulation of peroxidative substances (TBA-RS), an index of systemic oxidative status, was increased in migraineurs without Hp infection with respect to controls ( P< 0.001), while no significant differences of TBA-RS were found in migraineurs with or without Hp infection. Unmodified values of plasma nitrite/nitrate concentrations, expression of systemic nitric oxide (NO), were obtained in migraineurs in comparison to controls indicating that Hp infection does not modify the plasma oxidative status and the systemic NO bioavailability of migraineurs. In conclusion, our results do not support any specific correlation between Hp infection and migraine.
Nitroglycerin-Induced Activation of Monoaminergic Transmission in the Rat
Authors: Tassorelli C , Blandini F , Costa A , Preza E , Nappi G
Published: March 2003

When administered to migraine patients, nitroglycerin induces a spontaneous-like migraine attack, with a latency of several hours. Nitroglycerin acts directly and/or indirectly on the central nervous system, through the release of nitric oxide (NO). Systemic administration of the drug to the rat causes neuronal activation in selected subcortical areas, particularly in monoaminergic nuclei of the brainstem. In this study, we sought to investigate whether this activation correlates with changes in monoaminergic neurotransmission. For this purpose, we evaluated the tissue levels of catecholamines and serotonin in the hypothalamus, mesencephalon, pons and medulla of rats treated with systemic nitroglycerin or vehicle, at different time points (1, 2 and 4 h). We also evaluated the peripheral sympathetic response to the drug by measuring the concentrations of plasma catecholamines. Nitroglycerin caused an early (1 h) increase in cerebral (pons) and plasma levels of norepinephrine, followed by a delayed (4 h) decrease in medullary and pontine levels of serotonin. The initial noradrenergic activation may reflect the autonomic response to the rapid cardiovascular effects of the drug, while the delayed response may result from the interaction of nitroglycerin- released NO and 5-HT in central areas devoted to the modulation of nociception. These data might therefore help to clarify the mechanisms underlying the delayed migraine attack observed in migraine sufferers after systemic administration of nitroglycerin.
Unilateral Cranial Autonomic Symptoms in Migraine
Authors: Barbanti P , Fabbrini G , Pesare M , Vanacore N , Cerbo R
Published: March 2003

Unilateral cranial autonomic symptoms (UAs) such as lacrimation, conjunctival injection, eyelid oedema and nasal congestion, which are the hallmark of trigeminal autonomic cephalgias, may also occur in an as yet undetermined proportion of migraine patients. We studied 177 consecutive migraineurs to assess the frequency of UAs and the clinical characteristics of such patients. UAs were reported by 81 patients (45.8%), ocular symptoms alone or in combination with nasal symptoms being the most frequent. The headache was more severe ( P< 0.0002) and more strictly unilateral ( P< 0.0004) in patients who reported UAs than in those without. Thus, the presence of UAs suggests an activation of the trigeminal-autonomic reflex, probably related to an over-activation of the trigeminal afferent arm. These findings could have therapeutic implications, given the potential large-scale recruitment of peripheral neurovascular 5-HT1B/1D receptors (the target of acute migraine treatment) in such patients.
A Pharmacokinetic Interaction Study Between Butorphanol and Sumatriptan Nasal Sprays in Healthy Subjects: Importance of the Timing of Butorphanol Administration
Authors: Vachharajani NN , Shyu W-C , Nichola PS , Boulton DW
Published: March 2003

Sumatriptan and butorphanol nasal sprays are commonly used agents for the management of migraine headaches. Under certain circumstances, these two agents may be administered closely in time. However, the possibility of a pharmacokinetic interaction and the safety of this regime have not been examined. In this crossover design study, 24 healthy subjects received the following four treatments, each separated by at least 7 days: 1 mg butorphanol (Stadol NS7®); 20 mg sumatriptan (Imitrex® Nasal Spray); or both formulations together with butorphanol administered either 1 or 30 min after sumatriptan. Serial plasma samples were collected for 24 h post-dose and analysed for butorphanol and/or sumatriptan by HPLC-MS/MS. Butorphanol plasma concentrations were reduced when it was administered 1 min (mean 28.6% decrease in AUC0-∞)

, but not 30 min, after sumatriptan. The pharmacokinetics of sumatriptan were not substantially altered by butorphanol. The combination of nasally administered sumatriptan and butorphanol appeared safe. However, if butorphanol nasal spray is administered < 30 min after sumatriptan nasal spray, the analgesic effect of butorphanol may be diminished due to reduced nasal absorption resulting from probable transient vasoconstriction of nasal blood vessels by sumatriptan.
Hemicrania Continua: Comparison Between Two Different Classification Systems
Authors: Bigal ME , Tepper SJ , Rapoport AM , Sheftell FD
Published: March 2003

Hemicrania continua is an uncommon primary headache disorder. This study of nine patients compares two different classification systems, proposed by Pareja et al. and Goadsby and Lipton. Although it seems logical to position the nosologic status of hemicrania continua under group 3 of the International Headache Society Classification, as proposed by Pareja et al., the Goadsby and Lipton classification is more clinically useful and should be included in future International Headache Society reclassification.
A Prospective Study of the Headache Phase in 32 Migraine with Aura Patients
Authors: Cologno D , Torelli P , Manzoni GC
Published: March 2003

For an accurate description of the clinical features of the headache phase in migraine with aura (MA) attacks, we thought it useful to conduct a prospective study of consecutively referred MA patients seeking treatment at the Headache Centre of the University of Parma Institute of Neurology. The case series included 32 patients (22 women and 10 men). At the time of the first visit, each patient was given a questionnaire to be filled in at the next MA attack. Six patients (four women and two men) had attacks of migraine aura without headache. Among the remaining 26 patients (18 women and eight men), the duration of the headache phase was < 24 h in 23 (88.5%); pain location was bilateral in 14 (53.8%) and unilateral in 12, but occurring on the opposite side to aura only in one patient; pain intensity was mild or moderate in 13 (50.0%). The headache phase of MA appeared to have clinical features that differed widely from patient to patient and was consistent with the International Headache Society diagnostic criteria for migraine without aura in 26.9% of patients and for tension-type headache (TTH) in 23.1%.
The Early Use of Ergotamine in Migraine. Edward Woakes' Report of 1868, Its Theoretical and Practical Background and Its International Reception
Authors: Koehler PJ , Isler H
Published: March 2003

Although ergot had been used in obstetrics for several centuries, it was proposed for the treatment of migraine only in the 19th century. The British ENT-surgeon Edward Woakes (1837-1912) recommended ergot as a vasoconstricting agent for migraine and other neurogenic conditions associated with vasodilatation in 1868. He subscribed to the theory of vasodilatation by sympathetic deficit, presented in the early 1850s by Brown-Séquard and Claude Bernard. Du Bois-Reymond proposed vasoconstriction by sympathetic overactivity as the cause of migraine in 1860; Brown-Séquard opposed this in favour of vasodilatation. Vasodilatation due to sympathetic deficit in migraine was again supported by Möllendorf, with clinical evidence, in 1867. Woakes' paper of 1868 introduced ergot as a vasoconstrictor for the same condition. Reception abroad was prompt. A German version appeared in 1869, and Eulenburg cited Woakes in his textbook of 1871. Eulenburg presented the use of ergot for migraine as a routine measure in the second edition of his textbook in 1878, and in a paper published in 1883. The method was internationally accepted, but it became really popular only after the isolation of pure ergotamine in 1918, resulting in the first reliable compounds with stable properties and predictable effects. Contrary to Woakes' theory, in the early 20th century ergot was used for migraine because of its well-documented adrenolytic properties, as migraine was by then again believed to be a sympathotonic and vasospastic condition.
Atypical Presentations of Cluster Headache
Authors: Rozen TD
Published: March 2003

Recently, cluster headache has been shown to occur with aura, suggesting that as more cluster patients are seen by headache specialists new forms of this well-defined primary headache syndrome will be identified. This study presents three atypical presentations of cluster headache: persistent or unremitting cluster, periodic cluster, and reflex or event-related cluster. Case reports are presented with an explanation as to why these headaches should be considered cluster headache.
Sunct Syndrome: Priming of Symptomatic Periods and Worsening of Symptoms by Treatment with Calcium Channel Blockers
Authors: Jiménez-Huete A , Franch O , Pareja JA
Published: March 2003

We report a SUNCT patient who showed both a precipitation and worsening of symptomatic periods after treatment with L-type calcium channel blockers. This pharmacological response may provide us with important clues for understanding the pathophysiology of SUNCT, and hopefully to find a remedy for the victims of this syndrome. This observation could also support a verapamil trial in SUNCT patients as a precipitating of attacks.
Hypnic Headache - the First German Cases Including Polysomnography
Authors: Evers S , Rahmann A , Schwaag S , Lüdemann P , Husstedt I-W
Published: March 2003

We report the first four German cases of hypnic headache according to the criteria suggested in the literature. Furthermore, we present the results of polysomnography in two theses cases with hypnic headache occurring during REM sleep. In one case, hypnic headache was also associated with periodic limb movements. Although mean nocturnal oxygen saturation was decreased in another patient, nightly oxygen inhalation did not result in an improvement of the headache.
A Review of Intractable Facial Pain Secondary To Underlying Lung Neoplasms
Authors: Eross EJ , Dodick DW , Swanson JW , Capobianco DJ
Published: March 2003

We describe a 63-year-old smoker who suffered from intractable facial pain secondary to an underlying lung neoplasm. Data from 30 previously reported and similar cases are also summarized. The clinical triad of a smoker suffering from periauricular pain and an elevated ESR should alert the clinician to the possibility of an occult lung mass. In these cases a computed tomography of the chest should always be obtained. Previously refractory pain typically responds to surgical resection of the mass and/or radiation therapy.
Women and the Mental Deficiency Act of 1913: citizenship, sexuality and regulation
Authors: Walmsley Jan
Published: March 2003

The present paper examines how women were targeted for sexual regulation and treated as ‘mental defectives’ under early‐twentieth‐century legislation, depriving them of citizenship. It also looks at factors which determined whether they continued to be detained in institutions or were ‘released’ into the community.
Future aspirations of students with severe learning disabilities and of their parents on leaving special schooling
Authors: Smyth Marisa , McConkey Roy
Published: March 2003

The majority of school‐leavers over 2 years from two special schools in Belfast were individually interviewed (n = 34) as were their parents (n = 37). The almost unanimous wish of the young people to have a job was not matched by the parents, although nearly half of the parents did express the wish that they would have at least part‐time work. The majority of young people and the parents envisaged living with the family albeit for different reasons. However, there was a strong emphasis on fostering the young person's independence and living with friends. Consequently, only a minority of families mentioned their son or daughter moving into traditional residential care settings. It is argued that it is not just the availability of services that need to increase in order to meet the aspirations of the young people and their parents; major changes are also needed in their form and function.
Application of boron isotopes to the understanding of fluid–rock interactions in a hydrothermally stimulated oil reservoir in the Alberta Basin, Canada
Authors: Williams L. B. , Wieser M. E. , Fennell J. , Hutcheon I. , Hervig R. L.
Published: March 2003

Boron isotope ratios of reservoir minerals and fluids can be a useful geothermometer and monitor of fluid–rock interactions. In Cold Lake oil sands of northern Alberta, there is a large variation in δ11B of the produced waters generated during steam injection and recovery of oil and water. The higher temperature waters (∼ 200 °C) have isotopically light δ11B values (+ 3‰ to + 14‰) and high B contents (∼150 p.p.m.). It is inferred that the range of δ11B values of the hydrothermal fluids results from reaction with the reservoir rock, and is a function of the temperature of the fluid–rock interaction. The distinct B geochemistry of the produced waters can be used to show that there is no detectable mixing of the oil recovery waters with the regional formation waters or shallow groundwater aquifers containing potable water.

Examination of B isotope ratios of reservoir minerals, before and after steam injection, allows the evaluation of sources of B in the reservoir. The only significant phase containing B is pumice. It shows generally positive δ11B values before steam injection and negative values after steam, with δ11B as low as − 28‰. Other possibly reactive phases include clay minerals and organic matter, but their abundance is not great enough to impact on the isotopic composition of the produced waters.

This information makes it possible to evaluate the boron isotope fractionation equation derived from experimental data (Williams LB (2000) Boron isotope geochemistry during burial diagenesis. PhD Dissertation. The University of Calgary, Alberta, Canada; Williams LB, Hervig RL, Holloway JR, Hutcheon I (2001a) Boron isotope geochemistry during diagenesis: Part 1. Experimental determination of fractionation during illitization of smectite. Geochimica et Cosmochimica Acta, in press). The results show that the fractionation curve predicts the difference between δ11B of the pumice and hydrothermal fluids in the Cold Lake reservoir. This not only indicates that the reservoir fluids have approached boron isotope equilibrium with the reservoir rock, but also shows that B isotopes provide a useful geothermometer for hydrothermally stimulated oil reservoirs.
Quantifying secondary migration efficiencies
Authors: Sylta Ø.
Published: March 2003

Exploration success relies on properly risking the hydrocarbon system relevant for each prospect. Accurate risking of secondary migration efficiencies has been difficult due to lack of simple procedures that relate rock properties such as permeability and entry pressures to migration velocities, oil stringer heights and saturations. In order to achieve improved estimates of charge probabilities, equations for the secondary migration process are formulated based upon the Darcy flow and buoyancy conditions. An analytical solution of the formulated equations is shown, making it possible to construct charts for efficiently assessing the column height of secondary migration hydrocarbon stringers. The average oil (hydrocarbon) saturation of the migrating stringer can be computed, making it easy to compute the permeability related, secondary migration losses. Inputs to the chart are hydrocarbon flow‐rates and flow‐path width, hydrocarbon viscosity and density, carrier bed dip, permeability and entry pressures. Outputs are stringer heights, hydrocarbon saturation, relative permeability, migration velocities and migration losses. A procedure for including the new equations into existing basin scale fluid flow simulators is outlined and a Java applet for calculating the properties is described. The Java applet is useful for sensitivity studies, and can also be used to test results from basin simulators with the new migration efficiency equations. The analytical solution suggests that many published methods for calculating hydrocarbon migration in fluid flow simulators will over‐estimate hydrocarbon saturations and therefore losses. Calculated migration velocities will also be too low.
Upper crustal fluid flow in the outboard region of the Southern Alps, New Zealand
Authors: Upton P. , Craw D. , Caldwell T. G. , Koons P. O. , James Z. , Wannamaker P. E. , Jiracek G. J. , Chamberlain C. P.
Published: March 2003

The currently active fluid regime within the outboard region of the Southern Alps, New Zealand was investigated using a combination of field observations, carbon‐ and oxygen‐stable isotopes from fault‐hosted calcites and interpretation of magnetotelluric (MT) data. Active faulting in the region is dominated by NE striking and N striking, oppositely dipping thrust fault pairs. Stable isotopic analyses of calcites hosted within these fault zones range from 10 to 25‰δ18O and from −33 to 0‰δ13C. These values reflect mixing of three parent fluids: meteoric water, carbon‐exchanged groundwater and minor deeper rock‐exchanged fluids, at temperatures of 10–90°C in the upper 3–4 km of the crust. A broad, ‘U‐shaped’ zone of high electrical conductivity (maximum depth c. 28 km) underlies the central Southern Alps. In the ductile region of the crust, the high‐conductivity zone is subhorizontal. Near‐vertical zones of high conductivity extend upward to the surface on both sides of the conductive zone. On the outboard side of the orogen, the conductive zone reaches the surface coincident with the trace of the active Forest Creek Faults. Near‐surface flow is shown to dominate the outboard region. Topographically driven meteoric water interacts, on a kilometre scale, with either carbon‐exchanged groundwater or directly with organic material within Pliocene gravels, resulting in a distinctive low 13C signal within fault‐hosted calcites of the outboard region. The high‐strain zone in the lower crust focuses the migration of deeply sourced fluids upward to the base of the brittle–ductile transition. Interconnected fluid is imaged as a narrow vertical zone of high conductivity in the upper crust, implying continuous permeability and possibly buoyancy‐driven flow of deeply sourced fluids to higher levels of the crust where they are detected by the isotopic analysis of the fault‐hosted calcites.
Improvement of temperature uniformity in microwave‐reheated rice by optimizing heat/hold cycle
Authors: Lee Dong Sun , Shin Dong‐Hyuk , Yam Kit L.
Published: March 2003

A mathematical model using a finite difference method was established to predict the temperature distribution of a microwave‐heated food tray. The model was linked with an optimization algorithm to minimize temperature non‐uniformity in the microwave‐reheating of a cooked rice package. The mathematical model developed was validated by comparing the predicted and measured temperatures, and was used to obtain the optimum heat/hold cycle. Temperature non‐uniformity was predicted to increase initially with time and then decrease after the surface corner temperature reached around 100 °C. Minimized temperature non‐uniformity was thus attained with the longest heating time, satisfying the highest allowable average temperature under the appropriate number of heat/hold cycles. The control strategy may serve as a useful concept in food service, to improve the heating uniformity of microwaveable dishes.
Problems with areal definitions of endemism: the effects of spatial scaling
Authors: Townsend Peterson A. , Watson David M.
Published: March 2003

The concept of endemism is useful in quantifying the biological uniqueness of an area, and has been used by many authors as a meaningful alternative to simple species richness. The traditional definition of endemism includes those species with ranges restricted to a particular region, and therefore is useful only in reference to that region. To compare different regions, however, a standardized approach is required, so several authors began using area‐based definitions. Accordingly, those species with ranges smaller than a particular area (e.g. 50,000 km 2) are deemed endemic. Nevertheless, several problems are associated with this approach: as the area threshold changes, scaling of endemism also changes, producing a different picture of endemism for each spatial scale. Moreover, the areal definition assumes equal levels of heterogeneity in different landscapes (clearly a simplification), which overemphasizes fine‐grained regions. Herein, the importance of distinguishing the regional definition (endemism) from the areal definition (range restriction) is emphasized, and investigators are encouraged to consider multiple spatial scales and geographic dimensions in evaluations of biodiversity.
From representation to persistence: requirements for a sustainable system of conservation areas in the species‐rich mediterranean‐climate desert of southern Africa
Authors: Cowling R. M. , Pressey R. L. , Lombard A. T. , Desmet P. G. , Ellis A. G.
Published: March 2003

Conservation planning has hitherto concentrated largely on the representation of biodiversity patterns within a system of conservation areas. Only recently has there been an emphasis on retaining segments of the optimal conservation area by defining implementation priorities in terms of the irreplaceability of areas and their vulnerability to threatening processes. The conservation of ecological and evolutionary processes that sustain and generate biodiversity, a requirement for a system of conservation areas that promotes biodiversity persistence, has received very little attention. By designing conservation systems in order to represent spatial features as surrogates for ecological and evolutionary processes, and by scheduling the implementation of areas in order to minimise the impacts of threats on these processes, it is theoretically possible to achieve a conservation system that combines retention and persistence. Here we discuss the requirements for establishing a sustainable (retention+persistence) conservation system in southern Africa's Succulent Karoo, a mediterranean‐climate desert that is very rich in plant species. Firstly, we discuss planning issues salient to both representation and design, and indicate the location, size and role in conservation of the spatial components (surrogates for processes) necessary for a system of conservation areas in the Succulent Karoo intended for retention+persistence. Next we lay out the requirements for a conservation system in the region and summarise some existing work on representation and retention of plant species. We then present a protocol for decision‐making and apply it by designing a hypothetical system of conservation areas. Finally, we compare representation of Red Data Book plant species in a system identified for pattern retention with our similar‐sized system designed for retention+persistence. The latter conserves 37% fewer species, indicating that design for persistence incurs a cost in terms of representation. This cost is offset by developing a conservation system that is likely to persist in the face of global change, and that will sustain processes responsible for the maintenance and genesis of biodiversity.
An intercontinental comparison of dung beetle diversity between two mediterranean‐climatic regions: local versus regional and historical influences
Authors: Lobo Jorge M. , Davis Adrian L. V.
Published: March 2003

The species richness of biological communities is influenced by both local ecological, regional ecological, and historical factors. The relative importance of these factors may be deduced by comparison between communities in climatically and ecologically equivalent, but geographically and historically separate regions of the world. This claim is based on the hypothesis that community processes driven by similar local ecological factors lead to convergence in species richness whereas those driven by differing regional or historical factors lead to divergence. An intercontinental comparison between the winter rainfall regions of South Africa and the Iberian Peninsula showed that overall species richness of dung beetles was dissimilar at local, subregional and regional scales in Scarabaeidae s. str. but similar at all scales in Aphodiinae. Removal of species widespread in the summer rainfall region of Africa or the temperate region of Europe (regional component) resulted in dissimilarity in species richness of mediterranean endemics at all scales in both dung beetle taxa. However, the lines joining each set of species richness values were parallel which may indicate similarities in processes between different mediterranean climatic regions despite slight differences in latitudinal range. The dominant pattern of dissimilarity or non‐convergence may be related primarily to intercontinental differences in regional biogeographical and evolutionary history (faunal dispersal, glaciation effects in relation to geographical barriers to dispersal, speciation history, long‐term disturbance history). The limited pattern of similarity or convergence in overall species richness of Aphodiinae may be a chance result or primarily related to intercontinental similarities in local ecological factors.