bluuebunny/crossref_metadata_2025 huggingface dataset:
Migraine With and Without Aura: The Same Disease Due to Cerebral Vasospasm of Different Intensity. A hypothesis based on CBF studies during migraine.
Authors: Olsen Tom Skyhøj
Published: May 2005

SYNOPSIS

The CBF studies performed so far during attacks of migraine, may be interpreted as favouring “the vascular theory.” This applies to migraine with aura as well as to migraine without aura. Migraine without aura may be due to mild focal CBF reduction ‐ too mild to be detected by the available CBF techniques (i.e. 20% or less) and too mild to produce ischemia and aura phenomena. Migraine with aura may be due to focal CBF reduction severe enough to produce ischemia (i.e. 50% or more) and therefore also aura phenomena.

The phenomenon termed “spreading oligemia” typically seen in CBF studies during migraine with aura, may be an artifact reflecting a gradual decrease of CBF in an area of constant size. The typical “march” of the aura symptoms may reflect differences in the ischemic threshold of various neurones leading to dysfunction of more and more neurones as the blood flow gradually decreases.

It is concluded that migraine with and without aura may be due to the same disease process‐the only difference being the intensity of vasospasm and CBF reduction.
Demographics of Headache in Elderly Patients
Authors: Solomon Glen D. , Kunkel Robert S. , Frame Joy
Published: May 2005

SYNOPSIS

This study seeks to define the types of headache and the sex and age distribution, of headache patients aged 65 and older. A computer search was performed of outpatients with a diagnosis of headache or temporal arteritis seen during 1988 at the Cleveland Clinic Foundation. Of over 120,000 outpatients treated at the clinic 9,950 had a diagnosis of headache; of these, 359 were 65 or older. We found that, compared with younger patients, older headache patients had more tension headache and less migraine headache. In our population, temporal arteritis occurred with the same frequency as migraine, and in patients with a similar demographic profile.
Trigeminal Neuralgia‐Like Pain in an Aged Woman with Fibrous Dysplasia of the Skull Base
Authors: Bollen E. , Vielvoye J. , Van Dijk J. G. , Roos R. A. C.
Published: May 2005

SYNOPSIS

A 72 year old women with attacks of severe lancinating pain in the right frontotemporal region of her face had, on CT scan of the skull base, fibrous dysplasia of the right sphenoid bone, involving the areas traversed by the trigeminal nerve. Her pain ceased following treatment with methysergide.

In patients with hemifacial pain but no evident facial or skull deformities, CT scan of the skull base may be helpful in elucidating the diagnosis.
Tuberoinfundibular Dopaminergic Tonus in Common Migraine
Authors: Capellan J.I. Lara , Dacosta C. Varela , Garcia J.M. Gutierrez , Servan P. Riobo , Cermeño J.C. Alvarez
Published: May 2005

SYNOPSIS

Changes in dopaminergic tonus have been hypothesized in patients with common migraine, suggesting that prolactin may play a role in the pathogenesis of the migraine. We investigated the prolactin response to domperidone, a dopamine receptor blocker.

We tested 22 patients with common migraine (8 men, 7 women in the follicular phase of the menstrual cycle, and 7 women in the luteal phase), and 22 normal subjects adjusted for age, sex and phase of the menstrual cycle. Domperidone produced a significant rise of serum prolactin (p<0.01) in migrainous patients (7.77 ± 3.09 vs 71.06 ± 9.97 in men, 7.05 ± 2.3 vs 129.58 ± 14.15 in women in the follicular phase of the menstrual cycle, and 14.28 ± 3.51 vs 169.71 ± 16.63 in women in the luteal phase) and control subjects. The response did not show significant differences between migrainous patients and normal subjects. These data do not suggest changes in the tuberoinfundibular dopaminergic tonus in migrainous patients, in contrast to reports of other authors.
The VEP in Acephalgic Migraine
Authors: Mortimer M. J. , Good R A , Marsters J. B.
Published: May 2005

SYNOPSIS

The diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms.

Using both flash and pattern stimulation, visual evoked potentials (VEPs) were examined as a means of differentiating between acephalgic migraine, migraine with aura, migraine without aura, demyelinating disease and a control group.

This study demonstrated that by analysing the amplitude of the background fast activity in the flash and pattern VEP, acephalgic migraine can be differentiated from demyelinating disease, migraine with aura, migraine without aura and absolute controls.
“Hemicrania Episodica”‐A New Type of Headache or a Pre‐Chronic Stage of Hemicrania Continua?
Authors: Pareja Juan A. , Palomo Tomás , Gorriti Miguel A. , Pareja Julia , Espejo José
Published: May 2005

SYNOPSIS

For seventeen years, a young man suffered from headaches of one to three days duration occurring once every six or seven days and totally disappearing between episodes. These were strictly unilateral (always on the left side), and were absolutely responsive to indomethacin. They differ clinically from the other two indomethacin‐responsive headaches described up to now: Hemicrania Continua (HC) and Chronic Paroxysmal Hemicrania (CPH). He has a sister suffering from HC.

Similar to HC, but unlike CPH, topical tyramine in our patient's eyes resulted in anisocoria before, but not after, indomethacin treatment. Our case differs from HC, however, in its time pattern; it could either be a pre‐chronic stage of HC or a new type of headache. it seems unlikely that a time pattern that has remained unchanged for 17 years will become continuous, as in HC, in the future, and thus it is possible that our patient represents a case of a new type of headache that we propose to name “Hemicrania Episodica.” In any case, it seems probable that this type of headache, although clinically different, may share a common pathogenic basis with HC.
Nuchal Features of Cluster Headache
Authors: Solomon Seymour , Lipton Richard B. , Newman Lawrence C.
Published: May 2005

SYNOPSIS

Nuchal symptoms were found in the majority of 100 consecutive patients with cluster headache. In 10%, pain was experienced in the neck with the initial typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the attack by a few minutes. During an attack, neck stiffness was reported in 40% and tenderness in 29%. Movement of the neck, especially flexion, precipitated cluster headache in 9% of patients. This was particularly true of patients with chronic cluster headache. Neck movement aggravated the headache in 16 of 100 patients and an equal number reported amelioration of pain by neck movement, especially extension.

The nuchal features did not necessarily accompany every attack and were usually overshadowed by the severity of the typical headache. Nevertheless, symptoms referable to the neck occur more commonly than is generally appreciated.
Cluster Headache: MRI Studies of the Cavernous Sinus and the Base of the Brain
Authors: Sjaastad Ottar , Rinck Peter
Published: May 2005

SYNOPSIS

Fourteen patients with cluster headache (13 with the episodic and I with the chronic form; 11 males and 3 females) were studied. One patient was in remission at the time of investigation; no one was studied during an ongoing attack. The cavernous sinus and its immediate surroundings were studied at 0.5 Tesla (n=7) and 1.5 Tesla (n=7). No definite pathological changes were found in the area of particular interest. Since the evidence implicating the cavernous sinus in cluster headache pathogenesis is rather strong, the search for abnormalities in this area should continue.
Migraine Headache in the Infant and Young Child
Authors: Elser Joseph M. , Woody Robert C.
Published: May 2005

SYNOPSIS

Migraine is a common clinical diagnosis, occurring in 4–10% of school age children. Migraine in the infant and preschool child has been infrequently described in retrospective studies. We report the prospective evaluation and therapy of six children (5–42 months) with migraine. In four of the children, Prensky's criteria were used for diagnosis, while the two youngest children presented with ophthalmoplegic migraine. All children had a strong family history of migraine and presented with headache and prominent features including facial pallor, irritability, sleep disturbance or mood changes. The oldest four children were successfully treated with either amitriptyline or imipramine in low doses. Theinfants with ophthalmoplegic migraine failed to completely respond to any therapy. At followup 2 to 18 months later, all children were well and without toxicity. The pediatrician should be aware that migraine may begin in infancy and can be effectively and safely treated.
Flunarizine Plasma Concentrations and Side Effects in Migraine Patients
Authors: Albani Fiorenzo , Baldrati Anna , Cortelli Pietro , Riva Roberto , Baruzzi Agostino
Published: May 2005

SYNOPSIS

Flunarizine plasma concentrations and side effects were evaluated in migraine patients during a 3 month course of prophylactic treatment. Plasma concentrations did not correlate with daily dose (in mg/kg). Mean flunarizine levels were higher in patients showing sleepiness or sedation. Weight gain was independent of plasma concentrations. Future clinical trials of flunarizine should be supported by drug monitoring in order to clarify the relationship between plasma levels and drug effects.
Magnetoencephalographic Studies of Migraine
Authors: Barkley G.L. , Tepley N. , Nagel‐Leiby S. , Moran J.E. , Simkins R.T. , Welch K.M.A.
Published: May 2005

SYNOPSIS

We report for the first time the detection by magneto‐encephalography (MEG) of signals observable inmigraine patients during headache, but not in controls. These signals consisted of three features: suppression of spontaneous cortical activity, long duration field changes, and large amplitude waves(LAW) of several seconds duration. LAW were also seen during the interictal period. We discuss the possible relationship of these signals to spreading depression (SD), and why the LAW have not been observed in previous studies of SD.
Pattern Reversal Visual Evoked Potentials (VEP‐PR) in Migraine Subjects With Visual Aura
Authors: Mariani Emilio , Moschini Vincenzo , Pastorino GianCarlo , Rizzi Franco , Severgnini Amelia , Tiengo Mario
Published: May 2005

SYNOPSIS

Twenty patients with migraine with visual aura, aged 19 to 55 years (2 men and 18 women) were studied by the method of Visual Evoked Potentials (VEP). The control group consisted of an equal number of healthy subjects, comparable for age and sex. The most important finding in our study is that migraine patients with visual prodromata have a significantly longer P100 latency than the subjects of control group. These modifications of the VEP‐PR could indicate, as other investigators have pointed out, that there are some special metabolic conditions and abnormalities of neuromediators during and between attacks.
Swimmer's Migraine
Authors: Indo Toshikatsu , Takahashi Akira
Published: May 2005

SYNOPSISThree cases of sudden, severe headache occurring during swimming are described. A 51‐year‐old female had been engaging in a swimming exercise for about 20 minutes when she suddenly experienced a pulsating headache in the parietotemporal region, accompanied by nausea. A few days later, she experienced a similar episode, again during swimming practice. A 45‐year‐old male developed a pulsating headache with nausea immediately after diving into a swimming pool, and had a similar attack during diving practice 1 week later. A 32‐year‐old male developed a pulsating headache accompanied by nausea while swimming in the sea. In all three cases, blood pressure, pulse rate, neurological findings, cervical spinal x‐rays, brain CT scans, and hematological findings were normal and the outcome was good. Although these patients' headaches were diagnosed as benign exertional headache, pathophysiologically they appeared to resemble the headache associated with sexual activity.
Thermographic Findings in Cranio‐Facial Pain
Authors: Mongini F. , Caselli C. , Macri V. , Tetti C.
Published: May 2005

SYNOPSIS

This work assesses the differences in the thermographic findings in the craniofacial and neck areas between normal individuals and patients with craniofacial pain or headache, and investigates the influence of muscle contraction on such findings. Thermographic records were taken in 10 healthy subjects and 47 patients suffering from craniofacial pain or headache of different kinds. In the patients with painful episodes the record was taken between attacks. In all the normal subjects and in 19 patients lateral thermograms were also taken during and after maximal tooth clenching for three minutes. The majority of the patients, as compared to the normal group, showed some thermal alterations and asymmetry. Such alterations seem to be due both to vascular instability and muscle contraction: these two factors may be variably superimposed in the different conditions. In patients with cluster headache or chronic paroxysmal hemicrania the presence on the symptomatic side of a cold spot along the supraorbital area and/or the inner orbital canthus, was a constant finding. We conclude that thermography is useful as an additional diagnostic means in patients with head and face pain, and that the clenching test may increase the amount of information provided.
A Study of the Seasonal Variation of Migraine
Authors: Brewerton Timothy D. , George Mark S.
Published: May 2005

SYNOPSIS

Available evidence supports the contention that migraine involves a disturbance in serotonin function.Several parameters of serotonin function in humans have been found to vary seasonally and may underliethe seasonal fluctuations observed in many clinical neuropsychiatric phenomena that are thought toinvolve serotonin dysfunction. We therefore postulated that migraine headaches might also varyseasonally and examined the admissions to our hospital over a 20‐year period with a primary diagnosis ofmigraine. Peak admissions were found to occur most frequently in the spring for females in comparison tomales (p£0.04, chi‐square). The implications of these findings are discussed.
Clinical Characteristics of Migraine and Episodic Tension‐Type Headache in Relation to Old and New Diagnostic Criteria
Authors: Iversen Helle K. , Langemark Michael , Andersson Poul Gertz , Hansen Per Evald , Olesen Jes
Published: May 2005

SYNOPSIS

Eighty‐one patients were diagnosed as having migraine, tension headache or both according to previously used criteria. Then we performed a standardized interview to determine the frequency and severity of headache characteristics used in the new operational diagnostic criteria of the International Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain criteria and in 8 (4 migraine, 4 tension headache) they did not fulfill the criteria for accompanying symptoms. Overall the HIS criteria are sensitive and specific, but they may possibly be improved with regard to accompanying symptoms. The present study suggests that recording of frequency and graded severity of characteristics using a headache diary may further improve the distinction between the different types of headache.
Alteration of Platelet Serotonin in Patients with Chronic Tension‐Type Headache During Cold Pressor Test
Authors: Shimomura Tokio , Takahashi Kazuro
Published: May 2005

SYNOPSIS

Change of 5‐hydroxytryptamine (5‐HT) concentrations in platelets from patients with chronic tension‐type headache (TH) and controls were observed during cold pressor test (CPT). Before cold stimulation, 5‐HT concentrations in platelets from patients with TH were significantly lower than those found in controls. One minute after the start of cold stimulation, 5‐HT levels in platelets from patients with TH were significantly much lower than in the controls, as control levels rose and TH levels fell. The results show that, under stress, the absorbance of 5‐HT into the platelets in patients with TH is reduced. It is suggested that, in patients with TH, there are abnormalities of 5‐HT uptake into platelets and factors which cause release of 5‐HT from platelets.
Assessment and Treatment of Children's Headaches from a Developmental Perspective
Authors: Marcon Rebecca A. , Labbé Elise E
Published: May 2005

SYNOPSIS

Childhood headache is a common pediatric problem. Clinical researchers have evaluated several behavioral treatments, such as biofeedback and relaxation training, that may be viable interventions. Adding a developmental perspective to the evaluation and treatment of childhood headache is a likely way to increase the effectiveness of these strategies. This paper presents developmental issues related to the assessment and treatment of childhood headache. Three major areas of development are examined and the impact of these areas on the treatment and assessment of headache are discussed. The three major areas are cognitive development, self‐regulation and psychosocial development. Provided are practical suggestions for the application of child development principles to assessment and intervention practices that may be more developmentally appropriate.
Nocturnal Sleep Recording with Cassette EEG in Chronic Headaches
Authors: Drake Miles E. , Pakalnis Ann , Andrews Jodie M. , Bogner Janet E.
Published: May 2005

SYNOPSIS

Many headache patients complain of poor sleep, and sleep disturbance has been shown to play a role in chronic pain. We recorded nocturnal sleep with a 4‐channel cassette EEG monitoring device in 10 common migraine patients, 10 individuals with muscle contraction (tension) headache, and 10 chronic tension‐vascular headache sufferers.

Migraine patients had essentially normal sleep, although rapid eye movement (REM) sleep and REM latency were increased. Patients with tension headache had reduced sleep time and sleep efficiency, decreased sleep latency but frequent awakenings, increased nocturnal movements, and marked reduction in slow wave sleep, without change in REM sleep or latency. Mixed‐element headaches with both tension and vascular features were associated with reduced sleep, increased awakening, diminished slow wave sleep, and REM sleep that was decreased in amount and reduced in latency.

The findings suggest that patients with intermittent migraine may have minimal sleep disturbance, while chronic headache may be worsened by chronically poor sleep. Muscle contraction headache may be associated with frequent awakenings and decreased slow wave sleep similar to the sleep changes of fibrositis, while chronic tension‐vascular headache may have a depressive substrate. Four‐channel sleep recording may miss contributory sleep apnea, but nonetheless cassette EEG may facilitate outpatient evaluation of refractory headaches.
Acetylsalicylic Acid vs. Metoprolol in Migraine Prophylaxis ‐ A Double‐Blind Cross‐Over Study
Authors: Grotemeyer K‐H , Scharafinski H‐W , Schlake H‐P , Husstedt IW
Published: May 2005

SYNOPSIS

In a double blind cross‐over study, 28 patients, 5 male and 23 female, aged 31 ± 14 years, after a run‐in period of 8 weeks, were treated for 3 months with acetylsalicylic acid and for another 3 months with metoprolol, both in a prophylactic mode. Attack frequency was reduced significantly with both therapeutic regimens (ASA p<0.001, metoprolol p<0.00005). Reduction of attacks below 50% was seen with metoprolol in 14 cases, and with ASA in three cases. Even though ASA was of statistically significant efficacy in migraine prophylaxis, it clearly is not the drug of first choice in migraine prophylaxis.
The Cluster Diathesis
Authors: Gawel M.J. , Krajewski A. , Luo Y.M. , Ichise M.
Published: May 2005

SYNOPSIS

We present further evidence for a sympathetic defect of vasomotor control of the anterior cerebral artery (ACA) on the side of the headache during cluster periods. In 119 cluster headache patients, utilizing transcranial Doppler, we measured CO2 reactivity of the major intracranial vessels, in and out of cluster. Reactivity was significantly lower during the cluster period, but only in the ACA on the side of the headache. Nineteen patients followed sequentially for a full cycle (ie/both in and out of a cluster period) showed the same changes. In 3 out of 6 patients in an active cluster period, we describe a lesion on Gallium single‐photon emission computerized tomography (SPECT) in the region of the cavernous sinus which fades as the patient moves out of cluster. It is felt that this lesion may represent the cavernous sinus plexus lesion postulated as the central lesion in cluster, Changes in the sympathetic outflow at this point could explain the changes we have described in ACA CO2 reactivity during cluster.
Cluster Headache: The Effect of Low Oxygen Saturation
Authors: Zhao JM , Schaanning J , Sjaastad O
Published: May 2005

SYNOPSIS

The present study concerns the possible relationship between hypoxia and the generation of cluster headache attacks. Fifteen controls and 25 cluster headache patients were studied. The patients were allocated into two groups according to cluster headache stage, i.e. cluster or remission period. During the tests, all the subjects were asked to inhale 12% oxygen (88% N2) for 30 min, and the decreasing oxygen saturation (SaO2 %) was monitored. Patients in the remission period showed nearly the same decrement of SaO2% as controls. At the end of the test, patients in the bout showed significantly less reduction of SaO2% than the controls. In 5 patients, the test was carried out both in and outside the cluster periods. The tendency to less decrement in oxygen saturation in the cluster phase was as marked with this comparison, but the difference between the groups was not significant, probably partly due to the low number of tests carried out. Only one patient got a typical attack. it seems that hypoxia of this magnitude per se is not the cause of attacks. The different pattern with respect to SaO2% following 12% O2 inhalation in cluster headache may be due to an abnormality in central regulation and/or chemoreceptor sensitivity.
Recurrent Tension Headache in Adolescents Treated with Self‐Help Relaxation Training and a Muscle Relaxant Drug
Authors: Larsson Bo , Melin Lennart , Döberl Anton
Published: May 2005

SYNOPSIS

Forty‐eight adolescents suffering from recurrent tension headache participated in a controlled trial conducted in a high school setting. During the first treatment phase self‐help relaxation training was compared with a waiting‐list group. Following this phase a pharmacological regimen consisting of a muscle relaxant (chlormezanone) and placebo was superimposed on relaxation therapy in a double‐blind crossover design. Each treatment phase encompassed a 5‐week period. In addition to the evaluation of headache complaints, psychological distress among students was measured with respect to their experience of somatic complaints, depressive, anxiety and stress symptoms. Although self‐help relaxation training significantly decreased the severity and annoyance of adolescents' headache besides their somatic complaints, the clinical improvement of headache was modest. The addition of chlormezanone did not help those who were nonresponders to self‐help relaxation training. Finally, a set of pretreatment variables consisting of baseline headache severity and annoyance, experience of anxiety and daily life stress among adolescents could predict outcome of self‐help relaxation therapy.
Headaches in Dementia
Authors: Takeshima Takao , Taniguchi Reiko , Kitagawa Tatsuya , Takahashi Kazuro
Published: May 2005

SYNOPSIS

We investigated 288 elderly subjects with various degree of dementia, focusing on headaches. Seventy‐three of 288 elderly subjects (25.3%) complained of some headaches. The most common type was the tension‐type headache, from which 43 of the 73 subjects with headaches (58.9%) suffered. The degree of cognitive disturbances, evaluated by Hasegawa's intelligence scale, significantly correlated to the prevalence of headaches, and indicated that patients with dementia appeared to have less headaches. The methodological issues and views on headache research in dementia were assessed, and it is concluded that the field is a difficult one, with potential for error.
Headaches Due to Spontaneous Internal Carotid Artery Dissection Magnetic Resonance Imaging Evaluation and Follow Up
Authors: Cox Linda K. , Bertorini Tulio , Laster Robert E.
Published: May 2005

SYNOPSIS

Spontaneous internal carotid artery (ICA) dissection is not an infrequent cause of headache and acute neurologic deficits in the younger population. Angiography has been the imaging modality of choice for both diagnosis and follow‐up. The use of magnetic resonance imaging, (MRI), in conjunction with angiography, is described in three patients shown to have ICA dissection. Our clinical findings suggest that MRI may provide a less expensive, non‐invasive, diagnostic and particularly a follow up modality in patients with headache and signs suggestive of ICA dissection.
The Relationship of Cocaine to Headache in Polysubstance Abusers
Authors: Dhopesh Vasant , Maany Iradj , Herring Christina
Published: May 2005

SYNOPSIS

In a questionnaire survey of inpatient polysubstance abusers it was found that cocaine relieved migraine‐type headaches much more often in chronic headache sufferers than in those with only occasional headaches (p < .05). However, cocaine could also bring on headaches after several hours, both in chronic headache sufferers and in those not subject to headaches. The fasts that cocaine may relieve headache immediately, and also may precipitate headaches several hours after use, suggests that the well‐known vasoconstrictive actions of cocaine may be responsible. Migraineurs seem more susceptible to some of these effects of cocaine than are people without chronic headaches.
"Hemicrania Continua": A Clinical Review
Authors: Bordini Carlos , Antonaci Fabio , Stovner Lars Jacob , Schrader Harald , Sjaastad Ottar
Published: May 2005

SYNOPSIS

Hemicrania continua (HC) is a headache entity completely responsive to indomethacin. Since 1984, 18 cases have been described, 15 females and 3 males, i.e. a F:M ratio of 5.0. The finding of a female preponderance, like that in chronic paroxysmal hemicrania, is a new observation. HC is, in general, a unilateral headache in the sense that it sets in on one side and subsequently sticks to this side. In two case, both sides might possibly be involved, when the pain was at its maximum. In another (somewhat dubious) case the headache was bilateral. The pain was continuous from the beginning in 8 of 18 cases (early stage ratio continuous: non‐continuous = 0.8). Over time, the headache developed a continuous character in 16 of the 18 cases, producing a "continuous: non‐continuous ratio" of 8:1. The intensity of pain generally was moderate and was not reported as excruciatingly severe by any patient. The autonomic involvement from a clinical point of view, was clearly less pronounced than that of other unilateral headaches, such as cluster headache and chronic paroxysmal hemicrania.
Valproate in the Treatment of Persistent Chronic Daily Headache. An Open Label Study
Authors: Mathew Ninan T. , Ali Sabiha
Published: May 2005

SYNOPSIS

Thirty patients with persistent chronic daily headache, unresponsive to various combinations ofpharmacological and non‐pharmacological treatment were selected for an open label study using divalproex sodium. All patients had normal liver function tests. After a baseline observation period of 1month, patients were given divalproex sodium 1000 to 2000 mg per day, for a period of 3 months. Blood valproic acid levels were kept between 75 and 100 mcg/ml. Liver function studies and blood ammonia levels were obtained periodically. Based on weekly headache index, headache‐free days, dysfunctional days and patients' general well‐being rating and physicians' global assessment, two thirds of the patients improved significantly. The common side effects included weight gain, tremor, hair loss and nausea. Liver functions were unaffected by treatment.

The possible mechanism of action of valproate in headache is discussed. Valproate appears to be aworthwhile addition to the prophylactic treatment of chronic recurrent headache.
The Differential Effects of Biofeedback in the Treatment of Menstrual and Nonmenstrual Migraine
Authors: Gauthier Janel G. , Fournier Anne‐Louise , Roberge Claude
Published: May 2005

SYNOPSIS

The aim of the present study was to investigate the effects of biofeedback training in the treatment of menstrual and non‐menstrual migraine. Accordingly, 39 female patients suffering from both migraine associated, and migraine not associated, with menstrual periods were drawn from a pool of research volunteers enrolled in a biofeedback treatment program for migraine headaches. All patients were required to complete 5 weeks of daily self‐monitoring of headache and menstruation activity immediately before and after treatment, and again at 6‐month follow‐up. Within‐subjects comparisons of the effects of biofeedback on menstrual and nonmenstrual migraine, and between‐subjects comparisons of the effects of biofeedback on patients suffering predominantly from either menstrual or nonmenstrual migraine showed that biofeedback is just as effective in reducing menstrual migraine as it is in reducing nonmenstrual migraine. Questions as to whether or not these conclusions can apply to patients who experience migraine headaches only during, or shortly before or after, menstruation, are raised.
Headache Spectrum in Arnold‐Chiari Malformation
Authors: Khurana Ramesh K.
Published: May 2005

SYNOPSIS

Exertional headaches in patients with Arnold‐Chiari malformation (ACM) are well described. Were port four patients with Type I ACM and recurrent headaches. These patients presented, respectively, with low spinal fluid pressure headache, migraine without aura, migraine with aura, and migraine with prolonged aura. This report suggests the need for observing patients with recurrent headaches for any physical stigmata of craniovertebral junction anomalies, and the need to exclude ACM in such patients. Possible implications of the association between ACM and different types of headaches are discussed.
Headache in the Use and Withdrawal of Opiates and Other Associated Substances of Abuse
Authors: De Marinis M. , Janiri L. , Agnoli A.
Published: May 2005

SYNOPSIS

The incidence and character of headache were retrospectively studied in 40 opiate addicts and 40 control subjects. The relationships between headache and use and withdrawal of opiates or other associated substances of abuse were investigated. In the opiate‐dependent patients, the effects of opiate intake and withdrawal on headache were also investigated during detoxification treatment. A higher (p<0.001) incidence of headache was found in the opiate addicts (60%), particularly those with a longer history of addiction, than in the control subjects. A history of different types of headache (tension type headache, migraine‐like headaches), which seemed respectively to be associated with the use of certain types of heroin, cocaine intake, and opiate withdrawal, was reported by the addicts who suffered from headache. Out of the 24 patients who completed the detoxification therapy, a migraine‐like headache occurred in 37.5% of the subjects after opiate withdrawal.
Subcutaneous Sumatriptan in the Treatment of Headache During Withdrawal From Drug‐Induced Headache
Authors: Diener H.C. , Haab J. , Peters C. , Ried S. , Dichgans J. , Pilgrim A.
Published: May 2005

SYNOPSIS

In a pilot study (5 patients) we investigated the effects of subcutaneous sumatriptan, a 5‐HT1‐like receptoragonist, on headache experienced during the withdrawal period of drug‐induced headache. The pilot studyindicated that the substance was effective mostly in patients who originally suffered from migraine. In a patientwith tension headache the substance was less effective. In a second double‐blind study on six migraine patientswith severe drug‐induced headache, the drug was highly effective in ameliorating headache and autonomicdisturbances. Blood flow velocities measured in extracranial parts of internal and external carotid arteries byduplex‐sonography and in middle cerebral and basilar arteries by transcranial Doppler showed no changes afteradministration of sumatriptan or placebo. This result suggests sumatriptan does not act primarily via constrictionof the large cerebral arteries.
Chronic Cluster Headache Associated With a Vertebral Artery Aneurysm
Authors: West Paul , Todman Don
Published: May 2005

SYNOPSIS

This is a report of a patient with chronic cluster headache‐like pain of 12 years duration. Investigation revealed an aneurysm at the junction of the vertebral and posterior inferior cerebellar arteries and after removal the patient experienced resolution of his cluster headache. The headache and aneurysm were both right sided suggesting a possible relationship.
5‐Hydroxtryptamine 1D Receptor Agonism Predicts Antimigraine Efficacy
Authors: Anastasia V. , Deliganis B.S. , Peroutka Stephen J.
Published: May 2005

SYNOPSIS

The interactions of four abortive anti‐migraine agents and four prophylactic anti‐migraine agents with 5‐HT1D receptors in bovine brain were analyzed using radioligand binding techniques and adenylate cyclase assays. In bovine caudate, the affinities of abortive anti‐migraine agents (i.e. 5‐hydroxytryp‐tamine, ergotamine, dihydroergotamine, sumatriptan) for 5‐HT1D receptors range from 4.0 – 34 nM while the affinities of prophylactic anti‐migraine agents (i.e. methysergide, amitriptyline, (‐)propranolol, verapamil) range from 46 – 11,000 nM. In adenylate cyclase studies in bovine substantia nigra, all four abortive anti‐migraine agents dose‐dependently inhibit forskolin‐stimulated adenylate cyclase activity, a biochemical effect mediated by 5‐HT1D receptors. No agonist effect on cyclase activity is observed with the four prophylactic anti‐migraine agents. These date support the hypothesis that abortive anti‐migraine agents are 5‐HT1D receptor agonists and that this effect may underlie their anti‐migraine efficacy.
EEG and Topographic Frequency Analysis in Common and Classic Migraine
Authors: Neufeld M.Y. , Treves T.A. , Korczyn A.D.
Published: May 2005

SYNOPSIS

Electroencephalographic (EEG) changes occurring in patients with migraine have received much attention. However, almost equal number of reports indicate the predominance of normal and abnormal findings. We studied the EEG in symptom‐free, otherwise healthy, unmedicated 18–28 year‐old patients: 22 with common migraine, 20 with classic migraine, and 20 age‐matched controls. The routine EEG findings in the three groups revealed mild non‐specific slowing in 2 (9%), 3 (15%) and 2 (10%), respectively. Simultaneously, topographic EEG mapping and frequency analysis were performed in 13 consecutive patients with common migraine, 10 patients with classic migraine and 11 age‐matched controls. EEG mapping showed minimal regional differences with lower power in the alpha range in patients with eyes closed. The peak alpha power, as well as its reactivity, were lower among patients than controls. This difference reached statistical significance only for patients with classic migraine versus controls in the left occipital region. Patients also had slightly faster peak alpha frequency. No frank right‐left asymmetry was observed in the peak alpha power, neither among the controls, nor the patients. All the findings were rather minor. They may suggest some difference in the posterior background activity in the EEG in migraine patients as compared to the controls, but are not useful in differentiating migraine from non‐migraine patients.
Reading Problems In Adult Chronic Headache Sufferers
Authors: Cremins James J. , Spierings Egilius L.H. , Meltzer Lynn J. , Messinger Harley B. , Lebbink John
Published: May 2005

SYNOPSIS

In a questionnaire survey we determined the prevalence of problems with reading, at present as well as in the past, in adult chronic headache sufferers as compared with age‐ and sex‐matched controls. The reading problems inquired about were those with reading in general, reading quickly, prolonged reading and reading comprehension. The subjects were also asked about present and past problems with writing, concentrating, performing mathematics and overall learning.

Significant difference in the prevalences of the problems studied between the headache sufferers and controls were observed on just two items and only for the female groups. These items were present problems with reading comprehension (39.3% versus 7.5%; p=0.002) and concentrating (46.4% versus 17.5%; p=0.015). We concluded that adult female headache sufferers have impaired reading comprehension and concentration abilities which do not seem to originate from the past.
Questionnaire Versus Clinical Interview in the Diagnosis of Headache
Authors: Rasmussen Birthe Krogh , Jensen Rigmor , Olesen Jes
Published: May 2005

SYNOPSIS

A self‐administered questionnaire based on the operational diagnostic criteria of the International Headache Society (IHS) was evaluated in a cross‐sectional epidemiological survey of headache disorders. A clinical interview was used as index of validity. Seven hundred and thirteen subjects were included.Sensitivity, specificity, predictive value, and chance‐corrected agreement rate for the diagnosis of migraine was 51%, 92%, 50% (PVpos), 93% (PVneg), and 0.43 respectively. Corresponding values for episodic tension‐type headache were 43%, 96%, 95% (PVpos), 46% (PVneg), and 0.30; and for chronic tension‐type headache 14%, 100%, 100% (PVpos), 97% (PVneg), and 0.24. It is concluded that a questionnaire is not a satisfactory tool in diagnosing headache disorders according to the IHS criteria.The methods of data collection seem to have significant influence on the results. Caution in handling data obtained by means of subjective statements is advocated.
Anger and Hostility in Tension‐Type Headache
Authors: Hatch John P. , Schoenfeld Lawrence S. , Boutros Nashaat N. , Seleshi Ermias , Moore Patricia J. , Cyr‐Provost Margaret
Published: May 2005

SYNOPSIS

A battery of standardized psychometric tests was administered to a group of 47 episodic tension‐type headache sufferers and 47 headache‐free controls. Compared to controls, headache subjects showed higher levels of anxiety, depression, and anger/hostility. The groups did not differ significantly on a measure of anger expressed toward persons or objects, but headache subjects showed significantly greater levels of suppressed anger. The results provide objective data that are in general agreement with predictions derived from psychosomatic theories about the interrelationships among anxiety, depression, and anger/hostility.
The Disappearance of the “Cold Patch” in Recovered Migraine Patients: Thermographic Findings
Authors: Volta G. Dalla , Anzola G.P. , DiMonda V.
Published: May 2005

SYNOPSIS

In a previous paper we suggested that the vascular cold patch may be a useful prognostic index to followup migraine patients. Considerable criticism against our contention has been raised by Swerdlow and Dieter (Headache 29:562–568, 1989, ref. 1 ), who claim that the cold patch constitutes a “fixed geography” of the vasculature of migraine patients. In the present paper we replicate and extend our previous findings reporting the results of facial thermography in a sample of 246 consecutive migraine patients. Of these the 206 exhibiting a typical cold patch or a significant asymmetry in the forehead thermal dissipation were admitted to prophylactic treatment (beta blocker or calcium channel blocker). The thermography was performed at entry in the study and after six months of active treatment. The clinical outcome was compared to the thermographic findings. The patients were subdivided in three classes on the basis of the clinical outcome. Among the 136 patients who experienced complete or substantial relief from headache the cold patch disappeared or markedly improved in 85% of the cases. In the 46 patients with partial relief the thermogram showed an improved pattern in 48% of cases, most of the time of smaller extent than in the previous class. In 24 patients we observed no clinical improvement. Among these the thermogram remained unchanged in 85% of cases. Taken together these findings corroborate our previous suggestion that thermography is useful to monitor the clinical course of the disease. One additional suggestion from the present data is that thermography closely parallels the clinical course so as to represent a useful criterion for the decision of discontinuing the therapy.
Activation of Pain Fibers to the Internal Carotid Artery Intracranially May Cause the Pain and Local Signs of Reduced Sympathetic and Enhanced Parasympathetic Activity in Cluster Headache
Authors: Hardebo Jan‐Erik
Published: May 2005

SYNOPSISSeveral clinical and circulatory physiological observations indicate that the internal carotid artery (ICA) with proximal pial and orbital‐periorbital branches, as well as external carotid vessels adjacent to the orbital region, are involved in the autonomic symptoms of an attack of cluster headache. Evidence is presented here that an activation of pain fibers innervating the intracranial segment of ICA may cause not only the retroorbital pain of an attack but also, via the mechanical effect of a neurogenic inflammation in the vessel wall, the local symptoms of a sympathetic defect and, via a reflex arc to the parasympathetic pathway along the greater superficial petrosal nerve, the local symptoms from glands and vessels of parasympathetic discharge. Dilation of the intracranial ICA due to activation of this parasympathetic pathway may aggravate pain. Possible mechanisms behind such a local pain fiber activation are discussed.
EMG Activity in Pericranial Muscles During Postural Variation and Mental Activity in Healthy Volunteers and Patients With Chronic Tension Type Headache
Authors: Schoenen Jean , Gerard Pascale , De Pasqua Victor , Juprelle Martine
Published: May 2005

SYNOPSIS

EMG activity was recorded over frontalis, temporalis and trapezius muscles in a supine position, a standing position and during a mental task in 32 female patients suffering from chronic tension‐type headache and in 20 healthy volunteers. Measurements in patients were made before and after biofeedback therapy. All EMG levels were on average significantly higher in patients than in controls. 62.5% of patients had at least one abnormal EMG level, but only 34% were beyond the normal range, if 1 muscle and I recording condition was considered. EMG levels were not correlated with headache severity, anxiety or response to biofeedback treatment. It is therefore suggested that pericranial EMG activity is not pathogenetic in chronic tension type headache, but merely one of several pathophysiologic changes, that are produced by a central dysfunction.
Neural Processing of Craniovascular Pain: A Synthesis of the Central Structures Involved in Migraine
Authors: Goadsby Peter J. , Zagami Alessandro S. , Lambert Geoffrey A.
Published: May 2005

SYNOPSIS

In order to determine the anatomical distribution of cells concerned with relaying craniovascular nociception, local cerebral glucose utilization was determined by the 2‐deoxyglucose method in tissue autoradiographs of the a‐chloralose anesthetized cat. The superior sagittal sinus was carefully lifted from the brain by sectioning the dura laterally and the falx inferiorly and suspending the sinus across two platinum hook electrodes for stimulation. The sinus was stimulated electrically and its effect on caudal brainstem, upper cervical spinal cord and diencephalic metabolic activity determined. Stimulation of the sinus caused increased metabolic activity in the trigeminal nucleus caudalis, in the cervical dorsal horn and in a discrete area in the dorsolateral spinal cord at the second cervical segment. Metabolic activity was also increased in the ventrobasal thalamus, specifically in the ventroposteromedial (188%) nuclear group, in the medial nucleus of the posterior complex (70%) and the intralaminar complex (49%). There was no change in the surrounding thalamus, lateral geniculate nucleus or overlying cerebral cortex. These increases in 2‐deoxy‐glucose utilisation were blocked by bilateral trigeminal ganglion ablation. The dorsolateral area activated in the spinal cord corresponds to a hitherto unrecognised group of cells in or near the lateral cervical nucleus that may form an important relay for craniovascular nociception. Further electrophysiological studies with glass coated tungsten microelectrodes have characterised the cells in these regions of the thalamus to be responsible for relaying nociceptive information. An understanding of the connections and properties of the neurons that subserve craniovascular pain is an essential prerequisite to understanding the complex pathophysiology of migraine.
Review Article: Migraine and Pregnancy
Authors: Uknis Audrey , Silberstein Stephen D.
Published: May 2005

SYNOPSIS

A 27‐year‐old woman with no family or personal history of migraine presented with headache associated with unilateral paresthesias and blurred vision. This was her first, and so far only, attack of migraine with aura and led to the diagnosis of her pregnancy and to this review.

Migraine can begin for the first time with pregnancy, particularly in the first trimester. Cases of migraine with aura are the most commonly reported. Preexisting migraine usually improves with pregnancy, particularly if it was associated with menstrual migraine. Headache occurs frequently in the postpartum period, particularly in known migraineurs. Migraineurs have no increased risk of complications during pregnancy and their children have no increased incidence of birth defects.
Bilateral Episodic Mydriasis as a Migraine Equivalent in Childhood: a Case Report
Authors: van Engelen Baziel G.M. , Renier Willy O. , Gabreëls Fons J.M. , Cruysberg Hans R.M.
Published: May 2005

SYNOPSIS

We report a 14‐year‐old girl who presented with yearly attacks of bilateral internal ophthalmoplegia, nausea and headache, since the age of nine.

The episodic isolated bilateral mydriasis in this child is believed to be a migraine equivalent.
Migraine and Epilepsy With Infantile Onset and Electroencephalographic Findings of Occipital Spike‐wave Complexes
Authors: Romanis F. De , Buzzi M.G. , Cerbo R. , Feliciani M. , Assenza S. , Agnoli A
Published: May 2005

SYNOPSIS

An EEG finding of temporo‐occipital or temporo‐parieto‐occipItal spike‐wave complexes, suppressed by eye opening, coexisting with classical migraine, was observed in 14 children; in 13 of these patients, seizures were present. Classical migraine, visual phenomena and seizures coexisted in different clinical patterns.
An Unusual Angiographic Picture in Status Migrainosus
Authors: Schulman Elliott A. , Hershey Beverly
Published: May 2005

SYNOPSIS

Arteriographic findings suggestive of inflammation are described in a 26‐year‐old woman presenting with headache and syncope. There were no clinical findings of angiitis, and a diagnosis of status migrainosus was eventually made. We present her case, as well as a review o previous cases of arterial changes in patients with headache. Most previous cases report arterial narrowing, felt to reflect spasm, whereas our patient demonstrated segmental stenoses and dilatations, perhaps implicating inflammation. The inflammatory process has been postulated as the pathogenesis of migraine pain. As most migraineurs do not undergo arteriography, the incidence of arterial change in these patients is unknown. This finding has therapeutic implications for selecting the optimal anti‐migraine agent.