bluuebunny/crossref_metadata_2025 huggingface dataset:
“MIGRAINOUS” NEUROLOGIC DYSFUNCTION IN PATIENTS WITH PROSTHETIC CARDIAC VALVES
Authors: Caplan Louis R. , Weiner Howard , Weintraub Ronald M. , Austen W. Gerald
Published: June 2005

SYNOPSIS

Two patients developed frequent, multifocal, transient episodes of central nervous system dysfunction, frequently accompanied by headache, 14 and 42 months after insertion of prosthetic cardiac valves. The disorder satisfied the criteria for the diagnosis of classic migraine; it was self‐limited in one patient and remitted after diphenylhydantoin in the other. Three other patients with “migrainous accompaniments” after cardiac surgery have been seen. “Symptomatic migraine” may occur in patients with prosthetic cardiac valves. The mechanism and etiology of this disorder is obscure.
ICE CREAM HEADACHE AND ORTHOSTATIC SYMPTOMS IN PATIENTS WITH MIGRAINE
Authors: Raskin Neil H. , Knittle Steve C.
Published: June 2005

SYNOPSIS

Migraine is arbitrarily defined; biological markers for the condition are needed. Two stereotyped phenomena which may be manifestations of central vasomotor instability have been studied in migraineurs and in control subjects. These phenomena are (1) “ice cream headache”, the brief frontal pain that results from cold food contacting the roof of the oropharynx and (2) the presence of vertigo, visual obscurations, and/or scintillating scotomata following rapid postural shifts of the head.

Hospitalized (non‐neurologic) patients (60 women, 48 men) were interviewed regarding the presence, quality, and intensity of the two phenomena. A history of headache was then elicited in some detail. The headache histories were assessed by the usual arbitrary criteria for migraine; this was done by an independent observer without knowledge of the presence of ice cream headache or postural symptoms. In the non‐headache, control population (49), 31% had experienced mild ice cream headache; in the migraine group (59), 93% had experienced ice cream headache (p<.001), usually (77%) as a moderate to severe discomfort. Half of the migraineurs took precautions when ingesting cold foods. Of the controls, 8% had brief vertigo or lightheadedness with rapid postural shifts; postural symptoms were present in 68% of the migraine group (p>.001), most of whom (75%) reported that scintillating scotomata accompanied vertigo. Both syndromes occurred more regularly and more prominently in the migraine population.
ERGOTAMINE AND METHYSERGIDE AS SEROTONIN PARTIAL AGONISTS IN MIGRAINE
Authors: Fanciullacci M. , Granchi G. , Sicuteri F.
Published: June 2005

SYNOPSIS

Potentiation of venospastic action of 5‐HT by methysergide and ergotamine was demonstrated in man by using venomotor receptors as substrate in a venoconstriction test. 5‐HT facilitation was observed only when anti‐migraineous drugs were tested in concentrations similar to those expected after therapeutic administration. When ergotamine and methysergide were used in higher concentrations, the expected antagonism to 5‐HT was clearly demonstrated. It is concluded that methysergide and ergotamine therapy is not antiserotonergic. These drugs act as partial agonists of 5‐HT. Methysergide and ergotamine facilitation of 5‐HT activity may occur at peripheral vasomotor receptors, or centrally in the brain. This latter probably is consistent with the postulated central nature of pain in essential headache.
CEPHALIC VASOMOTOR AND ELECTROMYOGRAPHIC FEEDBACK IN THE TREATMENT OF COMBINED MUSCLE CONTRACTION AND MIGRAINE HEADACHES IN A GERIATRIC CASE
Authors: Feuerstein Michael , Adams Henry E. , Beiman Irving
Published: June 2005

SYNOPSIS

The effects of cephalic vasomotor response (CVMR) feedback and electromyographic (EMG) feedback on control of CVMR, frontalis EMG and temporal artery vasospasms in muscle contraction and migraine headaches were investigated in a 67 year old woman. Systematic reductions in EMG activity were not achieved during EMG feedback. The frequency of temporal artery vasospams declined. No changes in amplitude of blood volume pulse (BVP) were observed during EMG feedback. A decrease in headache activity was associated with EMG feedback which may have been due to the reduction in temporal artery vasospasms. A treatment withdrawal condition was introduced after six EMG feedback sessions during which an increase in headache activity occurred. When CVMR feedback was introduced, the patient achieved significant BVP reductions. This control was related to the largest reduction in headache frequency and duration. Ratings representing subjective perception of the degree of disability because of headache also decreased during EMG feedback, CVMR feedback, and follow‐up. At follow‐up, there was a moderate increase in headache activity which was partially attributed to limited home practice.

This case demonstrates the successful use of biofeedback therapy in the treatment of combined vascular and muscle contraction headaches in an elderly patient and suggests that age not be a criterion for eliminating patients from this treatment. In addition, this case further supports the use of cephalic vasomotor feedback as an alternative to temperature training in the treatment of migraine.
PROPRANOLOL FOR MIGRAINE PROPHYLAXIS
Authors: Forssman Bengt , Henriksson K‐G , Johannsson Valur , Lindvall Lars , Lundin Hakan
Published: June 2005

SYNOPSIS

The preventive effect of propranolol on migraine attacks was compared to placebo in a double‐blind cross‐over trial. Thirty‐two patients with serious and prolonged migraine participated in the 12‐week study. The effect of propranolol was significantly better than that of placebo. The number of migraine attacks during the propranolol period was reduced in 22 patients (69%), and in 11 of these (34%) a reduction of more than 50% was seen. The intensity of headache was significantly reduced during the propranolol period. The intake of analgesics and preparations containing ergotamine was significantly reduced during the propranolol period also. No serious side effects were noted.
PERSONALITY, DEPRESSION AND HEADACHE TYPE
Authors: Davis Roger A. , Wetzel Richard D. , Kashiwagi Tetsuo , McClure James N.
Published: June 2005

SYNOPSIS

Seventy‐four subjects with a chief complaint of headache of functional origin were tested using the California Psychological Inventory (CPI). No associations were found between individual headache types and personality dimension factors on the CPI. The differences found related to the effect of depression on psychologic test performance. Future studies of personality and headache types need to control for the effect of depression on psychologic testing.
BRIEF REPORT: HEADACHE AND DEPRESSION
Authors: Barolin G. S.
Published: June 2005

SYNOPSIS

Headache is the formost somatic symptom among depressed patients. Patients from an outpatient headache clinic, and from a field study were examined to determine the incidence of depression among headache sufferers. A preponderance of depressive criteria in the headache population was found. Depression was more common in non‐paroxysmal headache sufferers than in migraine patients. Subjects with headache and depression required twice as many leave days per year as those suffering from headache alone. Vertebral‐basilar insufficiency is a frequent cause of “depressive headache”. Anti‐depressant drugs should be used along with headache medication when depression is found. The relationship of depression and headache in the same patient is also discussed.
ABNORMAL CT‐SCANS IN MIGRAINE
Authors: Mathew Ninan T. , Meyer John Stirling , Welch K.M.A. , Neblett Charles R.
Published: June 2005

SYNOPSIS

Twenty‐nine patients with migraine were examined by CT‐Scans. Ten of these had abnormalities on the scans which consisted of cerebral parenchymal low densitometric areas, ventricular enlargements and conical atrophy. The cerebral parenchymal low densitometer zones tended to disappear on repeat scanning. Four cases in the series had hemiparetic migraine and all showed abnormalities on CT‐scans. The incidence of complicated migraine was higher in patients who showed abnormalities on the scans than in those with normal scans. It is suggested that the parenchymal low density areas on CT‐scans are the result of cerebral edema, but that repeated insults might lead to permanent changes in brain parenchyma which might be recognizable as cortical atrophy and ventricular enlargement.
MIGRAINE THERAPY WITH HEPARIN: PATHOPHYSIOLOGIC BASIS
Authors: Thonnard‐Neumann Ernst
Published: June 2005

SYNOPSIS

During headache‐free intervals, migraine patients had in their blood fewer basophilic leukocytes, which also contained less than a normal amount of heparin, and excreted less uroheparin than did controls. During migraine attacks the levels of basophils and of uroheparin rose but did not reach normal values.

Sixty patients with severe vascular headaches (fifty‐three migraine and seven cluster) were treated with heparin by intravenous injections or aerosol inhalations. After repeated treatments, basophilic leukocytes and uroheparin levels rose to normal values and remained normal for varying periods, up to 14 months, after the end of therapy.

Of the two treatment forms, aerosol therapy was the more effective. It reduced the migraine index of all but two of thirty‐three patients by an average of 86 (75–100) percent, whereas after intravenous therapy eighteen of twenty‐seven patients showed a better than 75 percent improvement.

Three to 14 months after the end of therapy, seven patients were entirely free from migraine headaches and three more reported an average improvement of 90 percent.

The role of endogenous heparin in migraine and the fate of injected and inhaled heparin are reviewed.
CHANGES IN BLOOD CLOTTING SYSTEMS DURING MIGRAINE ATTACKS
Authors: Kalendovsky Zdenka , Austin James H.
Published: June 2005

SYNOPSIS

The activity of various blood clotting systems was measured during attacks of migraine complicated by prolonged focal cerebral dysfunction and contrasted with those observed when the same and other patients had uncomplicated migraine. Results differed in the two groups.

In patients with complicated migraine, plasma coagulability rose during both complicated and uncomplicated attacks. During a complicated migraine attack, platelet aggregability to ADP also rose in all but one patient. Platelet aggregability fell in the same patients when they had uncomplicated migraine. Plasma coagulability consistently increased more when the headache was associated with focal cerebral dysfunction.

In patients with uncomplicated migraine, plasma coagulability dropped during the later phase of their attacks. This finding may reflect the release of endogenous heparin from mast cells and basophilic leucocytes. Platelet aggregability to ADP decreased in some but rose in others.

The results support the hypothesis that prolonged focal cerebral dysfunction may reflect thromboembolic phenomena. The influence of estrogens and genetic factors on clotting systems is reviewed.
FRONTALIS EMG RESPONSE TO STRESS IN SUBJECTS WITH FREQUENT MUSCLE‐CONTRACTION HEADACHES
Authors: Vaughn Richard , Pall Michael L. , Haynes Stephen N.
Published: June 2005

SYNOPSIS

Frontalis electromyogram (EMG) activity was monitored in ten subjects with a high frequency of muscle contraction headaches, and ten subjects with low frequency of muscle contraction headaches at rest, during stressful mental artithmetic and after stress. The frontalis EMG activity of the high‐frequency headache group was significantly greater than that of the low‐frequency headache group in the pre‐stress condition. Significant increases in EMG activity from pre‐stress to stress were found in the low‐frequency headache group but not the high‐frequency headache group. Significant correlations were found between perceived level of relaxation and EMG in the low‐frequency headache group, but not for the high frequency headache group.
A NEW TREATMENT FOR HEADACHE: PATHOPHYSIOLOGIC CONSIDERATIONS
Authors: Lechin Fuad , Van Der Dijs Bertha
Published: June 2005

SYNOPSIS

The oral administration of d‐amphetamine with propranolol led to an immediate improvement of 161 out of 163 treated headache patients. Total disappearance of headache and other associated symptoms occurred after a few days. No relapses were observed while on this therapy. This therapeutic trial lasted 16 months and indicated the safety of the treatment. The addition of the beta‐blocker propranolol appears necessary to counteract undesirable side effects of amphetamines. Low doses of d‐amphetamine are necessary for therapeutic success. We suggest that headache and depression are due to a predominance of the serotonergic over the noradrenergic system. Activation of the serotonergic system could be triggered by beta‐adrenergic effects of the noradrenergic system. We postulate also that serotonin acts like a weak alpha‐adrenergic agonist and competes with nor‐epinephrine for alpha‐receptors on cell membranes. Low doses of d‐amphetamine, by stimulating the noradrenergic system only, and propranolol by interfering with serotonin synthesis in neurons, reestablish normal physiologic conditions.
HEADACHE IN GENERAL PRACTICE
Authors: Philips Clare
Published: June 2005

SYNOPSIS

Characteristics of headache sufferers and their headaches were investigated in a random sample of general practice patients by way of postal questionnaire.

The results are consistent with previous studies in respect to prevalence, and the relation of headache to sex, age, and social class. Features of headache were found to be more closely associated with headache severity and sufferer's sex, than diagnositic group. Little justification was found for sharp division into migraine and muscle tension groups.
Paroxysmal Hypertensive Hemicrania
Authors: Duncan Gary W. , Roberts L. Jackson , Wilson James P.
Published: June 2005

SYNOPSIS

A patient with severe bilateral carotid occlusive disease and paroxysmal hypertensive attacks associated with vascular headaches localized to an area of a major collateral system is reported. The similarity of the patient's symptoms to many components of migraine illustrate the relationship of headache, conjunctival erythema and unilateral lacrimation to increased blood flow.
Sphenopalatine Ganglion Neuralgia and Cluster Headache: Comparisons, Contrasts, and Treatment
Authors: Ryan Robert E. , Facer George W.
Published: June 2005

SYNOPSIS

Whether spheoplatatine ganglion neuralgia and cluster headache are two distinct entities or are one and the same disease has not been decided. We reviewed records of patients with these diagnoses at the Mayo Clinic.

Sphenopalatine ganglion neuralgia and cluster headache are distinct entities because in sphenopalatine ganglion neuralgia (1) the pain is different, (2) duration of symptoms is longer, (3) an inflamed nasal mucosa is present on the involved side, (4) extended relief is obtained by cauterization of the sphenopalatine ganglion, and (5) the disorder is more frequent in women, in contrast to the male predominance in cluster headache. We recommend cauterization of the sphenopalatine ganglion in patients with sphenopalatine ganglion neuralgia.
Drug Dependency in Patients with Chronic Headaches
Authors: Medina Jose L. , Diamond Seymour
Published: June 2005

SYNOPSIS

New patients seen during eleven months were questioned about intake of narcotics or common analgesics with barbiturates prescribed for the treatment of headache. Out of 2,369 new patients, 62 received both medications frequently for at least six months. Thirty‐eight patients were taking a combination of common analgesics and butalbital for 0.5 to 40 years. Eight were dependent; six physically addicted, two psychologically dependent and two were abusers. Seventeen patients were taking codeine and six, propoxyphene for 0.5 to 35 years. No addictions occurred, but there were two codeine and one propoxyphere abuser. There is danger of dependency and abuse in patients with chronic headaches.
Lithium Prophylaxis for Chronic Cluster Headache
Authors: Kudrow Lee
Published: June 2005

SYNOPSIS

Thirty‐two patients with chronic cluster headache, not responding to conventional therapy, were treated with lithium carbonate for 32 weeks.

Treatment was discontinued in 4 cases because of intolerable side effects. Marked and continued improvement occurred in 27 of 28 patients throughout the treatment period. Twenty‐five percent of all patients had mild or transient side effects without increased serum lithium levels. Long‐term prophylactic lithium maintenance treatment is efficacious in selected cases of chronic cluster headache.
A New Post‐Traumatic Headache Syndrome; Clinical and Therapeutic Observations
Authors: Vijayan N.
Published: June 2005

SYNOPSIS

Clinical and therapeutic observations are described in seven patients with a new form of post‐traumatic headache. Unilateral fronto‐temporal vasodilatory headaches occurred associated with ipsilateral mydriasis and facial hyperhidrosis followed by partial ptosis and meiosis. Pharmacologic studies showed partial sympathetic denervation of the affected pupil during headache‐free intervals. There was no evidence of generalized autonomic dysfunction. Anterior neck injury occurred in all patients. The third neuronal sympathetic pathway appears partially damaged in the neck and probably is the cause of this dysautonomic headache. The patients responded to treatment with the beta‐adrenergic blocking agent propranolol, but not to ergotamine.
Humoral and Hormonal Changes in Menstrual Migraine
Authors: Nattero G. , Bisbocci D. , Bottini A. , Brandi G. , Griffa P.G. , Lisino F. , Ansini A. , Ceresa F.
Published: June 2005

SYNOPSIS

Circadian plasma levels of aldosterone, renin activity, cortisol, sodium and potassium were studied during the migraine attack and headache‐free periods in ten women with menstrual migraine. Aldosterone dropped at the onset of an attack in all cases, producing an inverted profile when plotted at two‐hourly intervals over a 24‐hour period and compared with aldosterone levels during a headache‐free period. Renin activity and cortisol levels were normal during migraine and headache‐free periods and potassium and sodium were normal during the migraine attack. A possible explanation for the fall in aldosterone during the attack phase is increased conjugation in the liver due to increased hepatic blood flow.
Variation of Plasma Free Tryptophan and CSF 5‐HIAA During Migraine
Authors: Hyyppä Markku T. , Kangasniemi Pentti
Published: June 2005

SYNOPSIS

Simultaneous plasma free and total tryptophan and CSF 5‐HIAA concentrations were determined in 18 migraine patients during headache‐free intervals, four hours and 24 hours after onset of headache. A statistically significant (p<0.05) positive correlation was found between CSF 5‐HIAA and plasma free tryptophan 4 hours after onset of headache. No other statistically significant correlations were noted. Increased catecholamines resulting from stress (of migraine attack) can cause elevation of unesterified fatty acids which displace tryptophan from its binding to plasma albumin, making free tryptophan available to the brain for serotonin metabolism. The increased CSF 5‐HIAA during the attack of migraine is related to stress, rather than to pathogenetic factors in the disorder.
Clonidine Prophylaxis of Childhood Migraine and Other Vascular Headache
Authors: Sillanpää Matti
Published: June 2005

SYNOPSISFifty‐seven children, ages 0–15 years, with migraine or other vascular headaches were treated with clonidine (28) and placebo (29). A double‐blind technique without crossover was used for two months. The mean daily dose was 1.2 mgkg body weight during the first month, and 2.1 mgkg during the second month. Mean total follow‐up period was 7.9 months. Headaches were completely abolished during treatment in one‐third of patients in both placebo and clonidine groups. Fifty‐seven percent of children on clonidine and 42 percent of those on placebo were greatly improved. This difference is not statistically significant. Cases with visual aura or positive family history for migraine or both, responded statistically better to clonidine than to placebo. Improved response was noted with increased dose of clonidine. Two patients had side effects which interfered with daily activities and one discontinued treatment because of nausea and vomiting.
Migraine Stupor
Authors: Lee C. H. , Lance J. W.
Published: June 2005

SYNOPSIS

Seven patients aged 10–52 years have had stupor lasting 2 hours to 5 days during attacks of migraine. Commonly associated symptoms included dysarthria, ataxia, incoordination, paraesthesiae, dilatation of one pupil and homonymous hemianopia which point to the vertebrobasilar arterial tree as the site of disturbance. Vasoconstriction in this circulation appears to be the most likely mechanism.

Aggressive and apparently hysterical behavior was a feature of the attack in 4 patients.
Clinical Effectiveness of Lisuride Hydrogen Maleate: A Double‐Blind Trial Versus Methysergide
Authors: Herrmann W.M. , Horowski R. , Dannehl K. , Kramer U. , Lurati K.
Published: June 2005

SYNOPSIS

In a controlled double‐blind study of the therapeutic efficacy and clinical tolerance of lisuride hydrogen maleate (LHM), 25 mcg tid, and methysergide (MET), 2 mg tid, in 253 patients 50% or more reduction in number of attacks was noted in 53% of patients treated with LHM and in 51% of patients treated with MET. Thirty‐nine percent of the MET group and 17% of the LHM group discontinued the medications because of side effects (p<0.05, Chi2 test). Complaints of muscle weakness, coldness of extremities and dizziness were less common in the LHM group than in the MET group. It is suggested that LHM is as effective as MET in the prophylaxis of migraine and is associated with fewer side effects.
Prophylaxis of Migraine in Children
Authors: Bille Bo , Ludvigsson Johnny , Sanner Gunnar
Published: June 2005

SYNOPSIS

About 4 percent of school children suffer from migraine. To prevent attacks it is important to inform the child, the parents and the teachers about the nature of migraine, to prescribe a sound rhythm for the child and to try to remove the attack‐provoking factors. It is not always necessary to use prophylactic therapy for migraine in childhood. However, if the attacks are severe and occur three or four times a month then the use of prophylactic drugs is worthwhile. In a pilot study cyproheptadine was given to 19 children aged 6 to 16 years with good effect. Pizotifen was also tried and gave the same good result. Thirty‐two school children aged 7 to 16 years were admitted to a double‐blind, single crossover propranolol vs. placebo study. The result was good, and side effects of these three drugs were benign.
The Dynamics of Post‐Spinal Headache
Authors: Hatfalvi B.I.
Published: June 2005

SYNOPSIS

Post spinal puncture headache has been a bothersome problem ever since the introduction of the spinal tap over a century ago. It is generally conceded to be due to leakage of spinal fluid through the hole produced by the needle. In this study in‐vivo and in‐vitro evidence suggests that tangential puncture of the subarachnoid space leads to less leakage than perpendicular puncture and that the size of the needle used may not be as important as the angle from which it pierces the dura and arachnoid membranes.
Migraine: A Generalized Vasomotor Dysfunction? A Critical Review of Evidence
Authors: Morley Stephen
Published: June 2005

SYNOPSIS

Evidence that migraineurs exhibit a generalized vasomotor dysfunction is critically assessed. After discussing the shortcomings of the reported results it is concluded that there is no evidence to suggest that migrainous individuals possess abnormal general vasomotor control. Suggestions for further research are made and the rationale of applying biofeedback techniques to migraine is questioned.
Sanomigran for Migraine Prophylaxis; Controlled Multicenter Trial in General Practice
Authors: Lawrence E.R. , Hossain M. , Littlestone W.
Published: June 2005

SYNOPSIS

Pizotifen, a tricyclic antiserotonin agent and inhibitor of certain other biogenic amines, was effective in reducing the severity and frequency of migraine attacks, producing complete remission in some cases, in a double‐blind placebo controlled trial in 36 patients. Serious side effects were not reported during the trial period.
Prostaglandins and Migraine
Authors: Horrobin D. F.
Published: June 2005

SYNOPSIS

A theory of migraine etiology should explain clinical features, biochemical correlates, and actions of effective therapies. Prostaglandin El (PGE1) involvement in migraine has been investigated, but the findings did not fulfill the above criteria. In the present study, low concentrations of PGE1 potentiated vasoconstriction, and increased PGE1 concentrations produced vasodilatation. Postaglandin synthesis in blood vessel walls was stimulated by prolactin, serotonin and angiotensin, explaining the assocation of migraine with sleep, stress, fluid and electrolyte retention, renal disease and dietary precipitating factors. Finally it was shown that propranolol, amitriptyline, caffeine and other drugs are prostaglandin (PG) antagonists, probably by virtue of membrane stabilizing properties. All drugs effective in migraine therapy oppose PG synthesis or antagonize its action. The understanding of prostaglandins physiology permits a more rational approach to migraine therapy than has been possible in the past.
Phantom Limb Pain: Sub‐Hallucinogenic Treatment With Lysergic Acid Diethylamide (LSD‐25)
Authors: Fanciullacci M. , Bene E. Del , Franchi G. , Sicuteri F.
Published: June 2005

SYNOPSIS

Oral treatment of phantom limb pain in five males and two females ranging in age from 25 to 78 years with sub‐hallucinogenic doses of Iysergic acid diethyImaide (LSD‐25) resulted in improvement in pain in five patients and reduction in use of analgesics. In two of the five patients improvement was striking and in the other three, pain and analgesic use were reduced moderately. LSD treatment was ineffective in two patients. Intravenous infusion or bolus injection of LSD‐25, 10ngml at 0.5 mlmin. resulted in facilitation of 5‐HT venospasm. The findings suggest that LSD‐25 facilitation of 5‐HT activity occurs centrally consistent with the hypothesis of the central nature of phantom limb pain.
Double‐Blind Study of Belladonna‐Ergotamine‐Phenobarbital for Interval Treatment of Recurrent Throbbing Headache
Authors: Stieg Richard L.
Published: June 2005

SYNOPSIS

In a double‐blind study comparing crossover and parallel group designs, 55 patients with recurrent throbbing headache were given either belladonna‐ergotamine‐phenobarbital (BEP) or placebo for headache prophylaxis. Analysis of the crossover design showed BEP to be significantly more effective than placebo in reduction of headache severity and overall effectiveness. During BEP treatment, patients had less days during which medications for relief of headache symptoms were required. Although there were period effects favoring BEP, no significant differences between treatments were observed in the parallel design. The greater variability in the parallel portion of the study precluded demonstration of statistical significance with this number of patients. The crossover design indicates that BEP offers benefits in the prophylaxis of recurrent throbbing headache, without serious or frequent side effects.
Migraine: A Psychosomatic Disorder
Authors: Pearce John
Published: June 2005

SYNOPSIS

Migraine has no single cause. It can be seen as a reaction of the organism, probably determined by the hypothalamus and released by a variety of extrinsic and intrinsic factors. Several factors may determine attacks at different times within a patient's lifetime. Vascular reactions are secondary to the primary cerebral mechanism, and account for many of the symptoms, notably the headache. The prodrome, aura, and the incubation during sleep are part of the attack.

Emotional disturbance is the commonest single trigger mechanism, and is the most important cause of frequent and severe attacks. There is, however, nothing specific about the emotional stimulus, nor is there a consistent personality type in migraine subjects. Certain personality reactions and patterns of behavior recur in migraine subjects; a tendency to anxiety reactions, sensitivity to stress and difficulty in handling aggressive and hostile drives. In this respect, migraine is similar to many other “psychosomatic diseases” without demonstrable pathology but characterized by disorders of homeostasis. In some patients extrinsic physical and biochemical precipitants are prominent and the “psychosomatic element” is slight. In most migraine patients, however, psychologic factors are important but are secondary rather than precipitating etiologic agents.
Transient Cerebral Ischemia and Brain Serotonin: Relevance to Migraine
Authors: Welch K.M.A. , Gaudet Robert , Wang T.P.F. , Chabi Eva
Published: June 2005

SYNOPSIS

Central pain supersensitivity related to depletion of serotonin in the central nervous system has been postulated as a mechanism for migraine. In the present study, transient cerebral ischemia in an animal preparation caused depletion of central nervous system serotonin. Ischemia associated with the prodromal phase of migraine must, therefore, be considered as a possible cause of altered central nervous system serotonin metabolism, possibly leading to increased pain sensitivity
Cerebral Blood Flow in Migraine
Authors: Edmeads John
Published: June 2005

SYNOPSIS

Cerebral blood flow has seldom been measured during attacks of migraine and cluster headache. The literature is reviewed and five cases studied in our laboratory are described. The results of these studies confirm Wolff's hypothesis that cerebral blood flow is decreased during auras and increased during headaches. However, the distribution in time and space of the blood flow changes do not always correlate with the clinical features of the attack. Autoregulation of cerebral blood vessels may be impaired in aura and headache, and this may be a factor in intensifying and prolonging attacks.
Transitory Platelet Monoamine Oxidase Deficit In Migraine: Some Reflections
Authors: Sandler Merton
Published: June 2005

SYNOPSIS

A transitory but highly significant decrease in platelet monoamine oxidase activity was found during headache attacks in migrainous subjects and reverted to normal during attack‐free periods. This is not the result of drugs used for the treatment of migraine. It is possible that decreased platelet monoamine oxidase and 5‐hydroxytryptamine occur in response to release of an unidentified substance into the circulation during headache and, perhaps, is responsible for it. Attention is drawn to the biochemical relationship of migraine and depressive illness
Brief Therapeutic Report: Papaverine Prophylaxis of Complicated Migraine
Authors: Vijayan Nazhiyath
Published: June 2005

SYNOPSIS

Use of vasoconstrictor agents for treatment of migraine associated with prolonged neurologic manifestations has been controversial because permanent sequelae, though rare, occur most commonly in these patients. A slowly released form of Papaverine, 150 mg twice a day prevented the premonitory neurologic symptoms in seven patients with complicated migraine. Four of these patients also became headache‐free and the remaining three were considerably improved. Papaverine therapy was effective in patients in whom the use of ergotamine or other potent vasoconstrictor agents might be hazardous
Immunoglobulin and Complement Studies in Migraine
Authors: Lord G.D.A. , Duckworth J.W.
Published: June 2005

SYNOPSIS

Serum complement components and immunoglobulins were measured in migraineurs. Patients were assigned to two groups: Group I (prodromal migraineurs), Group 2 (non‐prodromal). This group was subdivided into Group 2A (common) and Group 2B (with focal neurologic symptoms commencing after headache onset). In the immunoglobulin study: Group 1 had an elevated IgA level, Group 2A had elevated IgG, IgA and Group 2B elevated IgG, IgA and IgM when compared with appropriate controls. The IgM in group 2B was significantly higher than in Groups I and 2A, supporting the division into two groups of patients with focal neurologic symptoms. The complement study compared patients during headache and when headache‐free. The “in headache” patients were further subdivided into early and late groups. The complement results are from patients in Group 2 only. During headache, samples were obtained from 18 migraineurs. In 9 patients headache‐free specimens were collected enabling paired analysis of results. Reductions in levels of C4 and C5 in the paired study, lower levels of C4, C1s and C1(1) during early headache in the unpaired study are evidence of complement activation associated with migraine. Demonstration of complement breakdown products in three patients at least three hours before headache onset, and absence of difference in component levels between headache‐free and late headache migraineurs indicates complement activation of short duration. Elevated immunoglobulin levels and complement activation suggest a late‐onset immune reaction of short duration. Such a mechanism provides an explanation of many of the features of non‐prodromal migraine; platelet release of serotonin, basophil and mast cell degranulation, increased whole blood histamine during an attack, fluid retention, increased thrombotic tendency and increased CSF lactate and GABA.
Clonidine in Migraine Prophylaxis
Authors: Kallanranta T. , Hakkarainen H. , Hokkanen E. , Tuovinen T.
Published: June 2005

SYNOPSIS

Clonidine chloride, 25 ug three times per day, decreased the mean number of headache attacks per month to 2.26 compared to 3.94 before treatment and 2.98 during placebo use in 50 migraineurs. Fifty ug clonidine t.i.d. decreased mean number of attacks from 4 before treatment to 1.88 during treatment and 2.49 during placebo. Frequency of attacks decreased in 44% of patients, were unchanged in 46% of patients and increased in 10% of patients on 25 ug t.i.d., and 50 ug clonidine t.i.d. decreased attacks in 58% of patients, frequency was unchanged in 40% of patients and increased in 1%. Practolol, a beta adrenergic blocker, decreased frequency of attacks in 41% of patients, attack frequency was unchanged in 42% of patients, and increased frequency in 16% of patients receiving it 50 mg t.i.d. Mean duration of attacks decreased from 3.86 hours before treatment to 2.16 hours after clonidine in the 25 ug t.i.d. dosage and to 1.86 after clondine in the 50 ug t.i.d. dose. Attack duration was 2.37 hours after practolol therapy and 3.36 hours after placebo. The duration of attacks were decreased in 38% of patients receiving 25 ug of clonidine t.i.d., were unchanged in 60% and increased in 2%. In those patients receiving 50 ug clonidine t.i.d. duration of attacks were decreased in 52%, unchanged in 46% and increased in 2%. With practolol 50 mg t.i.d. duration of attacks were decreased in 41%, unchanged in 43% and increased in 16% of patients. Prodromal symptoms were not reduced by clonidine in the 25 or 50 ug t.i.d. dose nor with practolol. Medication was not clearly effective in improving general well‐being or ability to work of patients receiving clonidine in either dose nor practolol. Practolol was associated with sedation in 21% of patients. Increased clonidine dose was associated with sedation in 21% of patients. Increased clonidine dose was associated with increased nausea and sedation. It was concluded that practolol has insufficient anti‐migraine effect to justify its use as a routine prophylactic agent. Clonidine is useful in the prophylactic treatment of migraine
An Epidemiologic Study of Migraine and Headache in 10–20 Year Olds
Authors: Deubner David C.
Published: June 2005

SYNOPSIS

Headache histories of a random sample of 600 ten to twenty year‐olds were obtained by standard interview and questionnaires were completed independently by the parents of those aged ten to fifteen. Parental headache histories and clinical evaluations were obtained on subsamples. Migraine was defined as headache with two of three features: unilaterality, nausea, or neurologic manifestations. The prevalence of migraine was higher in females but did not vary significantly with age, social class, menstrual status or history of cyclic or nervous vomiting, travel sickness or recurrent abdominal pain. The familial pattern of migraine was evident. Interview of ten to fifteen year‐olds for history of unilateral headache or neurologic features was more sensitive than questioning their parents. Development and proper documentation of standard and reliable methods for headache identification are a prerequisite for the reliability and comparability of both clinical and epidemiologic studies of headache
Carotidynia
Authors: Lovshin Leonard L.
Published: June 2005

SYNOPSIS

The most common form of carotidynia is related to overdistention, relaxation, and increased pulsation in the carotid artery. This syndrome of vascular neck pain is closely associated with various forms of extracranial vascular headache. Analysis of 100 consecutive cases of carotidynia has revealed that it is more common in women than in men in a ratio of about 4 to 1; it occurs at almost any age but is most prevalent during the fourth and fifth decades; and there is often a history of vascular headache. The only significant abnormality on physical examination is the presence of a tender, throbbing, often dilated carotid artery. The condition is frequently misdiagnosed and therefore not properly treated. The preferred treatment is similar to that used for migraine and other painful vasodilating conditions of the head.
Transient Focal Cerebral Ischemia After Extreme Exercise
Authors: Miller Robert G.
Published: June 2005

SYNOPSIS

Two episodes of transient focal cerebral ischemia occurred after extreme exercise by a young man. The ingestion of foods containing tyramine and phenylethylamine followed the exercise and preceded the neurologic dysfunction. It is suggested that the vasoactive amines played a role in producing this syndrome.
A Follow‐Up Evaluation of the Menninger Pilot Migraine Study Using Thermal Training
Authors: Solbach Patricia , Sargent Joseph D.
Published: June 2005

SYNOPSIS

One hundred and ten headache sufferers entered the Migraine Headache Study from 1969 to 1974; 74 completed 270 days of training and follow‐up; 36 (33%) had thermal training, but dropped out before completing 270 days.

Records were examined for all participants with 23 variables identified. A progress report was obtained through questionnaire andor telephone survey from 56 (76%) of the 74 “graduates” and from 12 (33%) of the 36 “dropouts” through telephone survey alone.

Comparisons were made between respondents and nonrespondents in the Graduate and Dropout groups. Although there is reduction of headache frequency for both groups, Graduates show a greater decrease in headache intensity and duration, take fewer medications and practice more routinely and more often than Dropouts.
Preventive Treatment of Migraine with Mini‐Doses of Danitracene
Authors: Sulman F. G. , Pfeifer Y. , Superstine E.
Published: June 2005

SYNOPSIS

Danitracene is an oral antamine preparation; with three effects: anti‐serotoninic, anti‐histaminic and anti‐depressive. Its lack of unpleasant side effects permits its long use for the preventive treatment of migraine. Its chemical structure‐ring, C‐beta, C‐alpha, amine‐allows specific blockade of receptors for serotonin and histamine geared to the same configuration. Danitracene preventive treatment with 1‐3 x 0.5‐1 mgday for a period of 1‐3‐6 months can almost completely eliminate migraine attacks. Fifty out of 75 patients profited from treatment of 1‐3 x 0.5 mgday showing a drop from 5‐30 attacks per month to 0‐1 attacks per month. During this period 50 cases with high urinary excretion of serotonin, 5‐HIAA or histamine were normalized and relieved of their migraine attacks. Starting with very low doses at night overcomes the sedative anti‐serotonin effect, improves results and avoids dropouts. Two side‐effects typical for anti‐serotonin drugs were observed: sedation or dizziness and hyperorexia. The hypnotic effect tended to disappear after protracted treatment with one 0.5 mg doseday only. The hyperoraexia, however could only be overcome by reduced dosage. Randomization, “double‐blind” and cross‐over design were used in the trial.
Muscle Contraction and Migraine Headache: Psychophysiologic Comparison
Authors: Bakal Donald A. , Kaganov Judith A.
Published: June 2005

SYNOPSIS

Muscle contraction headache and migraine patients were compared for symptoms of muscular and vascular activity, and responsiveness to frontalis electromyogram (EMG) biofeedback therapy. Locations of head pain were non‐specific to the diagnostic groups. Migraine patients had higher frontalis EMG activity than muscle contraction headache patients and headache‐free controls. Both headache groups had higher neck EMG activity than controls. Pulse velocities in the superficial temporal arteries were similar in the two headache patient groups but different from controls. It is suggested that muscle contraction headache and migraine patients have similar physiologic predisposition for headaches. Further support for similar predisposition in the two groups was provided by the frontalis EMG biofeedback results which showed this treatment to be equally effective for both groups.
Fluphenazine for Tension Headache; Double‐Blind Study
Authors: Hakkarainen Heikki
Published: June 2005

SYNOPSIS

Fluphenazine, a fluorinated piperazine derivative of phenothiazine was compared with placebo in a double‐blind study of 50 patients with tension headache. Daily dose of fluphenazine was 1 mg. The trial was completed by 48 patients. Treatment periods were 2 months each.

Days with headache diminished significantly more during treatment with fluphenazine than placebo (P < 0.001). Duration ot the headache decreased and severity of pain was reduced significantly with fluphenazine. Mean quantities of analgesics used during one headache day was 1.6 on fluphenazine and 2.5 on placebo (P < 0.001). Thirty‐six patients considered fluphenazine and one placebo as the superior drug.

Side effects were reported by 19 patients on fluphenazine and 15 on placebo. Two patients interrupted fluphenazine trial because of extrapyramidal dyskinesias.
Hemicrania and Ipsilateral Trunk and Limb Symptoms
Authors: Summers David S.
Published: June 2005

SYNOPSIS

One hundred and eleven cases of migraine seen over 412 years were studied. A useful diagnostic feature was motor or sensory symptoms ipsilateral to hemicrania. It is suggested that this lateralization is inherent in the response of the sympathetic nervous system to a generalized body reaction, but the response is predominantly peripheral and confined to adrenoceptive components unilaterally. This hypothesis should be tested by assessing the frequency of ipsilateral symptoms in common and classic migraine, and by neuropharmacologic tests.
Metabolic Changes During the Prodrome of a Migraine Headache
Authors: Benson Herbert , Greenwood Martha M.
Published: June 2005

SUMMARY

The continuous measurement of oxygen consumption, carbon dioxide elimination and heart rate were serendipitously recorded during the prodrome of a migraine headache. Mean oxygen consumption and carbon dioxide elimination decreased by 17% and 35%, respectively. Paradoxically, heart rate increased by 41% during the prodrome. It is not known whether these physiologic changes are primary or secondary to the prodrome of the migraine headache.
Differential EMG Activity in Subjects with Muscle Contraction Headaches Related to Mental Effort
Authors: Boxtel A. van , van der Ven J. Roozeveld
Published: June 2005

SYNOPSIS

EMG activity of two groups of subjects was compared: seven subjects with frequent muscle contraction headaches, associated with mental effort, and eleven subjects without headaches. The EMG activity of frontalis, temporalis, trapezius muscles and forearm flexors was studied at rest (baseline) and during a mental task. Only the frontalis EMG activity differentiated reliably between the two groups, both at rest and during task.
Plasma Tryptophan in Migraine
Authors: Salmon S. , Fanciullacci M. , Bonciani M. , Sicuteri F.
Published: June 2005

SYNOPSIS

Free and total plasma tryptophan (TRY) was evaluated in migraine and daily headache sufferers. In migraineurs, free plasma TRY was significantly higher on the day of the attack, the day preceding and subsequent to the attack in comparison with controls.

The possibility that in migraineurs a lowering of brain 5‐HT may displace TRY from its binding to plasma albumin through an unknown feedback mechanism is suggested. In daily headache sufferers total plasma TRY levels were statistically significantly lower compared with controls. This may reflect a deficiency of 5‐HT in the brain.
Skin Temperature Biofeedback and Migraine
Authors: Mullinix Janice M. , Norton Barbara J. , Hack Stanley , Fishman Marvin A.
Published: June 2005

SYNOPSIS

Skin temperature biofeedback was used in treating two groups of patients with migraine. The experimental group received true auditory feedback controlled by increases in skin temperature of their fingers, while the control group received a similar “positive” signal independent of skin temperature changes and controlled by the investigator. The true feedback group increased their skin temperature significantly more (p < 0.05) than the control group, but both groups showed similar improvement in headaches. This study suggests that biofeedback techniques are useful in treating patients with migraine, and the mechanism, presumably a placebo effect, is independent of peripheral skin temperature changes.
Headache in Patients with Hypertension
Authors: Traube Y. M. , Korczyn A. D.
Published: June 2005

SYNOPSIS

The relationship between high blood pressure and headache (HA) was assessed retrospectively among 241 patients attending a hypertension clinic. HA was common (45.6%), particularly among women (68%). Patients with systolic blood pressure higher than 170 mmHg andor diastolic blood pressure higher than 110 mmHg had nocturnal andor early morning HA more often. Fifty‐four subjects became HA free during antihypertensive therapy. Their blood pressure (BP) decrease was significantly greater than the BP fall of those whose HA did not disappear with treatment. Nocturnal and early morning HA may be a symptom of hypertension in subjects with markedly elevated BP, and control of BP may be beneficial in some hypertensive patients.
A Controlled Study of the Effect of Oral Contraceptives on Migraine
Authors: Ryan Robert E.
Published: June 2005

SYNOPSIS

Headache frequency and index in migraine patients both on and off oral contraceptives were observed.

Twenty patients received an oral contraceptive for two months while another twenty patients did not. After two months the second group received the oral contraceptive, and the first did not. Increased frequency of headaches, and headache index most prominent in cases of moderate severity, occurred while the patients were on the pill. Three distinct groups of patients were identified. One group improved while on the pill; a second group had headaches and a third group showed no influence of oral contraceptives on headache.
The Dopaminergic and Noradrenergic Blockades:
Authors: Lechin Fuad , van Der Dijs Bertha , Lechin Ernesto , Peña Francisco , Bentolila Ana
Published: June 2005

SYNOPSIS

In accordance with a double‐blind pilot study carried out in 60 headache patients, it was found that dopaminergic blockage was able to maintain the improvement induced by d‐amphetamine plus propranolol (AP)‐treatment as well as to relieve significantly those patients not improved by the amphetaminic treatment. The addition of noradrenergic blockade provoked the total disappearance of the improvement in some (including those relieved by AP‐treatment), whereas it induced a significant further increment of the relief in other patients. These results suggest that there are two kinds of headache patients, those improved by the enhancement and those improved by the blockade of the noradrenergic system. The demonstrated fact that the dopaminergic blockade was able to relieve both types of headaches indicates that a common factor, located at the dopamine‐system level, is shared by the pathophysiologic mechanisms of both types ot headaches.