bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Headache Diagnosis Project
Authors: Pryse‐Phillips William , Aubé Michel , Gawel Marek , Nelson Robert , Purdy Allan , Wilson Keith 
Published: March 2003

Background.—Despite the availability of objective criteria, the diagnosis of migraine is thought to be missed frequently in primary practice.Objective.—To determine the most important questions assisting in the clinical diagnosis of migraine headache.Methods.—A cohort of 461 patients referred to headache specialists in Canada was assessed using a pro‐forma questionnaire that was completed by the patients alone or administered by the physicians themselves. A final clinical diagnosis was recorded after a complete clinical evaluation. In a subsequent validation study, three questions derived from the results of the first phase of the study were administered to a new cohort of 128 patients, and diagnoses of “migraine” or “not migraine” were recorded according to the decision generated in the first part of the study. The final clinical diagnosis was taken as the “gold standard” for diagnosis, and the results from the two independently derived diagnostic methods were compared.Results.—Statistical analysis of the responses from part 1 of the study yielded three questions (related to daily occurrence, unilaterally, and functional impairment) that distinguished between pure migraine and other headache diagnoses with high reliability and validity. The sensitivity and selectivity of the three‐question protocol exceeded 91%.Conclusions.—The use of three questions related to headache frequency, laterality, and impact on functioning may represent an attractive screening instrument in primary care practice, alerting physicians to the diagnosis of migraine in patients or to the possibility of a second or alternative headache diagnosis in patients in whom their diagnosis of migraine previously has been made. The presence of multiple headache syndromes in individual patients, as is common in tertiary referral practice, may reduce the discriminating power of the three‐question protocol.
Intravenous Dipyrone in the Acute Treatment of Migraine Without Aura and Migraine with Aura: A Randomized, Double Blind, Placebo Controlled Study
Authors: Bigal Marcelo E. , Bordini Carlos A. , Tepper Stewart J. , Speciali José G. 
Published: March 2003

Background.— Dipyrone (Metamizol) has been used in the acute treatment of migraines in Brazil. Some investigators have found it to be a highly effective medication for migraine pain and associated symptoms.Objective.—To conduct a randomized, placebo controlled, double blind study to assess the effect of dipyrone on the pain and symptoms associated with migraine without aura or with aura and the adverse effect profile of this medication.Methods.—For the migraine without aura group, 44 patients were assigned at random to receive 1 g intravenous dipyrone, and 30 patients received 10 mL 0.9% physiological saline. For the migraine with aura group, 30 patients received both dipyrone or placebo. We used seven parameters of analgesic evaluation and an analog scale to assess nausea, photophobia, and phonophobia.Results.—Patients receiving dipyrone demonstrated a statistically superior improvement (P<.05 andP<.01) in pain and all associated symptoms compared with control subjects.Conclusions.—Dipyrone is an effective drug for the relief of acute migraine pain and associated symptoms.
Safety of a Patented Special Butterbur Root Extract for Migraine Prevention
Authors: Danesch Ulrich , Rittinghausen Reiner 
Published: March 2003

Objective To report on the safety of a patented special butterbur root extract used for migraine prevention.Background Two placebo‐controlled clinical trials have been conducted supporting the beneficial use in humans.Methods Results from acute, subchronic and chronic animal toxicity studies as well as from mutagenicity studies are reported. Safety data gained from clinical trials, postmarketing surveillance studies and pharmacovigilance are evaluated and discussed.Conclusion The patented special butterbur root extract is safe for the treatment in humans.
Single Use of Sumatriptan: A Patient Interview Study
Authors: Rahimtoola H. , Buurma H. , Tijssen C.C. , Leufkens H.G. , Egberts A.C.G. 
Published: March 2003

Objective.—To investigate the possible reasons associated with the use of a single prescription of sumatriptan.Background.—A few population‐based studies concerning the usage patterns of sumatriptan have revealed a relatively high incidence (approximately 40%) of sumatriptan users who utilize only a single prescription of the drug.Design and Methods.—Using automated prescription data from 11 community pharmacies, we identified single and multiple sumatriptan prescription recipients. The data were collected from May 1, 1998, to April 30, 2000. Several patient‐ and medication‐related variables possibly associated with single recipiency of sumatriptan were analyzed. In addition, single recipients of sumatriptan were invited for an interview and asked a number of questions related to their clinical status and their experience with the medication.Results.—Four hundred ninety‐five, first‐time users of sumatriptan were identified during the patient selection period, of whom 38% were single recipients of sumatriptan. Of the latter, 102 patients were considered eligible for interview. Reasons for terminating treatment after only 1 prescription included: inefficacy and/or occurrence of side effects, 78% (n = 79); uncertain diagnosis of migraine, 39.2% (n = 40); and reduction in headache frequency, 33.3% (n = 34). Almost half of the population had terminated treatment without having consulted their physician. More than half relied upon the use of over‐the‐counter (OTC) analgesics after having tried sumatriptan. Compared to multiple users of sumatriptan, single recipients were far less likely to have used another form of migraine treatment prior to (odds ratio, 0.35; [95% confidence interval, 019 to 0.67]) and after (odds ratio, 0.34 [95% confidence interval, 0.19 to 0.63]) initiating sumatriptan. Furthermore, single recipients had demonstrated an increased tendency towards benzodiazepine use prior to receiving sumatriptan (odds ratio, 1.80 [95% confidence interval, 1.00 to 3.28]).Conclusions.—Single use of a sumatriptan prescription reveals some issues that may impact negatively the provision of effective migraine management. These include: rapidly developing dissatisfaction with the treatment provided and a lower tendency to seek out medical care. Our results also suggest that the drug may be used (inappropriately) as a diagnostic tool.
Mechanism of the Inhibitory Effect of Histamine on Amygdaloid‐Kindled Seizures in Rats
Authors: Okuma Chihiro , Hirai Tadashi , Kamei Chiaki 
Published: March 2003

Summary:  Purpose: The mechanism of the inhibitory effect of histamine on amygdaloid‐kindled seizures was investigated in rats.Methods: Under pentobarbital anesthesia, rats were fixed to a stereotaxic apparatus, and bipolar electrodes were implanted into the right amygdala. A guide cannula made of stainless steel tubing was implanted into the right lateral ventricle. Electrodes were connected to a miniature receptacle, which was embedded in the skull with dental cement. EEG was recorded with an electroencephalograph; stimulation of the amygdala was applied bipolarly every day by a constant‐current stimulator and continued until a generalized convulsion was obtained.Results: Intracerebroventricular (i.c.v.) injection of histamine at doses of 2–10 μg resulted in a dose‐related inhibition of amygdaloid‐kindled seizures. I.c.v. injection of calcium chloride at doses of 10–50 μg and A23187 at doses of 2–10 μg also caused dose‐dependent inhibition of amygdaloid‐kindled seizures. Calcium chloride at a dose of 10 μg, which showed no significant effect on amygdaloid‐kindled seizures when used alone, significantly potentiated the effect of histamine. Similar findings were observed with A23187 at a dose of 2 μg. In addition, EGTA and EGTA/AM antagonized the inhibition of kindled seizures induced by histamine. Moreover, the inhibition of kindled seizures induced by histamine was antagonized by KN62. However, calphostin C did not antagonize the inhibitory effect of histamine.Conclusions: These results indicated that histamine‐induced inhibition of amygdaloid‐kindled seizures may be closely associated with a calcium calmodulin‐dependent protein kinase II activation pathway.
Premature Ovarian Failure in Women with Epilepsy
Authors: Klein Pavel , Serje Adriana , Pezzullo John C. 
Published: March 2003

Summary:  Purpose: Women with epilepsy (WWE) have an increased risk for several reproductive endocrine disorders that may affect their fertility. The incidence of premature ovarian failure (POF) in women with epilepsy has not been systematically studied. This study examined the incidence of POF in women with epilepsy.Methods: Fifty consecutively evaluated cognitively normal women with epilepsy, aged 38–64 years, whose seizures began before age 41 years, were interviewed for symptoms of perimenopause and menopause. Endocrine studies, performed in women aged 45 years or younger at the time of evaluation, included serum follicle‐stimulating hormone (FSH; done on menstrual cycle day 3 in menstruating women), inhibin A levels when FSH was normal, thyroid‐stimulating hormone (TSH), prolactin, and, in menstruating women, menstrual cycle day 20 serum progesterone level. Nonsurgical premature menopause was defined as secondary amenorrhea of >12 months' duration with FSH levels of >14 International Units (IU) in women younger than 42 years. Premature perimenopause was defined by the presence of one or more of the following: somatic perimenopausal symptoms; change in previously regular menstrual cycles without evidence of other reproductive endocrine disturbance; and FSH level of >14 IU or inhibin A level of <7 pg/ml. Similarly aged neurologically normal women seen in the menopause and sleep clinics served as control subjects. Statistical analysis included Fisher's exact test, Kruskal–Wallis test, t test, and multivariate logistic regression analysis with significance set at p < 0.05.Results: Seven (14%) of 50 women with epilepsy had nonsurgical premature perimenopause (six of seven) or menopause (one of seven), compared with three of 82 control (p = 0.042). Five of 41 women with localization‐related epilepsy (LRE) had POF compared with two of nine women with primary generalized epilepsy (PGE; p = 0.595). Mean age of POF was 39.6 years (range, 37–42 years). Seizure duration, age at seizure onset, seizure severity and lateralization, smoking history, age of menarche, body mass index and incidence of depression was not statistically different between women with and without POF. There was no statistically significant association between POF and antiepileptic drugs (AEDs). Women with POF were more likely to have had catamenial exacerbation of their seizures than were women without POF (p = 0.02).Conclusions: Women with epilepsy have an increased risk for developing POF. This finding should be considered in counseling women with epilepsy on family planning.
AWD 140‐190: A Potent Anticonvulsant in the Amygdala‐Kindling Model of Partial Epilepsy
Authors: Tober Christine , Löscher Wolfgang , Hönack Dagmar , Bartsch Reni 
Published: March 2003

Summary:  Purpose: Evaluation of the effect of the new anticonvulsant drug, AWD 140‐190 [4‐(p‐bromophenyl)‐3‐morpholino‐1H‐pyrrole‐2‐carboxylic acid methyl ester] on focally induced seizures and on epileptogenesis in the kindling model.Methods: Effects of AWD 140‐190 were studied in amygdala kindled rats after oral and intraperitoneal administration. In addition, the effect on kindling development was evaluated. In all experiments, behavioral changes in the rats in response to AWD 140‐190 were monitored closely.Results: AWD 140‐190 exerted potent anticonvulsant activity against focal seizures. After intraperitoneal and oral administration in fully kindled rats, the substance dose‐dependently increased the threshold for induction of afterdischarges starting at 15 mg/kg. AWD 140‐190 only weakly influenced the seizure severity of the animals after stimulation at the elevated afterdischarge threshold current. No adverse effects were observed up to 30 mg/kg after intraperitoneal and oral administration in the open field and in the rotarod test. No differences were found between kindled and nonkindled rats when comparing neurotoxicity of AWD 140‐190. Prolonged treatment with AWD 140‐190 during kindling acquisition did not prevent kindling, but significantly retarded the development of fully kindled seizures during the treatment.Conclusions: This study demonstrates that AWD 140‐190 has anticonvulsant effects in the amygdala kindling model in rats, suggesting that the substance is particularly effective against partial seizures. AWD 140‐190 is orally active and devoid of neurotoxic effects in anticonvulsant doses, thus indicating that this compound has potential for antiepileptic therapy. AWD 140‐190 retards the kindling development during the treatment. This effect could be explained by the acute anticonvulsant effect of the substance.
Comparative Cognitive Effects of Carbamazepine and Gabapentin in Healthy Senior Adults
Authors: Martin Roy , Meador Kimford , Turrentine Luanne , Faught Edward , Sinclair Kristina , Kuzniecky Ruben , Gilliam Frank 
Published: March 2003

Summary:  Purpose: This study compared the cognitive effects of carbamazepine (CBZ) and gabapentin (GBP) in healthy senior adults by using a randomized, double‐blind crossover design.Methods: Thirty‐four senior adults were randomized to receive one of the two drugs followed by a 5‐week treatment period. A 4‐week washout phase preceded initiation of the second drug. Antiepileptic drugs (AEDs) were titrated to target doses of either CBZ (800 mg/day) or GBP (2,400 mg/day). Primary outcome measures were standardized neuropsychological tests of attention/vigilance, psychomotor speed, motor speed, verbal and visual memory, and the Profile of Mood State (POMS), yielding a total of 17 variables. Each subject received cognitive testing at predrug baseline, end of first drug phase, end of second drug phase, and 4 weeks after completion of the second drug phase.Results: Fifteen senior adults (mean age, 66.5 years; range, 59–76 years) completed the study. Seniors completing the study did not differ significantly from noncompleting seniors in terms of demographic features or baseline cognitive performances. Fifteen of the 19 seniors not completing the study dropped out while receiving CBZ. Adverse events were frequently reported for both AEDs, although they were more common for CBZ. Mean serum levels for the completers were within midrange clinical doses (CBZ, 6.8 μg/ml; GBP, 7.1 μg/ml). Significant differences between CBZ and GBP were found for only one of 11 cognitive variables, with better attention/vigilance for GBP, although the effect was modest. Performances on the nondrug average were significantly better on 45% of cognitive variables compared with CBZ and 36% compared with GBP. The overall pattern of means favored GBP over CBZ on 15 of 17 (p < 0.001), nondrug over CBZ on 17 of 17 (p < 0.0000), and nondrug over GBP on eight of 17 (NS).Conclusions: Mild cognitive effects were found for both AEDs compared with the nondrug average condition. The magnitude of difference between the two AEDs across the cognitive variables was modest. Self‐reported mood was not significantly affected by either AED. However, overall tolerability and side‐effect profile of CBZ were poorer than those of GBP in senior adults at doses and titration rates reported in this study.
Visual Function is Stable in Patients Who Continue Long‐Term Vigabatrin Therapy: Implications for Clinical Decision Making
Authors: Paul Scott R. , Krauss Gregory L. , Miller Neil R. , Medura Marianne T. , Miller Tracy A. , Johnson Mary A. 
Published: March 2003

Summary:  Purpose: Vigabatrin (VGB) has been shown to cause visual field constriction and other forms of mild visual dysfunction. We determined the safety of continuing VGB therapy in patients who had received prolonged treatment (>2 years) with the drug by serially monitoring changes in visual function over a 1‐year period of continued therapy. We also followed up patients who discontinued VGB to see whether alternative therapies are effective.Methods: Fifteen of 17 patients who continued VGB therapy had visual‐function testing (visual acuity, color vision, kinetic and static perimetry) every 3 months for 1 year. Eighteen patients who discontinued VGB were given alternative antiepileptic drugs (AEDs); their seizure responses were measured after ≥3 months of treatment.Results: Patients continuing VGB showed no worsening of visual acuity, color vision, or visual‐field constriction beyond that measured in the initial test. Many patients who discontinued VGB had good seizure control with either newer or previously unsuccessful AEDs.Conclusions: For patients who have an excellent response to VGB and only mild visual changes, continued therapy may be safe with close visual monitoring. Patients who do not have a significant reduction in seizures or who experience considerable visual dysfunction with VGB may respond well to alternative therapies.
AIDA, a Class I Metabotropic Glutamate‐receptor Antagonist Limits Kainate‐induced Hippocampal Dysfunction
Authors: Renaud Johanne , Emond Martine , Meilleur Sébastien , Psarropoulou Caterina , Carmant Lionel 
Published: March 2003

Summary:  Purpose: In the developing animal, intraperitoneal injections of kainic acid (KA) lead to a prolonged initial seizure followed by chronic recurrent seizures and long‐term hippocampal dysfunction. We investigated whether the class I metabotropic glutamate receptor (mGluR) antagonist 1‐aminoindan‐1,5‐dicarboxylic acid (AIDA) is neuroprotective in the KA model of epilepsy.Methods: Immature rats aged postnatal day 20 (P20) and P30 were injected with fixed volumes of KA, KA + AIDA, AIDA, or saline. We monitored recurrent seizures. Thirty days later, we tested hippocampal function with the Morris water‐maze test or prepared hippocampal slices to record extracellularly evoked and spontaneous potentials from the CA1 area. In a third group, we performed neuronal counts.Results: In both age groups, acute seizures were similar in KA and KA + AIDA groups. Rare spontaneous recurrent seizures occurred only in KA‐injected rats. The KA P20 group performed significantly worse than controls in the water‐maze test. The KA + AIDA group showed impaired performance on day 1, but learning improved substantially, reaching control values in the remaining 3 days. The P30 KA rats performed worse than controls on all trial days, whereas the KA + AIDA rats improved by day 3, but did not reach control values. Electrophysiologic recordings showed small but consistent differences between KA and control animals, suggestive of an adaptive modification in the γ‐aminobutyric acid (GABA)ergic system, reversed by AIDA. On histology, we observed a loss of CA1 interneurons in both ages. Cell loss was reversed by the use of AIDA.Conclusions: Blockade of the class I mGluR during KA‐induced seizures in the developing brain limits seizure‐induced hippocampal dysfunction.
Epileptic Negative Myoclonus in a Newborn with Hemimegalencephaly
Authors: Guzzetta Francesco , Battaglia Domenica , Lettori Donatella , Deodato Federica , Sani Emanuela , Randò Teresa , Ricci Daniela , Acquafondata Celeste , Faienza Carmine 
Published: March 2003

Summary:  Purpose: We report the case of a male newborn with Ohtahara syndrome and right hemimegalencephaly who presented epileptic negative myoclonus in the first days of life.Methods: Prolonged polygraphic studies were performed, as well as MRI and a full clinical examination.Results: EEG showed a constant and nonreactive pattern of burst suppression. There were several kinds of electro‐clinical seizures (generalized myoclonia, short atonias, typical spasm and tonic spasms) at the beginning of the EEG's burst. The periods of EMG silence, lasting less than 300 ms, were associated with stereotyped EEG transients.Conclusions: Epileptic negative myoclonus can be observed also in neonatal age. The short transient impairment of motor function observed in the newborn seems linked to the slow component of spike‐wave discharge, but its mechanism is still not clear.
Interictal Epileptiform Discharges Relate to 1H‐MRS–detected Metabolic Abnormalities in Mesial Temporal Lobe Epilepsy
Authors: Park Sun Ah , Kim Gyu Sik , Lee Seung Koo , Lim Sung Ryoung , Heo Kyoung , Park Soo Chul , Chang Jin Woo , Kim Dong Ik , Lee Byung In 
Published: March 2003

Summary:  Purpose: To examine whether the distribution of interictal epileptiform discharges (IEDs) recorded from foramen ovale electrodes (FOEs) correlates with metabolite levels in medial structures of the temporal lobes in patients with mesial temporal lobe epilepsy (MTLE).Methods: We studied 34 patients with MTLE. The lateralization ratio of IEDs was calculated after counting IEDs recorded from FOEs during prolonged video‐EEG monitoring. Metabolite ratio between N‐acetylaspartate (NAA) and creatine (Cr) was calculated in each medial temporal structure. The correlation between the lateralization ratio of IEDs and metabolic ratio was evaluated.Results: The asymmetry indexes of IEDs correlated with the asymmetry index of NAA/Cr ratio in the medial temporal structure (ρ = –0.380; p = 0.027). Analysis of IEDs and metabolite ratio revealed a significant inverse relation in the contralateral side to the major epileptogenic focus (ρ = –0.360; p = 0.037); however, this significance was not present in the ipsilateral side (ρ = –0.018; p = 0.921).Conclusions: There is a correlation between the neuronal dysfunction or damage detected by MRS and the epileptic activity in the contralateral medial temporal structure. Our results suggest that the pathomechanism underlying the contralateral reduction of NAA/Cr ratio, frequently observed in patients with MTLE, might be related to the process of epileptogenesis generating the independent contralateral IEDs.
Different Neurophysiologic Patterns of Myoclonus Characterize Lennox–Gastaut Syndrome and Myoclonic Astatic Epilepsy
Authors: Bonanni Paolo , Parmeggiani Lucio , Guerrini Renzo 
Published: March 2003

Summary:  Purpose: To study the neurophysiologic characteristics of epileptic myoclonus in patients with Lennox–Gastaut syndrome (LGS) and myoclonic astatic epilepsy (MAE).Methods: Three patients with symptomatic LGS (mean age, 15 years ± 4) and three with cryptogenic MAE (mean age, 9 years ± 3) were studied. Temporal relationships between electroencephalographic (EEG) and electromyographic activity were studied by analyzing latencies of EEG activity related to the onset of single myoclonic jerks, by using burst‐locked EEG averaging where necessary.Results: LGS: neurophysiologic analysis indicated that jerks and the accompanying premyoclonic spikes showed latency differences between sides (mean ± SD, 18 ± 5 ms for both) with a constant leading side in each patient. The premyoclonic spike latency was 20 ± 10 ms (mean ± SD). Topographic voltage mapping of the premyoclonic spike peak showed a unilateral frontal distribution. MAE: muscles from both sides were activated synchronously, and the EEG correlate was a generalized spike–wave, in which the negative peak of the spike preceded the generalized jerks by 30 ± 2 ms (mean ± SD). Topographic voltage mapping of the premyoclonic spike peak showed a diffuse distribution of the electrical field, predominating over the anterior regions, but not lateralized.Conclusions: These neurophysiologic findings indicate that epileptic myoclonus in LGS originates from a stable generator in the frontal cortex, to spread to contralateral and ipsilateral cortical areas, whereas myoclonus in MAE appears to be a primary generalized epileptic phenomenon.