bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of Amitriptyline and Fluvoxamine in Migraine Prophylaxis
Authors: Bánk Jozsef 
Published: May 2005

SYNOPSISCurrent treatment of migraine either abortive or prophylactic is often unsatisfactory. Prophylactic treatment of severe migraine may reduce attack frequency, and current therapy centers on beta‐blockers, serotonin (5‐HT) reuptake blockers and 5‐HT 2 receptor antagonists. The author compared the efficacy and safety of amitriptyline and fluvoxamine among migraine patients (24F, 8M vs. 23F, 9M) in a double blind study. The efficacy of amitriptyline has already been established by earlier clinical studies. The other investigated drug, fluvoxamine, has a more selective 5‐HT reuptake blocking property than amitriptyline. In this study, amitriptyline significantly reduced the number of headache attacks, but it caused severe drowsiness in many migraineurs. The fluvoxamine also favorably influenced on the number of headache attacks and caused only slight side effects. These findings suggest, that fluvoxamine may be an alternative drug in migraine prophylaxis, however, further studies should be performed with more subjects.
Neurophysiological Studies in Chronic Paroxysmal Hemicrania and Hemicrania Continua
Authors: Antonaci Fabio , Sandrini Giorgio , Danilov Andrei , Sand Trond 
Published: May 2005

SYNOPSISTo explore the possible involvement of the pain control system, pain pressure threshold (PPT), nociceptive flexion reflex (RIll), blink and corneal reflexes have been studied for pain perception assessment in 12 patients with chronic paroxysmal hemicrania (CPH) and 12 patients with hemicrania continua (HC). PPT was found to be reduced in HC and CPH when separately compared to controls. In addition, a significant reduction of subjective pain perception (Tp) which was most marked on the symptomatic side, has been demonstrated after sural nerve stimulation in CPH. The RIll reflex threshold on the symptomatic side was significantly reduced when patients were compared to controls, No major differences between CPH and HC as regards blink reflex latencies were found; nor was any such difference observed when comparing the two headache groups to controls. The corneal reflex thresholds were found significantly reduced bilaterally in CPH, irrespective of whether the treatment was given or not.
Increased 11‐dehydrothromboxane B 2 in Migraine: Platelet Hyperfunction in Patients with Migraine during Headache‐free Period
Authors: Kitano Ayumi , Shimomura Tokio , Takeshima Takao , Takahashi Kazuro 
Published: May 2005

SYNOPSISSeveral disturbances in platelet function have been reported in migraine and tension‐type headache (TH). The plasma 11‐dehydrothromboxane B 2 (11‐dTXB 2 ) is free from artifactual increase during blood sampling, and it can be a reliable indicator of thromboxane A 2 (TXA 2 ) production in vivo. TXA 2 is a very potent proaggregatory and vasoconstrictory metabolite formed in the platelets. We investigated plasma 11‐dTXB 2 and 5‐hydroxytryptamine (5‐HT) levels in patients with migraine during headache‐free periods and in patients with chronic TH. The mean value of plasma 11 ‐dTXB 2 levels in migrainous patients was significantly higher than those in TH patients and healthy controls. The mean value of plasma 5‐HT levels in TH patients was significantly lower than those in migrainous patients and healthy controls. There was no correlation between plasma 11‐dTXB 2 levels and plasma 5‐HT levels in any group. The results suggest the existence of continuous platelet activation in migrainous patients.
Headache in Sturge‐Weber Syndrome
Authors: Klapper Jack 
Published: May 2005

SYNOPSISBased on reports of headache in arteriovenous malformations and epilepsy, one would predict that the prevalence of migraine headache in the Sturge‐Weber syndrome would be higher than in the general population.A questionnaire designed to determine the prevalence and type of headache by IHS criteria was sent to the 500 members of the Sturge‐Weber Foundation.The average age of the patients in this sample (71 patients) was 15 years. The sex ratio was approximately one to one. Headache meeting IHS criteria for migraine occurred in 28% (equally among males and females) compared to 17% in females and 5% in males in the general population, Neurologic deficits occurred in 58% during migraine, The prevalence of migraine in children under the age of 10 (31%) was higher than that reported in the general population (5%) and the age of onset was younger. The mechanism of migraine headache in Sturge‐Weber syndrome may be similar to that found in epilepsy and vascular malformations.
Low Flow Dural Arteriovenous Shunt: Another Cause of “Sinister” Tolosa‐Hunt Syndrome
Authors: Brazis Paul W. , Capobianco David J. , Chang Fenn‐Lei F. , McLeish William M. , Earnest Franklin 
Published: May 2005

SYNOPSISA 73‐year‐old man developed acute, painful, ophthalmoplegia. The pain improved with oral steroids and a diagnosis of Tolosa‐Hunt syndrome was made. Review of his angiogram revealed a low flow dural arteriovenous shunt that drained posteriorly. Dural arteriovenous shunts may thus be another cause of “sinister” Tolosa‐Hunt syndrome.
Video Assessment of Yawning Induced by Sublingual Apomorphine in Migraine
Authors: Del Bene Enrico , Poggioni Marco , De Tommasi Francesco 
Published: May 2005

SYNOPSISA double‐blind, placebo‐controlled study was carried out in 14 migraineous outpatients and 8 control subjects to assess yawning response to 0.25 mg of sublingual apomorphine, a dopamine receptor agonist, by means of an audiovisual technique. Apomorphine induced a significantly higher number of yawns than placebo in both groups of subjects, but the effect was significantly greater in migraine sufferers than in controls. The result seems to confirm the previous reported hyper‐responsiveness to pharmacological dopaminergic stimulation in migraine sufferers. Moreover, the audiovisual technique seems to be an appropriate tool to study yawning response in man.
Pet Ownership and Prophylaxis of Headache and Chronic Pain
Authors: Hirsch Alan R. , Whitman Bradley W. 
Published: May 2005

SYNOPSISThe belief that having household pets promotes good health is ubiquitous among Americans. Recent studies support this belief where certain medical conditions are concerned. To investigate the advantages of pet ownership in the prophylaxis of headache and other chronic pain conditions, we queried 62 patients suffering from such diseases about whether they owned pets and whether children and other adults shared their households. We similarly queried a control group of 38 patients with various conditions not involving headache or chronic pain. We found that statistically, the experimental group and the control group were not significantly different in their household compositions. In fact, those with headaches and chronic pain, on average, owned slightly more pets and had slightly more children and other adults sharing their households than did those without headache or chronic pain conditions. Thus, contrary to our expectations, pet ownership apparently conferred no analgesic benefits, nor did the presence of children or of other adults in the household confer any benefit to headache and other chronic pain sufferers.
Sumatriptan in Acute Migraine Using a Novel Cartridge System Self‐Injector
Authors: Gross M.L.P. , Kay J. , Turner A.M. , Hallett K. , Cleal A.L. , Hassani H. ,   the United Kingdom Study Group
Published: May 2005

SYNOPSISThis double‐blind. randomized, placebo‐controlled, parallel‐group, multicenter study assessed the efficacy, acceptability, safety, and tolerability of subcutaneous sumatriptan 6 mg administered using a novel cartridge system self‐injector for the acute treatment of migraine.Eighty‐six patients treated one migraine attack at home with sumatriptan or placebo. A second identical injection was available after 1 hour for inadequate relief or if the headache recurred. Rescue medication was available I hour later. The primary end point was headache relief (improvement in headache from moderate or severe to mild or no pain) within 60 minutes of the first injection. Secondary end points included the acceptability of the self‐injector, requirement for and efficacy of a second dose, relief of nonheadache symptoms, use of rescue medication, and adverse events.Significantly more patients taking sumatriptan than placebo reported headache relief I hour after the first injection (88% vs 11%, P <0.001). The device was well accepted by patients; about 90% found it easy to use and wanted to take further medication using it. Significantly fewer patients taking sumatriptan than placebo required a second injection (33% vs 92%, P <0.001) or rescue medication after the second injection (35% vs 67% P <0.05). Significantly more patients taking sumatriptan than placebo reported headache relief after the second injection (83% vs 32%, P <0.01), and resolution of non‐headache migraine symptoms (54% vs 23%, P <0.01). Sumatriptan was generally well tolerated.Subcutaneous sumatriptan 6 mg self‐administered using the novel self‐injector is an effective, well accepted, and well tolerated acute treatment of migraine.
The Effect of Verapamil Calcium Antagonist on Autonomic Imbalance in Migraine: Evaluation by Spectral Analysis of Beat‐to‐Beat Heart Rate Fluctuations
Authors: Zigelman Michal , Appel Shlomo , Davidovitch Simha , Kuritzky Arieh , Zahavi Izhar , Akselrod Solange 
Published: May 2005

SYNOPSISAbnormalities in autonomic control have been documented in migraine even during the headache‐free interval. It has long been recognized that spectral analysis of heart rate (HR) fluctuations can reflect the autonomic function, especially the sympathetic to parasympathetic balance. This technique is the basis for a quantitative approach to the investigation of migraine applied in the present study.A 24‐hour Holter ECG recording was performed for each subject in a group of five migraine patients during the inter‐headache period. In addition, shorter 5‐minute‐long recordings of blood flow (BF) and blood pressure (BP) were made in these patients in both supine and standing positions. Short, 256‐second subtraces were taken every 30 minutes along the 24‐hour ECG signal and were submitted, as well as the BF and BP traces, to A/D conversion and computation of the power spectrum of fluctuations in HR, BF, and BP. Spectral analysis of fluctuations in these hemodynamic parameters was performed in the migraine patients before and during the treatment with verapamil and compared to that of a healthy control group. This procedure enabled us to assess the autonomic function, the sympathetic vs parasympathetic balance, and their response to a change in position, before and during calcium blockade.A characteristic autonomic abnormality is revealed in the group of untreated migraine patients in supine position: enhanced low frequency (LF) fluctuations reflecting increased sympathetic sensitivity during the inter‐headache phase. An exaggerated sympathetic response is measured in the migraine patients during the transition from supine to standing position with a concomitant nonsignificant decrease in parasympathetic response. Under the influence of verapamil, the enhancement in low frequency fluctuations is reversed as well as the exaggerated sympathetic response to standing.
Treatment of Childhood Headache with Dihydroergotamine Mesylate
Authors: Linder Steven L. 
Published: May 2005

SYNOPSISThis study was undertaken to determine whether pediatric patients with migraine without aura who have failed standard outpatient regimens including intravenous dihydroergotamine mesylate (DHE) in conjunction with oral metoclopramide would respond to an inpatient treatment protocol of intravenous DHE and oral metoclopramide. Thirty patients were evaluated in this study which was an open label, retrospective review of treatment. Independent of the duration of the refractory migraine, 80% of the patients responded to the protocol with only minimal side effect. The dose of DHE mesylate ranged from 0.1 to 0.5 mg. The dose of DHE is lower than is typically utilized in standard adult protocols. The patients received an average of five doses of DHE.
Treatment of Juvenile Migraine with Subcutaneous Sumatriptan
Authors: MacDonald John T. 
Published: May 2005

SYNOPSISAn open, prospective study was undertaken to assess the efficacy and safety of subcutaneous sumatriptan in 17 children, ages 6 to 16 years, with severe, recurrent migraine. A 6‐mg dose was used in 15 patients and relieved headache within I hour in six and by 2 hours in five others. Two smaller children received a 3‐mg dose and both were headache‐free within 2 hours. Most also reported marked improvement in associated symptoms such as nausea and photophobia. Four subjects had no clinical improvement after a 6‐mg dose. Side effects, such as neck pressure, were brief and mild. These findings suggest that subcutaneous sumatriptan can be both effective and safe as an abortive agent in juvenile migraine, but the appropriate dose in smaller children will need further investigation.
Empty Sella and Headache
Authors: Catarci Teresa , Fiacco Fabrizio , Bozzao Luigi , Pati Manuela , Magiar Alice Valeria , Cerbo Rosanna 
Published: May 2005

SYNOPSISEmpty sella is an anatomical condition caused by herniation of the subarachnoid space into the pituitary fossa through an incompetent seller diaphragm. Headache seems to be one of the most frequently reported symptoms. We studied 13 headache patients (12 females, 1 male) presenting with primary empty sella (PES) on CT scan. The characteristics of the headache were analyzed and plasma levels of pituitary hormones or cortisol assessed. We confirmed the nonspecific nature of the headache in PES even though the majority of our patients complained of daily headache, mostly localized anteriorly. Hormone plasma levels were within normal range in all the patients assessed. However, four patients reported earlier endocrine disorders and more than half of the patients presented with obesity.In our opinion, PES should be suspected in middle‐aged overweight women with daily headache even in the absence of endocrine symptomatology.
Transcranial Doppler Monitoring of a Migraine with Aura Attack From the Prodromal Phase to the End
Authors: La Spina I , Calloni M.V. , Porazzi D. 
Published: May 2005

SYNOPSISTranscranial Doppler sonography (TCD) was performed in a case of migraine with aura during the different phases of the attack. In the prodromic period our patient showed a slight central deficit of the seventh right cranial nerve and hypesthesia in her right arm. TCD indicated a remarkable decrease of the mean flow velocity (MFV) of the left middle cerebral artery (MCA). During the headache phase and when the signs and symptoms subsided, TCD showed an increase in MFV of both middle cerebral arteries with normal symmetry. An electroencephalogram (EEG) demonstrated a left temporal disorder. A month later a cranial CT scan, an EEG, and TCD were normal. In our opinion all these findings suggest a focal reduction in cerebral blood flow in the prodromic phase.
Acetazolamide for the Treatment of Chronic Paroxysmal Hemicrania
Authors: Warner John S. , Wamil Artur W. , McLean Michael J 
Published: May 2005

SYNOPSISA 25‐year‐old patient presented with clinical characteristics of chronic paroxysmal hemicrania which failed to respond to indomethacin 300 mg daily. Total relief of headaches was obtained with acetazolamide 250 mg t.i.d.
Hypersensitivity to Substance P in the Etiology of Postlumbar Puncture Headache
Authors: Solomon Glen D. , Clark Jeffrey W. , DeSenanayake Preenie , Kunkel Robert S. 
Published: May 2005

Objective.‐Postlumbar puncture headache may represent a model which could be used to test the hypothesis that headache pain is caused by the release of substance P in patients who are predisposed to headache due to hypersensitivity to substance P.Methods.‐We measured substance P in CSF and plasma in 37 patients undergoing diagnostic lumbar puncture. In 9 patients, plasma samples were obtained before lumbar puncture, in 28 patients plasma was obtained after lumbar puncture. Patients were followed up by telephone to determine if they developed postlumbar puncture headache. Patients were also asked about a history of chronic or recurrent headaches. Substance P was determined by radioimmunoassay.Results.‐The mean plasma substance P levels obtained before lumbar puncture was 1.0 ± 0.1 pg/mL and 1.3 ± 1.2 after lumbar puncture (P<0.0005). The mean plasma substance P levels in subjects who developed postlumbar puncture headache was 0.6 ± 0.6 pg/mL compared with 1.4 ± 1.5 in subjects who remained headache‐free (P<0.05). The mean CSF substance P levels in subjects who developed postlumbar puncture headache was 0.7 ± 0.5 pg/mL compared with 1.2 ± 0.8 in subjects who remained headache‐free (P<0.05). There were no significant differences in substance P levels between chronic headache sufferers and nonheadache subjects.Conclusions.‐Postlumbar puncture headache may be mediated by the release of substance P triggered by lumbar puncture, in patients predisposed to headache by a hypersensitivity to substance P. Hypersensitivity to substance P may also represent a mechanism for headache pain in other headache disorders.
Headache and Quality of Life
Authors: Cavallini Anna , Micieli Giuseppe , Bussone Gennaro , Rossi Francesco , Nappi Giuseppe 
Published: May 2005

The present prospective‐type study quantified, by way of an ad hoc questionnaire, the impact of the headache attack in its various manifestations and the effect of headache on the quality of life of 400 headache sufferers. In addition, the functional status of episodic headache patients has been compared to that of patients with chronic daily headache.We observed that during headache attacks, episodic headache patients were significantly more disabled by physical symptoms. On the contrary, patients with chronic daily headache showed a significantly greater occurrence of emotional disturbances. A difference was detectable for mental health which was significantly more compromised in chronic daily headache than in episodic headache patients (P <0.05).During the interictal period, quality of life appeared more compromised in chronic daily headache than in episodic headache patients. Chronic daily headache subjects were characterized by higher disability scores in all the sections considered.The results of this investigation confirm that headache negatively influence a patient's quality of life not only during attack phases but also during interictal periods and underline the importance that future studies on the efficacy of headache treatments should also evaluate the impact on patient's quality of life.
Provocation of Unilateral Pain in Cluster Headache Patients by Breathing CO2
Authors: Hannerz Jan , Jogestrand Tomes 
Published: May 2005

Ten patients with cluster headache in an active period and 6 controls were studied as to heart rate, blood pressure, blood flow in the common carotid arteries (CCA), end‐tidal PCO2 and pain before, during and after 6 minutes of breathing 6% CO2 In air. Heart rate increased significantly during C02 breathing in controls but not in patients. The cluster headache patients had significantly lower baseline end‐tidal PCO2 than controls. CCA blood flow increased significantly during CO2 breathing in both groups. Vascular resistance decreased during CO2 provocation and increased above baseline levels 5 minutes after provocation in both groups and related to the end‐tidal PCO2. Six of eight cluster headache patients, who had an increase of blood flow at provocation, reported slight to moderate unilateral pain in relation to the CO2 provocation in contrast to controls.One patient treated with 6 mg sumatriptan 2.5 hours before the provocation had an end‐tidal PCO2 within the range of the controls, and did not get an increase of CCA blood flow or pain at provocation.Six of the cluster headache patients were restudied when out of the active period. There was still no heart rate increase during CO2 breathing and end‐tidal PCO2 was still lower than in the controls. Unilateral headache was not provoked.
Headache Due to an Extra Joint Between Head and Neck
Authors: Stolt‐Nielsen A. , Fredriksen T.A. , Sjaastad O. 
Published: May 2005

A girl, born in 1973, started having headache in preschool age. After a head trauma in 1985, there was a clear worsening of the headache, and the headache became chronic at around 14 years, making regular school attendance impossible. The headache was “symptom poor,” bilateral‐occipital, but with a clear left‐sided preponderance and occasionally spreading to the forehead. The headache was always worst in the morning hours, easing up by noontime. Neck rotation to the right could provoke long‐lasting exacerbations.Neck movement was restricted on rotation to the left. A sore bony structure was discovered on palpation just underneath the mastoid process of the left side. This proved to correspond to a bony “bridge” with an extra joint between the first vertebra on the left side and the skull, medially to the mastoid process that could be demonstrated on x‐ray tomography and CT scanning. This bony bridge was removed surgically more than 2 years ago, and the pain disappeared on the day of operation and has not recurred in the intervening time. Such bony bridges have in the past been considered to be innocuous and not symptom producing. Although this may be the general rule, the present case tends to show that even to this rule, there are exceptions.
Rapid and Sustained Relief of Migraine Attacks With Intranasal Lidocaine: Preliminary Findings
Authors: Kudrow Lee , Kudrow David B. , Sandweiss Jack H. 
Published: May 2005

In a noncontrolled study, 23 migraine headache patients were treated with intranasal instillation of 0.4 mL of a 4% lidocaine solution during attacks of varying intensities. Evaluated were pretreatment and posttreatment changes in pain intensity, nausea, and side effects. Posttreatment intensity ratings significantly improved over pretreatment ratings, as determined by a Sandler A analysis (0.077; P<.0005). Migraine attacks were aborted in 12 of 23 patients, of which 8 were completely relieved within 5 minutes. In no case did an aborted attack return to more than a dull level within 24 hours, as determined by follow‐up telephone calls.A successful response of migraine attacks to lidocaine treatment was more apt to occur in patients having migraine solely, when compared to migraine patients who also had daily dull headaches; the difference was not significant. Unilateral attacks, however, were significantly more treatment‐responsive when compared to bilateral attacks (X2=3.85; P=.05). Nausea, associated with migraine attacks in 6 of 12 responders, was similarly aborted by lidocaine in 5 of 6 patients. Other side effects included mild nasal and eye burning of short duration (seconds), and oropharyngeal numbness of approximately 20 minutes' duration. Despite the abrupt and absolute relief of migraine attacks afforded by lidocaine in most of our study patients, its level of efficacy awaits results of double‐blind, placebo‐controlled studies.Our findings raise new questions regarding the differential pathogenesis of migraine and cluster headache attacks. It is suggested here that the rapid effect of lidocaine in aborting migraine attacks, as shown by others in cluster headache, may be due to a conduction‐blocking action on pterygopalatine, internal carotid, and cavernous sinus ganglia. This implies that pain‐evoking mechanisms in migraine and cluster headache may similarly involve parasympathetic activity and calls into question the primacy of the trigeminovascular system to that of vaso‐parasympathetic efferents.