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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Headache patients disassociate themselves from their own automatic responses, relying on the traditional separation of body and mind. On the other hand, patients who obtain voluntary control of automatic functions by biofeedback training modify not only vegetative but also voluntary behaviour patterns, losing "neurotic" traits. The basic misconception of the separation of body and mind, Cartesian dualism, is now ingrained in our culture. In the 17th century Descartes asserted that concepts applied to the soul must be entirely different from those used for the body in order to improve comprehension of the immortality of the soul. This dualism also led to "enlightenment" and to many later social and philosophical developments. But his basic neurophysiology was obsolete when he wrote it down. Other models from mainstream natural philosophy were better compatible with observation and experiments. Gassendi assumed a "body soul" consisting of energy as the functional principle of the nervous system, and Willis accommodated a series of anticipations of 19th century discoveries within this model. No comparable progress resulted from Descartes' own medieval model. Cartesian dualism has become untenable in view of recent neuropsychology but it still obstructs our management of functional patients. Instead of reinforcing the delusion of separation of psyche and soma, we ought to encourage patients to understand that their malfunctioning organs are on-line with their emotions, and with their mind.
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PMID:[Cartesian misunderstanding as a cause of therapeutic failure]. 242

Although temporal arteritis (TA) is a common vasculitis, mental status changes and higher cortical dysfunction have received limited attention in the literature. We report a case which illustrates the potential for TA to produce chronic fluctuating delirium, delusional thinking, and memory impairment in the absence of concomitant symptoms of headache and visual loss. In addition, TA may produce differing symptoms at different times in the same patient.
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PMID:Mental status abnormalities in temporal arteritis: a treatable cause of dementia in the elderly. 280 29

The images of cranial computed tomographies on 7.921 patients aging between 50 and 98 years were analyzed retrospectively concerning the occurrence of WMLA. 3.344 patients were suffering from psychogeriatric disorders (organic brain syndrome, dementia, depressive or delusional psychoses). Neurological diagnoses (stroke, TIA, Parkinson's disease, Huntington's disease, space occupying lesions, seizures, cerebral trauma, vertigo, chronic headache) occurred in 4.577 patients. WMLA was established in 761 cases. The combination of WMLA with cerebral atrophies, with single or multiple infarcts and with both infarcts and atrophy will be demonstrated within 4 groups: 1. organic brain syndrome and dementia, 2. depression and delusional states, 3. stroke and TIA, 4. other neurological diagnoses. In group one the combination of WMLA with atrophy and infarcts is the most common finding in CT. In group two WMLA without atrophies and infarcts are the main tissue changes in CT. Group three is marked mainly by the occurrence of recent infarcts together with WMLA. In group four again WMLA only, in some cases together with multiple infarcts, do occur mainly. Compared to the cases without WMLA in each group WMLA is seen in cases with organic brain syndromes and dementias three to five times more than in the other diagnostic groups. WMLA in computed tomography seems to be a common finding in patients and healthy individuals of old age. Therefore the diagnostic and differential diagnostic significance for brain diseases in old age is limited. Nevertheless in the field of psychogeriatric disorders it may be possess a certain value to understand the nature of such diseases. This value will be discussed and demonstrated considering the pathogenesis of WMLA on the basis of neuropathological results.
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PMID:[Periventricular attenuation of the density of cerebral hemisphere white matter in computerized tomography of neuropsychiatric patients in the 2d half of life. Diagnostic significance and pathogenesis]. 322 Apr 19

During a 3-year period, all inpatients in the psychiatry unit underwent routine screening computed tomography (CT) in an effort to detect clinically unsuspected intracranial abnormalities. Of 261 patients examined who had no focal neurologic deficits, 103 had schizophrenia, 71 had depression, 48 had bipolar disorders, and 39 had paranoid delusions. Findings on 230 (88.1%) of the CT scans were within normal limits, and 27 (10.4%) showed only cortical atrophy. The remaining four cases (1.5%) demonstrated basal ganglia calcification (n = 2), old lacunar infarction (n = 1), or osteoma arising from the inner table of the skull (n = 1), all of which were considered to be clinically unrelated to the patients' psychiatric conditions. In the absence of focal neurologic deficits or other findings suggesting an intracranial abnormality (eg, papilledema, seizures, persistent or increasing headaches), there is no justification for routine CT scanning in patients admitted to the hospital for psychiatric disorders.
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PMID:Routine CT screening of psychiatry inpatients. 342 Feb 86

Lithium has been put to clinical trials in no less than fifteen neurological disorders. They are Huntington's chorea, tardive dyskinesia, spasmodic torticollis, Tourette's syndrome, L-dopa induced hyperkinesia and the "on-off" phenomenon in parkinsonism, organic brain disorders secondary to brain-injury, drug induced delusional disorders, migraine and cluster headache, periodic hypersomnolence, epilepsy, meniere's disease and periodic hypokalemic paralysis. This paper gives a brief summary of the clinical trials with lithium salts reported in the literature. There are encouraging results on the use of lithium in cluster headaches, cyclic form of migraine and hypomanic mood disorders due to organic brain disorders. The trials with lithium and amitriptyline in tardive dyskinesia needs independent confirmation. The effect of lithium on seizure disorders needs to be addressed too.
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PMID:A review of clinical trials of lithium in neurology. 624 Jun 62

One hundred patients, aged between 60 and 92 years, were treated with tiapride for neurological disorders (abnormal movements, buccofacial dyskinesias, dopa therapy complications, ballism, eyelid tics, senile tremor, post-traumatic headache, delirium tremens), psychiatric disorders with more or less marked agitation and of various types (hysteria, depression, mood disturbances, hypochondria, delusions, hallucinations), or for mental deficiency, senile dementia, or arteriopathic dementia. Results were excellent, being satisfactory in 70 p. cent, and even more marked in some groups. Tolerance was very good, with some rare cases of somnolence. The efficacy and safety of tiapride makes it of particular value for treating neuropsychiatric disorders in geriatric patients.
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PMID:[Tiapride in the treatment of neurological and psychiatric disorders in the elderly (author's transl)]. 627 32

A study was carried out in a rural area of Senegal to ascertain the pattern of mental disorders among patients presenting at primary health facilities. Among 545 children aged 5-15 years, attending health centres and posts, 17% were found to be suffering from some form of emotional problem, behaviour disturbance or neuro-psychiatric disorders. Using a 10-item screening questionnaire, it was shown that the symptoms "never plays with others' and "speech disturbance' were the strongest predictors of mental disorder among children. Among 933 adults, it was found that 16% reported more than seven symptoms commonly associated with psychiatric illness on a 24-item self-reporting questionnaire. The order in adults does not allow a precise estimate of morbidity to be made. Health workers diagnosed 9% of the patients as suffering from a mental health problem, usually in association with a physical problem. It was found that psychotic and suicidal symptoms (e.g. hallucinations, delusions) were more likely to be recognized by health workers as diagnostic of mental disorder, whereas psychophysiological symptoms (e.g. anorexia, insomnia, headache) and psychological symptoms (e.g. anxiety, depression) were less frequently recognized. The study supports the view that psychological symptoms and mental disorders occur relatively frequently among adults and children attending primary health facilities. Data allowing insight into the diagnostic sensitivity of primary health workers can provide a rational basis for planning training programmes in mental health.
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PMID:Diagnosis and symptoms of mental disorder in a rural area of Senegal. 630 31

Thirty-four patients were submitted to the conventional cervical myelography by administration of metrizamide (Amipaque) through three routes (lumbar 23, suboccipital 6, C1-C2 lateral 5). After the injection of metrizamide (4-11 ml, 170-250 mgI/ml), all procedures of the cervical myelography were done as soon as possible within 9 minutes. The adverse reactions of Amipaque were observed in 29 cases (85%) out of 34 cases initially 1 hour after cervical myelography and disappeared completely in an average of 16 hours. The total number of the side effects was 140 incidences such as meningeal irritation (headache 18, nausea 17, vomiting 17), cerebellar signs (dizziness 11, dysarthria 8, tremor 5, bradylalia 2, dysmetria 2, tipsy feeling 2, dysdiadochokinesis 1), autonomic signs (flushing 7, pale face 4, fever 4, sweating 2, hiccup 2, fatigability 2, micturition disturbance 1), sensory signs (exacerbation of numbness 6, perioral numbness 3, back pain 1, chest pain 1), motor signs (focal muscle spasm 5, exacerbation of paresis 4, areflexia 1), psychiatric signs (dysphasia 3, disturbance of consciousness 2, euphoria 1, persecutory delusion 1) and muddiness 7. We observed that waxing and waning of side effects correlated tightly with transient cortical penetration of dye in CT and cortical dysfunction mainly slowing of the background activity and slow wave burst in EEG. According to high frequency of side effects in our study, we suggest that a greater incidence of side effects may result when high concentration of Amipaque comes in contact with the cerebral cortex by using an inadequate fluoroscopic table which has only fixed one plane image and rough positioning control. Slow absorption into blood stream may affect appearance and maintenance of side effects. In order to decrease side effects after Amipaque cervical myelography, we propose that we should introduce a mobile rotating chair coupled with high power image and chose C1-C2 lateral route using 1500-1700mgI of Amipaque.
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PMID:[Side effects of metrizamide (Amipaque) cervical myelography (author's transl)]. 711 May 15

There is evidence that the psychiatric importance of hypochondriacal or cenestopathic symptoms in schizophrenia is prone to be neglected, in so far as these symptoms are expressed through the discourse of somatic medicine. Psychopathological studies of these symptoms are few as compared to studies of other schizophrenic symptoms such as delusion or verbal acoustic hallucination. However, it could be said that such study is indispensable in developing both an understanding of schizophrenics and therapeutic strategies for the treatment of them, in so far as hypochondriaco-cenestopathic symptoms directly indicate a pathology of body-consciousness in schizophrenia. Motivated by these practical as well as theoretical demands, the author presents first of all statistical characteristics of hypochondriaco-cenestopathic symptoms based on a longitudinal study of 183 schizophrenic patients, who were observed for at least 5 years. All the patients satisfied the DSM-III-R criteria for schizophrenia. Taking into consideration these statistical characteristics, as well as certain detailed representative cases, the author proposes a new psychopathological perspective of the hypochondriaco-cenestopathic symptoms in schizophrenia. The essential result of this statistical investigation is summarized as follows. 81 schizophrenic patients exhibited the hypochondriaco-cenestopathic symptoms, accounting for 44.3% of the sample. If we exclude the cases which presented physical experience of being influenced (physikalische Beeinflussungserlebnis), appearance frequency of hypochondriaco-cenestopathic symptoms accounted for 27.9% of the sample. Among the manifestations of these symptoms, uncharacteristic somatic complaint was the most frequent. Here, the most common was pain of body (especially headaches). The second most common was complaint of easy fatigability. Concerning the appearance pattern of the symptom, we found no significant difference between the acute and chronic types, nor between the early and tardive types, while the complex type was significantly more frequent in comparison with the simple type. Among the other symptoms that co-occurred with the hypochondriaco-cenestopathic symptom, the most common was acoustic hallucination, whose frequency was highly statistically significant when compared to the non hypochondriaco-cenestopathic group. Regarding the relationship of the hypochondriaco-cenestopathic symptom with the subtypes of schizophrenia, the proportion of the paranoid type was significantly high in the non hypochondriaco-cenestopathic group.
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PMID:[Psychopathological study of hypochondriaco-cenestopathic symptoms in schizophrenia]. 819 Aug 14

Cocaine abuse surged in the 1980s, forcing reevaluation of its previously benign image. Snorted, smoked, and injected, the drug is more widely abused than ever and, the consequences are devastating. Medical complications are frequent and range from mild (eg, cough, itching, headache) to life-threatening (eg. stroke, seizure, cardiovascular failure). Behavioral disturbances constitute the most dramatic and widespread effects of intoxication and withdrawal. Psychopathologic responses may include perceptual disturbances (eg. hallucinations) agitation, aggression, delirium, confusion, and profound delusional ideation. The goals of treatment are abstinence, rehabilitation, and relapse prevention. Hospital care may be necessary in certain circumstances. Regardless of where treatment takes place, a comprehensive program of supportive care, behavioral therapy, urine monitoring, and often psychopharmacologic intervention is required.
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PMID:The treatment of cocaine abuse. 831 99


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