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

Treatment of headache disorders is most likely to be successful when the pathophysiology of the disease is correlated with the pharmacologic actions of the available drugs. Beta blockers generally are considered first-line therapy for migraine prophylaxis, but calcium blockers also are appropriate for some patients. Antidepressants are the primary modality for treatment of tension type headaches, although they are also used for migraine prophylaxis. Mixed headache, which has features of both migraine and tension-type headache, usually requires treatment with more than one drug. Habituation to analgesics is common among patients with mixed headache.
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PMID:Pharmacology and use of headache medications. 222 48

An inpatient headache treatment unit provides a special environment for those patients whose headaches have failed to respond to outpatient therapy. Outpatient therapy may be precluded for a variety of treatment issues, including detoxification, initiation of copharmacy prophylactic medical therapy, and intravenous treatment for intractable chronic cluster headache and status migrainous headache. These complex medical treatments are viewed as some of the most valuable therapies by the patients and, at least in part, significantly decrease both headache indexes utilized in this survey. The various psychological, educational, and other adjunctive therapies utilized in an inpatient unit are considered beneficial by many patients. Psychological approaches are considered more useful to migrainous patients. Treatment failures may be due to variations in the etiology of chronic muscle contraction headache and posttraumatic headache. Denial of psychological factors in headache may also contribute to treatment failure. Habituation to analgesics and ergots may decrease patient response as compared with those not dependent.
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PMID:Inpatient treatment of headache. 252 Mar 74

Very little is known about the neural correlates of facial pain and headaches; diagnosis and treatment are for the most part clinically orientated. Of initial importance is the recognition of dangerous situations and the consequent appliance of additional methods of examination. The tension headache is taken as an example to show the principle aspects of therapy which also apply for the treatment of migraine. Pharmacological possibilities in acute and chronic circumstances are mentioned, in addition to the nonpharmacological alternatives. Particular emphasis is given to drug habituation, the significance of which has become increasingly recognized in recent years. The problems connected with the most common facial pains are discussed.
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PMID:[Therapy of headache]. 267 67

Visual information is conducted by two parallel pathways (luminance- and contour-processing pathways) which are thought to be differentially affected in migraine and can be investigated by means of pattern-reversal visual evoked potentials (VEPs). Components and habituation of VEPs at four spatial frequencies were compared between 26 migraineurs (13 without aura, MO; 13 with aura, MA) and 28 healthy volunteers. Migraineurs were recorded in the headache-free interval (at least 72 h before and after an attack). Five blocks of 50 responses to chequerboards of 0.5, 1, 2 and 4 cycles per degree (c.p.d.) were sequentially averaged and analysed for latency and amplitude. Differences in VEPs were dependent on spatial frequency. Only when small checks were presented, i.e. at high spatial frequency (2 and 4 c.p.d.), was the latency of N2 significantly prolonged in MA and did it tend to be delayed in MO subjects. Habituation behaviour was not significantly different between groups under the stimulating conditions employed. Prolonged N2 latency might be explained by the lack or attenuation of a contour-specific component N130 in migraineurs, indicating an imbalance of the two visual pathways with relative predominance of the luminance-processing Y system. These results reflect an interictally persisting dysfunction of precortical visual processing which might be relevant in the pathophysiology of migraine.
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PMID:Visual evoked potentials in migraine patients: alterations depend on pattern spatial frequency. 1035 66

Amplitude and habituation of event-related potentials are abnormal in migraine. We investigated 43 migraine and 41 healthy families to evaluate the influences of age, sex and familial contribution on the variance of amplitude and habituation of the contingent negative variation (CNV). Analysis of individual differences in relation to the CNV habituation was performed. The study demonstrated that habituation of the early CNV component characterizes migraine considerably better than the CNV amplitudes. Habituation, however, is strongly influenced by age. Migraine adults and children generally showed reduced habituation. Surprisingly, more than 30% of the healthy adults demonstrated a marked loss of habituation. The reduced CNV habituation represented a high sensitivity but low specificity to migraine, especially in children. CNV amplitude and habituation parameters revealed a considerable familial contribution associated with migraine. No familial influence on either morphology or habituation of the CNV in healthy families or between healthy members of migraine families was observed. The low specificity and familial transmission of CNV parameters in members of migraine families suggest that increased amplitudes and reduced habituation of CNV do not constitute a primary risk factor for migraine, but rather represent a predisposition. Genetic components probably affect variation of the CNV amplitude and habituation.
Cephalalgia 2000 Dec
PMID:Slow cortical potentials in migraine families. 1130 23

Four patients who had ingested large amounts of phenacetin-salicylate medications were studied during a 12-month period. Renal failure had progressed slowly over a number of years. All patients took the drug because of psychogenic headache. Considerable skill was required to elicit the history of drug habituation. The major features of the nephropathy were multiple episodes of metabolic acidosis, minimal proteinuria, pyuria but no bacteriuria, and polyuria and polydipsia early in the course of drug ingestion. Papillary necrosis was not a prominent clinical feature of this series. Discontinuation of drug ingestion by one patient was associated with recovery of a considerable degree of renal function. Preliminary experimental evidence obtained in the dog suggests that salicylate impaired the efficiency of the counter-current multiplier by decreasing sodium transport in the ascending limb of Henle, and decreased the permeability to water of the distal convoluted and collecting tubule; phenacetin had no such effect.
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PMID:PHENACETIN NEPHROPATHY. 1422 36

Cognitive processing was investigated interictally in 18 children with migraine without aura and 18 age-matched controls by measuring event-related potentials (ERPs) and reaction times (RTs) during an acoustic oddball paradigm. Results showed that N100 amplitude evoked by frequent stimuli was significantly smaller in patients compared with controls. Habituation of target P300 amplitude was observed in patients but not in controls. Mean RTs were equivalent in the two groups, but migraine children made more errors than controls.
Cephalalgia 2004 Jul
PMID:Auditory event-related potentials and reaction times in migraine children. 1519 98

The excitability of the cerebral cortex in the interictal state of migraine appears to be fundamental in the brain's susceptibility to migraine attacks. Subpopulations of cortical neurons are reported to have different physiological response properties to different interstimulus intervals (ISIs) and, hence, may be differentially altered or modulated in migraine. The aim of this study therefore was to evaluate response characteristics of temporally and spatially defined neuronal subpopulations in the cortex of migraineurs. To this end, we measured, by means of magnetoencephalography (37-channel neuromagnetometer), the response properties of the early components of the somatosensory evoked magnetic fields following electrical stimulation of the median nerve, the N20m and P35m, at ISIs ranging between 0.3 and 6 s. As a measure of the number of excited neurons underlying the N20m and P35m, we evaluated the root mean square (r.m.s.) of the deflections across all 37 channels at the corresponding latencies and the corresponding dipole moment of the equivalent current dipole (ECD strength). Twenty consecutive women with at least three migraine attacks/month (range 3-8/month) fulfilling the International Headache Society criteria and 20 age-matched healthy women were included in the study. In migraineurs, the r.m.s. and ECD strength of N20m was increased at all ISIs (r.m.s., P < 0.05; ECD strength, P < 0.01) and positively related to the mean attack frequency (r.m.s., R(s) = 0.6, P < 0.01; ECD strength, R(s) = 0.5, P < 0.05). In contrast, the r.m.s. and ECD strength of P35m did not differ significantly between migraineurs and control subjects and did not correlate significantly with the frequency of migraine attacks. Responses to different ISIs did not differ significantly between migraineurs and control subjects. The r.m.s. of N20m was stable for ISIs between 0.5 and 6 s and decreased significantly at an ISI of 0.3 s. In contrast, the r.m.s. of P35m decreased continuously as the ISI was decreased below 6 s and this reached significance for an ISI of < or =1 s. Habituation of N20m or P35m, i.e. a decrease in response magnitude following repetitive stimulation over time, was not found in either the control subjects or in the migraineurs. It is concluded that the population of neurons in the primary somatosensory cortex underlying the N20m are hyperexcitable and that this hyperexcitability is linked to the frequency of migraine attacks. This hyperexcitability appears not to be related to habituation since habituation was not found in the control subjects. In contrast, the magnitude of P35m is not pathophysiologically linked to the interictal state of migraine. Furthermore, the cellular mechanisms causing ISI-dependent depression of N20m and P35m are not altered in migraine.
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PMID:Hyperexcitability of the primary somatosensory cortex in migraine--a magnetoencephalographic study. 1547 3

Evidence for a disturbed maturation of information processing in migraine came recently from evoked and event-related potential studies during childhood. In adult migraineurs, deficient habituation is proposed as principal interictal abnormality and was found inter alia for Visual Evoked Potentials (VEPs). This study investigated response and habituation to pattern-reversal VEPs and its maturation in 102 children with primary headache (migraine with and without aura, tension-type headache) and 79 healthy controls from 6 to 18 years. A reduction of N180 latency from pre- to postpubertal age reflects maturation and was clearly present in controls but lessened in migraineurs. N180 latency was prolonged in migraineurs without aura from 12 years onwards. Habituation did not differ between groups. In conclusion, diminished N180 latency reduction with age in migraineurs gives further evidence that maturation of visual information processing is altered in migraine. Deficient habituation to pattern-reversal VEPs could not be confirmed during childhood migraine.
Cephalalgia 2005 Apr
PMID:Maturation of early visual processing investigated by a pattern-reversal habituation paradigm is altered in migraine. 1577 25

We investigated habituation effects during thermal quantitative sensory testing (tQST) using 8 repetitive measurements for thermal detection and pain thresholds. The same measurements were repeated two days later. 39 healthy subjects and 36 patients with chronic non-neuropathic pain syndromes (migraine, tension-type headache, non-radicular back pain) were enrolled. The pain intensity was assessed using an 11-point (0-10) numerical rating scale. Measurements correlated significantly over the two days in both groups (r=0.41...0.62). Warm detection (WDT) and heat pain threshold (HPT) revealed no significant differences over these days. Cold detection (CDT) and pain thresholds (CPT) showed significant differences but these were small compared to the range of normal variability (CDTDelta -0.28 degrees C; CPTDelta 1.51 degrees C). On both days, WDT showed no habituation during measurements. Although there was a small difference in CDT and CPT between first and second measurement, there was no habituation beyond the second stimuli. In contrast, HPT significantly increased between first and sixth stimuli, indicating pronounced habituation. Average HPT of first to third measurement was significantly lower than HPT of the fourth to sixth assessment (45.9 degrees C; 47.7 degrees C) with a good day-to-day repeatability. Repeatability and habituation was identical in both groups. Ongoing pain intensity in the patient groups correlated significantly with CDT/WDT but not with CPT, HPT, indicating that ongoing pain might suppress the sensitivity to non-painful stimuli. In summary, tQST proved a reliable diagnostic tool for clinical practice. Day-to-day differences were small but without clinical relevance. Habituation was most pronounced for HPT, probably due to peripheral fatigue of the receptors.
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PMID:Habituation and short-term repeatability of thermal testing in healthy human subjects and patients with chronic non-neuropathic pain. 1901 13


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