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

Naloxone per se causes no pain in normal man, indicating that opioidergic antinociceptive systems are not tonically active, but this might not be the case in chronic pain conditions. The present investigation tested the hypothesis that pain in chronic headache is the result of insufficiently attenuated nociceptive impulses. Forty-seven patients suffering from chronic tension headache entered the present double-blind cross-over trial of naloxone 4 mg i.v. versus saline. Adverse effects were negligible. Patients scored headache pain on a 100 mm visual analog scale and change in headache on a 5-point verbal rating scale after 5, 15, 30, 60 and 90 min. Mean arterial blood pressure decreased 4.2 mm Hg (P less than 0.05) after naloxone compared to saline, but naloxone had no effect on headache (P = 0.96). A bimodal distribution of acute pain patients into placebo responders and non-responders has been reported, but our chronic pain patients showed a homogeneous placebo response. Review of the literature indicates that acute clinical pain and stimulation-induced analgesia in experimental pain has a naloxone-responsive component. Chronic pain does not appear to be influenced by naloxone in moderate doses.
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PMID:Naloxone in moderate dose does not aggravate chronic tension headache. 268 74

Headache is one of the commonest neurological symptoms. One must first identify patients with structural disease requiring specific therapy, though this is unusual, especially in outpatient practice. While migraine, tension headache, and cluster headache are not life-threatening, they are major causes of morbidity, and much can be done to alleviate them.
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PMID:Diagnosis and management of headache. 268 68

Previous reports have suggested that platelet level of serotonin in chronic tension headache (CTH) is lower than in normal control subjects, and that there is continuous activation of platelets both in migraine and in CTH. In this study we compared platelet serotonin concentration in 95 patients with CTH, 166 patients with migraine and 35 normal control subjects. Mean platelet serotonin (ng/10(9) platelets) was 310 for the CTH group, 384 during migraine headache, 474 for normal control subjects and 514 in headache-free migrainous patients. There was significant statistical difference of values between CTH patients and those of normal control subjects as well as headache-free migrainous patients, but not of those of migrainous patients during headache. It is suggested that CTH is a low serotonin syndrome, representing one end of the spectrum of idiopathic headache, the other end being represented by migraine.
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PMID:Plasma serotonin in patients with chronic tension headaches. 279 54

It has long been assumed that the origin of pain in 'muscle-contraction headache' lies in the peri-cranial muscles, especially in the frontales. Pain, it is assumed, is experienced when the muscles are in spasm. It is further assumed that learned reductions in muscle tone between headache episodes will reduce the probability of future pain episodes. In this experiment, details are given of EMG measures made on the frontal, occipital, and neck muscles of separate groups of migraine and tension headache subjects. The measures were made before the onset of head pain and later when the same subjects reported pain. As part of the experiment, subjects were exposed to an experimental stressor during the pain-free period, and these results were compared with those of a group of non-headache subjects. Results showed that the headache groups did not differ on any of the pre-headache measures. Neck muscle levels varied markedly when compared with control subjects who had comparatively low levels reactive to an experimental stressor. When the data taken during the headache phase were analysed according to diagnosis, the occipital muscle output was found to be significantly lower in the migraine group and higher in the tension group.
Headache 1989 Feb
PMID:EMG cranial muscle levels in headache sufferers before and during headache. 270 38

Electronic pupillometry before and after phenylephrine eye drops was performed in 83 headache patients divided into two groups: Group A included 59 pediatric patients aged 5 to 16 years suffering from tension headache (TH = 8), common migraine (CM = 33) and classic migraine (CLM = 18); Group B comprised 24 adult patients aged 28 to 49 years suffering from CM. Comparisons were made with a group of healthy volunteer controls, 12 children and 15 adults, not suffering from headache. In Group A, only the CLM patients had significant mydriasis after phenylephrine; pupillary responses in the TH and CM cases did not differ significantly from the healthy controls, although there was an evident tendency for increased response in the CM by comparison with the TH cases. On the other hand, in Group B (adult CM) there was a significant pupillary hyper-responsiveness to adrenergic receptor stimulation, higher than in the same clinical condition in the pediatric group. In pre-pharmacological testing conditions, a significantly higher percentage of anisocoria (p less than 0.05) and a significant reduction in mean pupil size (p less than 0.01) were only evident in adult migraineurs as compared with controls. These findings suggest that a subtle chronic sympathetic deficiency affecting the iris neuromuscular junction in some clinical forms of primary headache may be detected by pupillometry at an early age. Moreover, apart from a temporal factor responsible for a progressive sympathetic imbalance during development, there may be a more evident neural transmission disorder in migraine forms as opposed to tension forms.
Headache 1989 Mar
PMID:Pupillary adrenergic sensitivity and idiopathic headache in pediatric patients. 270 45

We determined by radioimmunoassay plasma melatonin levels on blood samples drawn at 11 p.m. in migraine patients and control subjects. Ninety-three cephalalgic outpatients (75 females, 18 males) were compared to a control group (24 females, 22 males) matched according to age. Patients were divided into subgroups presenting common migraine (n = 38); ophthalmic migraine (n = 12); and tension headache associated with ophthalmic or common migraine (n = 24), and associated depressive status (n = 19). Statistical analysis revealed a decrease in plasma melatonin levels for the entire migraine population, compared to the control one, and a heterogeneity in both controls and patients; this heterogeneity was found mainly in the depressive and tension headache subgroups. When the migraine population--from which the depressive patients were excluded--was divided into male and female subgroups, a decrease in plasma melatonin levels was observed only for the female subgroups. Results are discussed with reference to the role of the pineal gland in the synchronization of the organism with the environmental conditions.
Headache 1989 Apr
PMID:Nocturnal plasma melatonin levels in migraine: a preliminary report. 271 76

One hundred and fifty patients with headache were studied by initial interview, before beginning treatment in the pain clinic. The McGill Pain Questionnaire (MPQ) for Headache and a Bakal Topographic Chart were translated into Chinese and employed to assess the characteristics of the headache. The series included significantly more women than men. The elderly were in low proportion, but teenagers were a significant proportion. Women tended to report a longer headache history than men. Topographically, 50% of patients had bilateral temporal headache, and 18% had unilateral headache, more on the right than on the left. Most of the patients were considered to belong to tension headache and mixed headache types (40% and 26%, respectively). Major aggravators resulting in headache hypersensitivity were overwork, fatigue, insomnia, poor sleep, stress, and tension. Analgesics were the primary means of relief reported in 46% of the patients, while resting and sleeping (44% and 27% respectively) were also found to be significant relief factors. In the McGill Pain Questionnaire, specific subclasses of miscellaneous dimension and sensory description. Chinese patients used different classes and far fewer MPQ words than patients reported in the western literature.
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PMID:Analysis of headache in a Chinese patient population. 272 81

Previous research has suggested a relationship between migraine pain and oral habits. The present study was designed as a replication of a prior study that found self-reported higher frequencies of certain oral habits in migraine as opposed to tension headache and non-headache groups. Three groups of subjects (common migraine, tension headache and non-headache) were given a single questionnaire in which five oral habits (i.e. teeth clenching, jaw jutting, cupping the chin in the hand, and resting the right and left side of the face on the hand) were rated on a 0 (not at all) to 10 (almost always) scale. Significant main effects were obtained for groups and oral habits in a 3 (groups) X5 (oral habits) ANOVA. Post hoc Tukey tests revealed the common migraine group reported significantly more frequent oral habits than did the tension headache group. The non-headache control group did not differ significantly from either headache group. Discussion focuses on the need for continued research in this area.
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PMID:Oral habits in common between tension headache and non-headache populations. 274 7

The purpose of this study was twofold: (1) to evaluate the role of disregulation in tension headache and (2) to demonstrate how disregulation may lead to erroneous inferences about the etiological role of stress in tension headache. A headache group (N = 25; ages 18 to 30) and a control group (N = 25; ages 10 to 25) matched for sex and roughly equated for psychopathology and self-report life stress was selected after screening 1219 undergraduate students. Measures of self-reported acute stress and headache status, vigilance performance, frontalis EMG, and peripheral temperature were obtained. Both groups were assessed before, during, and after a stressful hour-long vigilance task. The results provide the frequently sought but rarely, if ever, obtained support for Schwartz's disregulation model. As disregulation was apparent with respect to both self-report acute stress and life stress, the results also suggest that reliance on self-report measures of life stress in studies of the physical outcomes of life stress may conceal the process by which life events results in physical dysfunction.
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PMID:Complexities in life stress-dysfunction relationships: a case in point--tension headache. 274 43

Pain is generally recognized as being influenced by multiple psychological factors. Cognitive experiential therapy may use cognitive restructuring with imagery and hypnosis. The restructuring of negative cognitive, affective, behavioral, and physiological states occurs through six stages. This case study illustrates the use of cognitive restructuring and biofeedback with a woman hospitalized for depression and a chronic pain syndrome consisting of tension headache pain. Measures of headache pain (frequency, intensity), skin temperature, and assessment with the Millon Behavioral Health Inventory consisting of broad categories and scales were taken at pretest, posttest and follow-up. The biofeedback treatment alone showed some physiological improvement. Cognitive restructuring and biofeedback resulted in improvements on the Millon, and reduction of headache symptoms at the posttest. Gains on the Millon broad categories of personality coping styles and psychosomatic correlates were maintained at follow-up and chronic headache pain was not reported. Self-report headache frequency and intensity decreased over time with the cognitive restructuring and biofeedback approach.
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PMID:Psychological coping and the management of pain with cognitive restructuring and biofeedback: a case study and variation of cognitive experiential therapy. 276 71


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