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

In a controlled trial of amitriptyline hydrochloride in migraine prophylaxis, 100 patients received placebo for a four-week baseline period and then were randomized in double-blind fashion to therapy with amitriptyline (47 subjects) or placebo (53 subjects) for another four to eight weeks. Subjects received up to four 25-mg tablets of amitriptyline hydrochloride or identical placebo per day. Comparing the first and second four-week periods for each patient, the conditions of 55.3% of amitriptyline subjects as opposed to 34.0% of placebo subjects were greater than or equal to 50% improved and the difference between amitriptyline and placebo response rates was significant (P less than .05). Nondepressed subjects with severe migraine and depressed subjects with less severe migraine responded best to amitriptyline, whereas depressed subjects with severe migraine had little headache relief. Amitritryline is an effective antimigraine agent and the antimigraine effect seems relatively independent of antidepressant activity.
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PMID:Amitriptyline in migraine prophylaxis. 50 27

The incidence and different presentations of basilar migraine are described in a series of 132 children (80 boys, 52 girls) presenting with recurring headache considered to be migraine. Basilar migraine occurred in 29 children, and a further 18 had minor symptoms compatible with but not diagnostic of this form. The course was most often benign, with infrequent, fragmentary attacks and little disability. Rarely, attacks were both severe and frequent, but even then the clinical pattern and outcome usually followed a similar course. Only two children (with the youngest ages at onset) have serious disability, with mental slowing and (in one) permanent neurological sequelae. The relationship between basilar migraine and the syndrome of alternating hemiplegia of infancy is discussed. Because of the limited present knowledge, it is suggested that rigid definitions of migraine should be avoided.
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PMID:Basilar migraine in childhood. 52 Jun 93

A questionnaire survey of 120 children with migraine showed an average age of onset of 5.15 years, an equal sex ratio under nine years, and a positive family history in 79 per cent. Eye symptoms (42 per cent) and headaches (32 per cent) heralded an attack, with abdominal pain and vomiting later and less frequent. Visual aura was not recognized under five years, but occurred in 52 per cent of the 13 to 15 year age group. Most attacks occurred on schooldays and 82 per cent were over within two days.The 24-hour food intake before an attack was compared with the food intake seven days later when no migraine occurred. This suggested that fasting (41 per cent) or specific foods (38 per cent) could have been responsible for many of the attacks.
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PMID:Food intake before migraine attacks in children. 54 7

The treatment with oral contraceptives leads infrequently to serious thrombo-embolic cases of sickness in the eye and in the central nervous system with mostly irreversible results. Here is reported about three such cases in which--after intake of oral contraceptives with low-dose portion of oestrogen--ophthalmic complications have appeared, in which by reason of comprehensive internal, neurological and neuroradiological examinations, this treatment has very probably released the ophthalmic complications. As soon as there are appearing migraine-like headache attacks and vision disorders under treatment with oral contraceptives, termination of the treatment is recommended.
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PMID:[A contribution about serious ophthalmic complications with oral contraceptives (author's transl)]. 54 94

Four children with migraine raised some problems of differential diagnosis (cerebral circulatory disorders; structural brain diseases; or primary psychiatric disorders). Organic lesions were excluded through special investigations (EEG, CAT, Scintigraphy, Angiography etc.). Relationships between migraine and epilepsy in children were considered and the recent literature was reviewed. No agreement was reached on how to evaluate paroxysmal electroencephalograms recorded during migrainous episodes. In a child with personal and family history of migraine suffering from a sudden attack of acute headache accompanied by focal neurological deficits, migraine is the most likely diagnosis. Only if the neurological deficit fails to resolve rapidly (after a few hours), a detailed investigation is necessary (CAT etc.). A paroxysmal electroencephalogram during the attack of migraine does not imply necessarily a diagnosis of epilepsy. Children with history of migraine must be treated with specific anti-migranious drugs even if paroxysmal EEGs are recorded during the migraine attack. It must be remembered that both disorders (i.e. migraine and epilepsy) can exist in the same patient.
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PMID:[Hemicrania in children: diagnostic and therapeutic problems (author's transl)]. 54 16

The Authors have subjected 14 migraine patients to Doppler ultrasonic technique. Examinations have been performed on both common carotid arteries, either in headache phase or in pain-free periods. Results in each case suggest variable hemodynamic patterns during migraine attacks. Possible pathogenic mechanisms are discussed.
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PMID:[Doppler observations in migraine patients (author's transl)]. 55 14

A detailed questionnaire concerning life history of headache and its characteristics was administered to 1,809 nonmedical volunteers. Questions dealt with severity of headache, the nature of preceding and accompanying phenomena (nausea, visual scotomata, neurologic symptoms), precipitating factors, and history of other illness. For the total sample and in the 25 to 39 age group, severe or disabling headaches were significantly more frequent in women and mild headaches were significantly more common in men. Migraine characteristics were common with mild headache. An association between hypertension and severe headache was found in women, between asthma and severe headache in men.
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PMID:Characteristics of life headache histories in a nonclinic population. 55 63

In a double-blind study of 80 migraine patients, headache was precipitated by ingestion of 200 mg tyramine and not by placebo in eight individuals, but retesting of seven of these patients did not produce the same results. Placebo produced as severe headache as tyramine and in an even larger number of patients. It is concluded that dietary tyramine alone is rarely, if ever, the major precipitant of a migraine attack, although the possibility remains that it has such a role in the presence of particular physiologic states.
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PMID:Failure of tyramine to induce migraine. 56 Jun 45

Employing optical density methods, platelet aggregation in response to 1.275, 1.7, and 3.4 micrometer adenosine diphosphate was tested in 46 patients with migraine and 46 controls matched by age, sex, and race. The migraine patients demonstrated platelet hyperaggregability when compared with controls, as manifested by a lower threshold for the platelet-release reaction and increased platelet stickiness following aggregation. There was no correlation of platelet hyperaggregability with the severity of migraine or with the occurrence of migraine-associated neurologic symptoms, suggesting that platelet hyperaggregability is a concomitant feature of the migraine syndrome but not dependent on the occurrence of the actual headache. As platelet hyperaggregability may predispose to development of intravascular platelet aggregates or mural thrombi, the hyperaggregability found here may help explain the increased incidence of stroke and heart attack in migraine patients that has been reported elsewhere.
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PMID:Platelet aggregability in migraine. 56 34

We here enumerate criteria that we believe are suitable for the diagnosis of migraine in children. Using these criteria, we identified 84 children retrospectively, and studied their illness for 3 to 9 years thereafter. The majority were male, and 47 patients had frontal headaches. EEGs were performed in 64 children: 17 were paroxysmal, but 7 patients never developed seizures. Referral to a neurologist occurred when there was a marked increase in the frequency or severity of headaches. Irrespective of the form of treatment, about one-half of all patients had more than a 50% reduction in headache frequency in the 6 months following their initial visit to a neurologist.
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PMID:Diagnosis and treatment of migraine in children. 57 49


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