Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ergot derivatives have been used in the treatment of migraine for more than 50 years. We have compared the efficacy of dihydroergotamine (DHE) nasal spray with that of placebo in patients with classic or common migraine attacks. The study was performed in accordance with a double-blind, crossover design. In this study a great placebo effect was observed with a dose of 1.36 mg/attack, and the overall efficacy was rated by the patients to be 41% and 52% for placebo and DHE, respectively.
Cephalalgia 1987 Jun
PMID:Dihydroergotamine nasal spray during migraine attacks. A double-blind crossover study with placebo. 330 Oct 1

General concepts and specific factors to be used in the selection of patients for clinical drug trials in migraine are discussed. The definition of common migraine has been unsatisfactory and new diagnostic operational criteria are recommended. Patients with headaches that are a mixture of tension headache and migraine, and migraineurs who have interval headaches which are not clearly differentiated from migraine should be excluded. The headaches should be of moderate to severe degree, in the range of 2-6 per month, and should last from 3 h to 3 days. It would be best for migraine to have been present for at least 1 year, with 3 months retrospective and 2 months prospective observation prior to drug trial. The age of onset of migraine should be below 50, and the age of entry into the study less than 60. Migraineurs in good health, of either sex, are to be included in the study. Occasional use of minor tranquilizers and sedatives as well as of contraceptive drugs is acceptable, but patients who abuse drugs, who are allergic to compounds related to the trial drug and who require major psychotropic medication should be excluded. Also excluded are those whose compliance with the drug trial is doubtful for intellectual or, more often, psychological reasons.
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PMID:Selection of patients for clinical drug trials in migraine. 331 96

Sudden, transient loss of vision in one eye (amaurosis fugax) is associated frequently with atherosclerosis of the internal carotid artery in adults and may herald a stroke. Thus, cerebral angiography is often performed. Amaurosis fugax in children is uncommon and an underlying cause is rarely demonstrated. Recurrent episodes of amaurosis fugax occurred in five adolescents. A characteristic evolution and pattern of visual loss, consistent with choroidal ischemia as the underlying mechanism, was described by four of them. Although none of the episodes were accompanied by headache, four patients had a history of common migraine at other times or a family history of migraine. These episodes of visual loss may represent a migraine variant, and cerebral angiography is not indicated in adolescents with such a history.
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PMID:Amaurosis fugax in teenagers. A migraine variant. 334 21

In a study of serotonin (5-HT) function in patients with eating disorders and healthy control subjects, severe headaches with features of common migraine occurred unexpectedly in 28 of 52 subjects (54%) 8 to 12 hours after receiving a single oral dose of the 5-HT receptor agonist m-chlorophenylpiperazine (m-CPP), 0.5 mg/kg. None of the same subjects developed similar late-occurring headaches after placebo or the 5-HT precursor, L-tryptophan, 100 mg/kg given intravenously. The frequency of these migrainelike headaches was not significantly different between patients with bulimia or anorexia nervosa and control subjects, but incidence of headaches was significantly greater in subjects with a personal or family history of migraine, with almost all predisposed individuals (18 of 20, 90%) developing severe symptoms. Headache ratings were also significantly correlated (rho = 0.70; p less than 0.0001) with peak concentrations of m-CPP in plasma. These observations indicate that m-CPP may provide a novel probe for studies of the pathophysiology of migraine headaches.
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PMID:Induction of migrainelike headaches by the serotonin agonist m-chlorophenylpiperazine. 337 82

Regional cerebral blood flow (rCBF) was measured as gray matter blood flow using the 133Xe inhalation technique in 50 pain-free headache patients: Eight patients having classic migraine with normal computed tomograms were matched to patients having common migraine and to normal controls. Interictal rCBF was determined at least 6 days after the last migraine attack and more than 24 hours before the next one. There were no between-group differences for age, PCO2, mean hemispheric blood flow, interindividual and intraindividual variabilities, hyperfrontality, or rCBF symmetry. However, when subjects were classified as to overall abnormal perfusion, a significant number (n = 4, p less than 0.04) of patients with classic migraine had rCBF abnormalities, whereas only one such patient was seen in the group with common migraine. Patients with classic migraine had abnormal mean hemispheric blood flows or disturbed intrahemispheric rCBF patterns. Oligemic and hyperemic regions topographically corresponded to the clinical symptoms in one patient. We conclude that during migraine attacks and interictally there is an instability of rCBF control in patients with classic but not common migraine.
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PMID:Abnormalities of interictal cerebral perfusion in classic but not common migraine. 341 8

The personality inventory for children (PIC), which is similar in structure to the MMPI and hence free from subjective interpretation, is applicable to children from 6 to 16 years of age. We used it in 40 children with common migraine aged 8 to 14 years and in 40 controls comparable in age, sex, and socioeconomic status. Although the migraine subjects did not emerge as globally different from the controls, they presented significantly higher scores on the Somatic concern, Depression, and Anxiety scales, irrespective of sex. These results underline the value of PIC in the diagnostic assessment of childhood migraine.
Cephalalgia 1987 Dec
PMID:Personality inventory for children and childhood migraine. A case-controlled study. 342 23

Although asymmetric EEG abnormalities have been reported during the headache-free period in migraineurs, asymmetries of regional cerebral blood flow (rCBF) have not been studied. Headache-free rCBF values measured by 133Xe inhalation were lower in migraineurs than in controls. Interhemispheric CBF and regional (anterior versus posterior) CBF did not differ between the groups. When a novel scoring system was used to obtain a mean asymmetry index (MAI), the MAI of the classic/complicated group was significantly higher than that of the controls but not significantly different from that of the common migraine group. These data suggest that in the headache-free interval rCBF asymmetries, variable in location, exist in classic/complicated migraineurs. These rCBF changes may be related to the cause or the effect of the focal neurologic dysfunction that occurs during an attack in these patients.
Cephalalgia 1987 Dec
PMID:Asymmetric cerebral blood flow patterns in migraine. 342 24

The results of a double-blind cross-over clinical trial involving 27 patients with classical or common migraine are described to compare the prophylactic effect of the calcium entry blocker flunarizine with that of pizotifen. Duration of the treatment was two months, with an evening single-dose administration of both drugs. For most parameters, there was no definite difference between flunarizine and pizotifen in migraine prophylaxis. It has been demonstrated previously that pizotifen is an effective drug in migraine prophylaxis, and these results suggest that flunarizine is effective, too. Weight gain as a side effect was less frequent and less severe with flunarizine than with pizotifen; other side effects showed the same incidence with both drugs.
Cephalalgia 1986 Mar
PMID:Flunarizine-pizotifen single-dose double-blind cross-over trial in migraine prophylaxis. 351 6

After four weeks of medication-free baseline observation, 29 patients with common migraine randomly received flunarizine (10 mg daily) or placebo for a 16-week period. After four weeks wash-out they crossed treatments for another 16 weeks; 27 patients completed the trial. Compared with placebo, flunarizine significantly reduced the frequency of migraine attacks and the derived headache indices, but the duration and severity of single attacks remained unchanged (Mann-Whitney U-test). The effect of flunarizine increased during the 16-week treatment period and during the last four weeks the number of migraine attacks reduced to 50% compared to the wash-out period. The only side-effect of flunarizine was mild daytime sedation in three patients. It is concluded that flunarizine is a valuable new prophylactic agent for common migraine.
Cephalalgia 1986 Mar
PMID:A placebo-controlled, double-blind, cross-over trial of flunarizine in common migraine. 351 9

Irrespective of their mechanism of action, which so far has not been clarified, calcium channel blockers (CCBs) have a documented prophylactic effect on classical and common migraine, as well as on cluster headache. The drugs may reduce migraine prodromes, the frequency of migraine attacks, and also decrease the severity and possibly the duration of these attacks. Notably, their optimum effect is often seen after more than 2 months of treatment. Side effects seem to be few and mild. Whether or not there are differences in therapeutic efficacy between different CCBs is presently unclear. As comparisons with other alternatives of treatment are sparse, the place of CCBs in migraine therapy remains to be established.
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PMID:Migraine treatment with calcium channel blockers. 352 Nov 94


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