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

Cluster headache is a rare headache entity that predominantly occurs in younger males. The clinical features are characterized by sudden attacks of unilateral excruciating pain localized periorbitally, associated with ipsilateral autonomic symptoms. The attacks occur in periods: clusters. The pathophysiology is still unknown. Such vasodilating substances as histamine, nitroglycerin and alcohol may provoke attacks. These substances may be used as diagnostic tests, but the interpretation of a negative result must be careful, as the attacks can not be induced in a refractory period after spontaneous occurrence, or at the beginning and end of cluster periods. As symptomatic treatment, ergotamine is the drug of first choice. High attack frequency may lead to overconsumption with ergotisme and further increased frequency. In such cases and for nocturnal attacks, oxygen inhalations represent an alternative. As prophylactic treatment ergotamine, methysergide, lithium and prednisone have proved efficacious. Most patients benefit from such treatment and may become virtually free from attacks. It is, therefore, important to differentiate this headache entity from classical migraine, common migraine and trigeminal neuralgia.
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PMID:Cluster headache: a review. 353 83

A brief review of the literature related to migraine headaches is presented. Information is presented on the epidemiology and diagnostic criteria of migraine headaches and is followed by a discussion on the problems inherent in the current classification system. Previously proposed vascular mechanisms of common migraine are discussed in the light of recent non-supporting data and a possible link between common migraine and orofacial pain dysfunction syndromes is proposed. The role of oral behavioural patterns and related muscular/temporomandibular joint problems are advanced as probable factors related to common migraine. The discussion focuses on the need to distinguish classic from common migraine headache sufferers in assessment and treatment outcome studies, as well as suggesting future avenues of research.
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PMID:Common migraine: a review and proposal for a non-vascular aetiology. 354 Feb 39

The efficacy of nimodipine in comparison with that of pizotifen was assessed in the prophylaxis of migraine in a double-blind cross-over study, in which a double-dummy technique was also utilized. The study was carried out on 43 migraine patients, of whom 15 had classic and 28 had common migraine. A 4-week run-in placebo period preceded the drug treatments, the drug treatments lasted 12 weeks, and there was a washout placebo period of 4 weeks between nimodipine and pizotifen treatments. The dosages used were 40 mg three times daily for nimodipine and 0.5 mg three times daily for pizotifen. Both nimodipine and pizotifen proved to be better than placebo, the number of migraine attacks showing a significant reduction. There was no difference between nimodipine and pizotifen in antimigrainous efficacy, but there were fewer side effects during the nimodipine period. The results suggest that nimodipine is an effective drug for the prophylaxis of migraine, with few side effects and therapeutic efficacy equal to that of pizotifen.
Cephalalgia 1987 Mar
PMID:Efficacy of nimodipine in comparison with pizotifen in the prophylaxis of migraine. 355 38

Pupil diameter was measured in darkness and in dull and bright illumination in 39 migrainous patients and in 15 tension headache sufferers during headache. In 21 migrainous patients, measurements were repeated during the headache-free interval. Mean pupil diameter was smaller in patients with common migraine at the time of examination than in 20 nonheadache control subjects, and smaller on the symptomatic side in migrainous patients with unilateral headache. During the headache-free interval mean pupil diameter did not differ from values in non-headache controls. These findings suggest that migraine is associated with a sympathetic pupillary deficit which is greater on the habitually-affected side.
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PMID:Pupil diameter in migraine and tension headache. 357 38

MMPI personality profiles were obtained from three clinical groups (n = 79). One group consisted of men and women with chronic muscle pain (MP; n = 34), a second group of male and female chronic tension headache patients (TH; n = 12), and a third group of female migraine patients (M; n = 33). The M group was subdivided on the basis of source of referral and into groups of classic versus common migraine. Elevation of the MMPI subscales usually interpreted as neuroticism scales were found in all groups. A "psychosomatic V" pattern was found on these scales in the M group but not in female TH patients. The difference in scale configuration between groups was caused primarily by different elevations on the depression scale. A relationship between severity of headache and elevation of the "psychosomatic V" was found in migraine patients. Male MP and TH patients showed a descending slope on the neuroticism scales, not observed in females. There was a tendency for common migraine patients to show a more elevated and psychosomatic configuration on the MMPI, as compared with classic migraine patients.
Cephalalgia 1987 Mar
PMID:MMPI patterns in chronic muscle pain, tension headache, and migraine. 358 Nov 61

Because serotonin, released from platelets, has been suggested to initiate migraine, a decreased platelet serotonin content, attained by a reduced intake of serotonin and the serotonin precursor tryptophan, might be beneficial. In the brain, however, increased serotonin levels, achieved by a high carbohydrate intake, are probably favourable. Seven migraine patients (four with classic, three with common migraine) were placed on a carbohydrate-rich diet, low in protein-tryptophan. Three of the four classic migraineurs, but none of the common migraineurs, noted improvement in their migraine. Platelet serotonin uptake was within the normal range both before and at the end of the diet period. The apparent positive effect in the classic migraineurs could be due to a reduced intake of migraine-precipitating foods and/or increased brain serotonin levels.
Cephalalgia 1987 Jun
PMID:Effect of a carbohydrate-rich diet, low in protein-tryptophan, in classic and common migraine. 360 71

Intracarotid injection of 133-Xenon and recording of wash out of radioactivity by 254 external stationary detectors was used to measure rCBF. Initial slope values were calculated by a computer, translated into color code and displayed on a TV-screen. rCBF in patients with epilepsy has been the object of former studies. Those who had a cortical focus showed corresponding high blood flow values during attack and during EEG paroxysms without clinical attacks. On the contrary, all other patients with a cortical focus were normal. Patients with complex partial seizures displayed no abnormalities interictally. During generalized epileptic seizures rCBF and metabolism doubled. Distinction must be made between patients with aura (classic migraine) and patients without aura (common migraine). In the latter CBF was normal or slightly elevated. In the former the aura symptoms are associated with reduced CBF. The reduction usually starts posteriorly and spreads gradually anteriorly. rCBF remains depressed for up to several hours into the headache phase. After 8-12 hours a reactive hyperemia may ensue. In common migraine rCBF remains normal throughout the attack. During classic migraine attacks rCBF is depressed whereas it is increased during epileptic attacks. Thus rCBF studies further strengthen the differences between epilepsy and migraine.
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PMID:Regional cerebral blood flow (rCBF) studies in migraine and epilepsy. 360 67

Nociceptive flexion reflexes, RIII reflex in particular, have been demonstrated to be a useful tool for pain research in humans, since the threshold of RIII reflex is that of pain. In this study a reduction of RIII reflex threshold, strictly related to the severity of the disease, is described in migraine with interval headache (MIH), that is considered a severe and evolutive form of common migraine (CM). These abnormalities were not found in CM or in other chronic pain conditions, i.e. chronic tensive headache (CTH), suggesting that this electrophysiological parameter may be useful in the clinical assessment of primary headache. Moreover, the administration of amitriptyline, a drug producing analgesia mainly by blocking serotonin uptake, was able to markedly increase the RIII reflex threshold in MIH. This fact supports the hypothesis that an impairment of serotoninergic antinociceptive system may exist in this type of headache. A significant correlation between percentage increase in RIII reflex threshold and reduction of PTI was also observed after amitriptyline treatment, indicating that pain reflex may be used for predicting treatment response in migraine.
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PMID:Pain reflexes in the clinical assessment of migraine syndromes. 360 72

Most headaches, including the chronic ones, have an organic background. This applies in particular to the unilateral headaches, but also probably to some of the global ones. In spite of this, there seems to be a clear, but variable influence of stress in the various types of headache. This effect may be a dual one. Thus, in migraine the effect of the low-degree, daily, annoying stress may be much worse than that of major stress, which may in fact prevent a headache almost even completely. A distinction should be made between the influence of stress on the headache as such and on the separate attacks. An example of this may be cluster headache: the mechanism underlying the long-term development may be under influences of external stressors, whereas the shortlasting, solitary attacks are scarcely influenced by such factors. The negative influence of stress is probably most apparent in common migraine and the acute form of tension headache. Headaches like the "atypical facial neuralgia" have been thought to have a strong, psychogenic background. Atypical facial neuralgia is one of the unilateral headaches, and bears a great similarity to cervicogenic headache. In the latter headache, attacks may even be precipitated mechanically, so that a psychogenesis or a marked stress-influence seems to be unlikely. In some cases of classic migraine, attacks seem to appear in their own inherent, stereotypical rhythm irrespective of outer events of a possible harmful nature.
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PMID:Headache and the influence of stress. A personal view. 366 6

Three groups of patients, long-time sufferers from classic migraine, common migraine, and cluster headache respectively, and three control groups, age- education- and sex-matched, underwent a set of neuropsychological tests and tachistoscope tasks in order to evaluate cognitive functions and interhemispheric balance. Migraineurs and cluster headache patients were selected on the basis of the constant (90%) unilaterality of both pain and focal neurological deficits. No significant differences emerged between patients and controls in any of the neuropsychological and tachistoscopic tasks administered, thus indicating that between attacks of migraine as well as of cluster headache no evidence of cortical dysfunction is detectable.
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PMID:Analysis of higher nervous functions in migraine and cluster headache. 367 42


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