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

Increasing materialism in society is resulting in more wide spread nervous tension in all age groups. While some degree of nervous tension is necessary in everyday living, its adverse effects require that we must learn to bring it under control. Total tension is shown to have two components: a controllable element arising from factors in the environment and the inbuilt uncontrollable residue which is basic in the individual temperament. The effects of excessive or uncontrolled stress can be classified as 1) emotional reactions such as neurotic behaviour (anxiety hypochondria, hysteria, phobia, depression obsessions and compulsions) or psychotic behaviour and 2) psychosomatic reactions (nervous asthma, headache, insomnia, heart attack). Nervous energy can be wastefully expended by such factors as loss of temper, wrong attitudes to work, job frustration and marital strains. Relaxation is the only positive way to control undesirable nervous tension and its techniques require to be learned. A number of techniques (progressive relaxation, differential relaxation, hypnosis, the use of biofeedback, Yoga and Transcendental Meditation) are described and their application to dental practice is discussed.
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PMID:Tension and relaxation in the individual. 37 62

The case of a 28-year old woman with headache resembling hemicrania continua (HC) is described. Since her childhood she had a history of right-sided, side-locked, painful headache attacks, with increasing attack frequency during the last two years, each attack lasting around 24 hours. There were only a few "migrainous" symptoms and signs, thus no photo- and phono-phobia and no vomiting. Only occasionally did she have slight nausea. The clinical picture as well as the complete indomethacin effect suggested a case of HC. However, the indomethacin effect faded away after > 2 months. At that time, a CT scan revealed a tumor in the right sphenoidal bone involving the clinoid process and the base of the skull. A biopsy of the tumor during craniectomy showed a mesenchymal tumor, and the patient was considered inoperable (April, 1989). After cytostatic treatment, she is back in full time work; the headache disappeared and it still has not recurred after approximately 2 years of observation. Neuroradiological investigation should, therefore, be included in the work-up of patients with HC. At the present stage of knowledge, neuroradiological investigations should probably also be included when faced with a typical clinical picture.
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PMID:Hemicrania continua: a possible symptomatic case, due to mesenchymal tumor. 129 26

A retrospective review was done on medical records of 13 patients with persistent post-dural-puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post-laminectomy syndrome after "wet taps" while performing epidural blocks. In two patients post-dural-puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran-40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD +/- 0.79). In five patients headache ceased in less than five hours. Nausea and photo-phobia subsided earlier. Patients with post-dural-puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran-40.
Headache 1994 May
PMID:Persistent post-dural-puncture headache treated with epidural infusion of dextran. 751 25

Throughout history writers have attempted to describe the symptoms and evoke the misery of "a dismal headache." Writers from Plato to Stephen King have used the phenomenology of headache to illustrate their work. Lewis Carroll, for example, vividly describes the central scotoma, tunnel vision, phono-phobia, vertigo, distortions in body image, dementia and visual hallucinations that often accompany migraine. Although many authors have discussed the topic seriously, others have addressed the issue in a dismissive and even contemptuous manner, relegating this very real disorder to the status of a medical stepchild. We will examine headache etiology, triggers and treatment and explore the attitudes toward headache and headache sufferers found in literature. We have recently seen a growing understanding of the physiological basis of headaches. However, this knowledge has not yet reached the level of literature or popular culture. In an age when it seems every Sunday night brings a new "disease of the week" movie, and every human ill is subjected to often intense and numbing scrutiny by the media, the anguish of a chronic migraine sufferer will probably remain unexplored--unless she kills her husband and children during an attack.
Headache 1993 Feb
PMID:Sometimes Jello helps: perceptions of headache etiology, triggers and treatment in literature. 845 26

Panic Disorder (PD) is a common anxiety disorder, which has its onset relatively often during adolescence. Twenty-five percent of adult patients with PD have previously suffered from school phobia. In young patients it often represents a form of agoraphobia, although it may be present also in other psychiatric disorders which have their onset in young age. In this report we describe the results of 8 to 15-month citalopram treatment on three young patients with school phobia associated with PD. In our patients, low doses with citalopram were effective as in all patients the severity of school phobia decreased and the panic attacks disappeared. There were few drug-related side-effects as only one patient had mild headache at the beginning of the treatment. Our very preliminary results suggest that citalopram may be effective in school phobia related to PD. However, controlled studies are needed to demonstrate the safety, efficacy and appropriate length of citalopram treatment in childhood PD before it can be widely used in this disorder.
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PMID:Citalopram in the treatment of early-onset panic disorder and school phobia. 885 32

Dentists are trained to provide treatment for patients with straightforward problems that respond to routine therapy and do not recur. However, patients may present to dentists and complain solely of physical symptoms such as toothache, headache, and facial pain: only after much inappropriate treatment these symptoms are revealed to be due to emotional disturbance. The dentist may spend hours investigating such patients, in some of whom dental pathology may be present, but the symptoms and ensuing disability cannot be satisfactorily explained as a result. There are other patients who are preoccupied by physical symptoms or by their appearance. In others, anxiety may manifest itself as a phobia, or a dysmorphic concern about certain aspects of their appearance. This article reviews the role of liaison psychiatry and psychology in dentistry.
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PMID:Liaison psychiatry and psychology in dentistry. 939 63

Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.
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PMID:Psychiatric morbidity following motor vehicle accidents: a review of methodological issues. 960 76

Recently, we showed that most migraine patients exhibit cutaneous allodynia inside and outside their pain-referred areas when examined during a fully developed migraine attack. In this report, we studied the way in which cutaneous allodynia develops by measuring the pain thresholds in the head and forearms bilaterally at several time points during a migraine attack in a 42-year-old male. Prior to the headache, he experienced visual, sensory, motor and speech aura. During the headache, he experienced photo-, phono- and odour-phobia, nausea and vomiting, worsening of the headache by coughing or moving his head, and cutaneous pain when shaving, combing his hair or touching his scalp. Comparisons between his pain thresholds in the absence of migraine and at 1, 2 and 4 h after the onset of migraine revealed the following. (i) After 1 h, mechanical and cold allodynia started to develop in the ipsilateral head but not in any other site. (ii) After 2 h, this allodynia increased on the ipsilateral head and spread to the contralateral head and ipsilateral forearm. (iii) After 4 h, heat allodynia was also detected while mechanical and cold allodynia continued to increase. These clinical observations suggest the following sequence of events along the trigeminovascular pain pathway of this patient. (i) A few minutes after the initial activation of his peripheral nociceptors, they became sensitized; this sensitization can mediate the symptoms of intracranial hypersensitivity. (ii) The barrage of impulses that came from the peripheral nociceptors activated second-order neurons and initiated their sensitization; this sensitization can mediate the development of cutaneous allodynia on the ipsilateral head. (iii) The barrage of impulses that came from the sensitized second-order neurons activated and eventually sensitized third-order neurons; this sensitization can mediate the development of cutaneous allodynia on the contralateral head and ipsilateral forearm at the 2-h point, over 1 h after the appearance of allodynia on the ipsilateral head. This interpretation calls for an early use of anti-migraine drugs that target peripheral nociceptors, before the development of central sensitization. If central sensitization develops, the therapeutic rationale is to suppress it. Because currently available drugs that aim to suppress central sensitization are ineffective, this study stresses the need to develop them for the treatment of migraine.
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PMID:The development of cutaneous allodynia during a migraine attack clinical evidence for the sequential recruitment of spinal and supraspinal nociceptive neurons in migraine. 1090 99

Investigations of migraine comorbidity have confirmed its association with diverse psychiatric conditions. This association appears to be strongest for major depression and anxiety disorders (particularly panic and phobia), but increased comorbidity has also been reported with substance abuse and certain mood disorders. This literature also indicates that greater psychiatric comorbidity exists for migraine sufferers with aura than without. Some support is found for the notion that psychiatric comorbidity is higher in transformed migraine than in simple migraine (particularly in the case of chronic substance abuse). However, research into the possible mechanisms underlying these associations remains limited. Studies examining the order of onset and the cross-transmission of migraine and psychiatric disorders in families have been unable to distinguish fully between causal and common aetiological models of association. The conclusions are discussed in light of both methodological and conceptual issues relevant to understanding migraine comorbidity.
Cephalalgia 2005 Mar
PMID:Psychiatric comorbidity in migraine: a review. 1623 65

School phobia is a serious disorder affecting up to 5% of elementary and middle school children. Long-term consequences include academic failure, diminished peer relationships, parental conflict, and development of additional psychiatric disorders. Hiding behind such common physical symptoms as headaches, stomachaches, and fatigue, school phobia evades diagnosis with ease. Unraveling the problem of school phobia is challenging for the school nurse and is complicated by an overall lack of knowledge regarding the serious potential outcomes. The purpose of this article is to define school phobia, differentiate it from truancy, and highlight some interventions useful in the treatment of this increasingly common and potentially serious disorder.
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PMID:School phobia. 1589 49


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