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

Seven children with illnesses diagnosed as hysterical conversion reactions (HCRs) were treated at our institution over a period of nine months. They all had neurological symptoms that included one or more of the following: paralysis, headache, seizures, and episodic blindness. All patients but one were misdiagnosed as having an organic disease prior to our final diagnosis. Five children were treated with medications for presumed organic illnesses. In all of these children a diagnosis of HCR was made on the basis of their history and neurological examination findings. They all recovered or began recovery within a few days of having HCR diagnosed, and none of them had had a relapse three to 11 months after the diagnosis of HCR was made. We believe, and there is ample evidence in the literature, that a positive diagnosis of HCR in childhood can be made when neurological manifestations cannot be explained on an anatomic and physiological basis. Although absence of an obvious organic cause is a helpful clue, exhaustive exclusion of all possible organic causes is not necessary for the diagnosis of HCR.
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PMID:Hysterical conversion reactions mimicking neurological disease. 317 27

Migraine headaches may be confused with other types of headache, namely, those caused by tension and by organic disorders, but several features often set them apart. For one, migraines are often accompanied by other symptoms, such as nausea and vomiting. Also, they often are present in the family history. Treatment can involve such methods as biofeedback, diet, and limitation of exercise, and a number of medications are available for both treatment and prophylaxis. Studies of drug treatment of childhood migraine are few, so clinicians must tailor treatment to the individual case, watching for side effects and limiting the duration of treatment as much as possible.
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PMID:Childhood migraine. Differential diagnosis and treatment. 376 32

The frequency of functional complaints was examined in a group of 780 health men, employees of an industrial firm, who had no evidence of organic disease, were not under medical treatment and thought of themselves as healthy. As part of a standardised examination, questions were asked about 11 possible functional complaints, in addition to ten characteristics of their work. The presence of at least one functional symptom was affirmed by 48.3%, with a mean of two symptoms per person. Headaches and sweating were most frequent. In addition to an autonomic fatigue syndrome, a headache syndrome was the most characteristic. Some functional complaints were related to work stress, with factorial analysis distinguishing between time-limited overwork and emotional strain. These findings and corresponding one in the literature suggest that functional complaints frequently occur also in healthy persons.
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PMID:[Functional complaints--healthy or ill? A study of 780 working men]. 711 68

Patients attending neurological clinics with headaches that proved not to be due to clearly defined structural disease were interviewed before and after the consultation and approximately one year later. Their expectations of the consultation were ill-formed. About two-thirds of the patients had fears about organic disease although few had psychiatric morbidity. These fears were generally dispelled by the consultation. About one-third of the patients were dissatisfied by the consultation, nearly all by what the neurologist said rather than by what technical procedures he did or did not undertake. Women with a long history of migraine, with significant psychiatric morbidity, and who had initiated the referral themselves were particularly likely to be dissatisfied. Although most patients were still having headaches one year later, visits to the general practitioner for this symptom had greatly declined.
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PMID:Referrals to neurologists for headaches not due to structural disease. 733

A great number of calcium antagonists are available for the treatment of cardiovascular diseases. Differences in pharmacodynamic and/or pharmacokinetic properties can be used to optimize therapy in patients and to minimize side effects. In contrast to all dihydropyridine (DHP) derivatives, drugs of the verapamil type slow atrioventricular conduction and are widely used for treatment of supraventricular tachycardia. The higher vasoselectivity of new DHP derivatives as compared with nifedipine should be regarded as an advantage for the treatment of patients with impaired left ventricular function. Besides vasodilation, additional effects such as antiatherosclerotic action, amelioration of rheological parameters, bronchial relaxation, or improvement of cerebral capacity in patients with cerebro-organic disorders have been documented for individual drugs. The long plasma half-life of some new calcium antagonists is advantageous with respect to patient compliance. Furthermore, a delayed increase in plasma concentration (high tmax values) is useful to minimize side effects such as reflex tachycardia, flush, headache, and dizziness.
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PMID:Calcium antagonists in comparison: view of the pharmacologist. 789

A patient's medical history, age of onset, location of pain, pain characteristics, pain chronology, associated signs and symptoms, and signs of neurologic dysfunction are all important considerations in making a diagnosis. The International Headache Society has developed a thorough classification system to aid in the diagnosis of headache, which includes primary disorders of migraine, tension-type headache, and cluster headache, as well as secondary, organic disorders.
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PMID:Diagnosing the severe headache. 820 32

Headaches in elderly persons are usually benign. Nevertheless, the possibility of underlying organic disease increases with age. To facilitate diagnosis and determine suitable treatment, primary care physicians should become familiar with diagnostic criteria for common causes of headache in elderly persons. Thorough physical examination and history taking can help rule out many underlying diseases. Benign headaches can usually be managed successfully with available non-pharmacologic and/or pharmacologic interventions. When organic disease (eg, temporal arteritis, cerebrovascular disease, tumor) is suspected, referral to an appropriate specialist may be indicated.
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PMID:Headache in elderly patients. How to recognize and manage benign types. 824 89

Functional disorders mainly occur in young, anxious hyperactive, sometimes obsessional patients and involve all parts of digestive tract: feeling of obstruction the upper oesophagus or dysphagia; aerophagia related to a slow gastric emptying or gastric fullness relieved by eructation; biliary vomiting and pain in right abdominal upper quadrant which might correspond to a form of migraine without headache; irritable bowel, characterized by abdominal discomfort and constipation. Obviously, the diagnosis of functional disorders required elimination of an organic disease by appropriate endoscopic investigations. Psychosomatic disorders mainly comprise gastroduodenal ulcers and inflammatory bowel diseases. Although psychologic profiles have been associated with gastro-duodenal ulcer, these are not necessary for the development of the disease. The role of emotional factors has decreased since very efficient anti-secretory drugs are available. Inflammatory bowel diseases, in particular ulcerative colitis is frequently associated to behaviour disorders. The patient is usually a young woman brought up by an overprotective family. It is generally recognized that attacks of ulcerative colitis may be triggered by emotional factors. Thus, Stress may interact with digestive tract. In some cases, as in patients with irritable bowel or distal ulcerative colitis, psychotherapy such as Schultz's Autogenous Training, improves the patient's condition.
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PMID:[Stress and the digestive system]. 828 96

Headache is very frequent and it has many different causes. It is caused by a severe organic disease only in a small number of patients. In most cases a clinical examination, with special emphasis on the history, is sufficient for a correct evaluation. Only in selected cases additional investigations are needed. Headaches which necessitate an urgent examination are rather infrequent. In most cases the natural course may be observed for a certain period of time without the risk of missing important therapeutic measures.
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PMID:[Meaningful and useful assessment in headache]. 837 3

Headache prevalence and etiology vary dramatically with age. The prevalence of primary headache disorders, such as migraine and cluster, declines with age, while the prevalence of secondary headache disorders, such as temporal arteritis and mass lesions, increases. In evaluating elderly patients with new onset of headache, a high index of suspicion for organic disease is required. Headache symptomatology also varies with age. For example, migraine may evolve into a pattern of chronic daily headache, or auras may occur in the absence of headache (late-life migraine accompaniments). A careful longitudinal headache history is therefore important. Headache management is also influenced by age. Elderly people are more susceptible to medication side effects and are often treated with several drugs. Medications may cause headaches and drug interactions may complicate therapy. For these reasons, age of onset and duration of illness are critical headache features that guide the subsequent approach to diagnosis and treatment.
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PMID:Headaches in the elderly. 849 6


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