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

In order to quantify the pain associated with first trimester abortions and to analyze its influences, patient observations by doctors and attending counselors and patient interviews were conducted. Of the 2299 patients, 86% received 20 cc of lidocaine as paracervical anesthesia (14% received less) and 76% choose to receive 5 mg oral diazepam preoperatively (4% received 3-8 intravenously during the procedure). Patients compared their pain with other familiar types of pain. Doctors and counselors rated the pain during each of 8 specific stages of the abortion (examination, speculum insertion, tenaculum placement, administration of paracervical local anesthesia, uterine sounding, cervical dilatation, vacuum aspiration, and sharp curettage) as compared with the average pain they had observed. In addition, counselors rated the degree of apprehension with which the patient faced the procedure. These methods were analyzed on the basis of internal consistency among each group and agreement across the 3 sources and were found to be sufficiently dependable for the purpose at hand. The pain most often experienced was less severe than an earache or toothache, more severe than a menstrual pain or headache. Physicians and counselors agreed that vacuum aspiration is the most painful stage followed by dilatation and sharp curettage. Pain was positively associated with 1) age of 15 years or less, 2) with gestation of less than 7 weeks or more than 12 and with dilatation on a curvilnear basis, and 3) with patient fear. Despite expectations to the contrary, administration of 5 mg oral diazepam did not reduce pain.
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PMID:Pain of first-trimester abortion: its quantification and relations with other variables. 44 87

It is suggested that damage by mild trauma, viruses or bone disease to the otic capsule or to the membranes between the cochlea and the middle ear is common, and involved in many syndromes of obscure etiology. The clinical perilymph fistula (PF) syndrome can consist of any combination of the following: tinnitus, deafness, phonophobia, vertigo, ataxia, otalgia, facial palsy, headache, diplopia, blackouts, psychological distress. The following testable hypotheses are proposed: otitis media is due to perilymph in the middle ear, with secondary changes resulting from infection or inflammation: otosclerosis results from a slow leak in the presence of enzymes promoting bone growth: Meniere's syndrome follows reduced perilymph support for the endolymphatic system: Bell's palsy results from a perilymph provoked oedema in the bony facial nerve canal: PFs may be responsible for progressive rubella deafness, and for some cases of migraine, epilepsy, anxiety neurosis and hysteria: psychiatric sequelae of the PF syndrome predominate in the post-concussional syndrome and infantile autism: organisms can pass from the throat into the spinal fluid, causing meningitis or encephalitis. The tinnitus and vertigo are caused by random labyrinthine fluid movements, the headache and diplopia by reduced spinal fluid pressure.
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PMID:Perilymph fistula: a cause of auditory, vestibular, neurological and psychiatric disorder. 78 62

The authors report the case of an eight-year-old girl hospitalised for severe headache with paroxysmal left otalgia, vomiting, aprexia, paralysis of the left 6 th cranial nerve and slight left facial weakness. Left carotid arteriography revealed a very large aneurysm of the internal carotid, involving its entire intra-petrous and intra-cavernous course. Treatment consisted of ligation of the internal carotid in the neck. Postoperative angiographic studies showed complete exclusion of the aneurysm, and it was unecessary to carry out "trapping" by ligation of the supra-cavernous carotid, as had initially been envisaged. The postoperative course was uneventful : immediate disappearance of otalgia, secondary complete recovery of the oculo-motor involvement and facial paresis. The absence of any infections or traumatic past history, together with the young age of the patient, represent arguments in favour of the congenital origin of this intra-petrous carotid aneurysm.
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PMID:[Case of giant intra-petrous and intra-cavernous internal carotid aneurysm in a child]. 103 Jul 83

Fifty-one subjects with documented intra-articular pathology refractory to non-surgical therapy underwent temporomandibular joint (TMJ) disc repositioning surgery. Following surgery, subjects were evaluated for 6 months to 6 years by clinical examinations and questionnaires at designated times, and by postsurgical joint imaging. Significant decreases were noted in pain (headache, TMJ pain, ear pain, and neck/shoulder pain), the incidence of joint sounds and locking, and the presence of dietary restrictions. However, 35% of the subjects continued to have residual TMJ pain, and a similar percentage continued to need periodic nonsteroidal anti-inflammatory drugs for analgesia. Some degree of dietary restriction remained in approximately 50% of the subjects, and joint sounds persisted in a similar percentage following surgery. Mean mouth opening was improved by 8 mm, although lateral movements were increased by less than 0.5 mm. Surgery did not decrease the occurrence of jaw deviation, and disc position was unchanged in 86% of the joints imaged at an average of 2 years following surgery. Although TMJ disc repositioning surgery significantly improved pain and dysfunction in TMJ surgery patients, the improvement in disc position was not maintained in most subjects following surgery.
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PMID:Changes in signs and symptoms following temporomandibular joint disc repositioning surgery. 154 84

An accurate history is essential to the diagnosis of chronic sinusitis. Patients classically present with several weeks of daily facial pain or pressure between the eyes, headache, nasal congestion, postnasal drip, ear pain or blockage, and fatigue. The headache in chronic sinusitis is usually worse in the morning and following head movement. Purulent nasal discharge, spiking fever, an elevated white blood cell count, and intense, brief headache associated with nausea and vomiting are uncommon. Palpation, transillumination of the sinuses and anterior rhinoscopy are of minimal value in making the diagnosis. Fiberoptic nasopharyngoscopy can be used to identify the source of sinus discharge and the cause of obstruction. Although plain sinus radiographs are useful in diagnosing and monitoring acute sinusitis, they are of limited value in confirming chronic sinusitis. The sinuses are better imaged with computed tomographic scanning. Prolonged antibiotic therapy, in combination with decongestants and steroids, is usually effective for chronic sinusitis. In recalcitrant cases, sinus surgery may be necessary.
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PMID:Chronic sinusitis: an update. 157 14

Two patients with cervical spine arthritis and ear pain were recently evaluated at our clinic. Injection of the C1-2 facet joints with local anesthetic plus corticosteroid resulted in relief of the pain. Therapeutic cervical facet injections may be indicated in cases of recalcitrant head and neck pain due to cervical spine arthritis.
Headache 1991 Nov
PMID:Ear pain due to cervical spine arthritis: treatment with cervical facet injection. 144 94

Temporomandibular (TM) disorders among children are uncommon. Their many etiologies include interferences with the formative process, malocclusion, and muscle disharmony. Facial pain, earache, headache, difficulty with chewing, and joint noise during mandibular function are symptoms. The two year course of a TM disorder that first became symptomatic in a six month old child is described.
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PMID:Temporomandibular disorder in a child. 181 46

Temporomandibular joint (TMJ) dysfunction may manifest itself clinically by a variety of presentations ranging from headache, pre-auricular pain or tenderness, otalgia, to mandibular hypomobility. Some symptoms may mimic forms of facial pain such as: temporal arteritis, migraine, cluster headache, trigeminal or glossopharyngeal neuralgias, myofascial pain dysfunction, or muscle contraction (tension) headache. This article will focus on a relatively new diagnostic tool that may be used to examine the TMJ for intracapsular pathology which may be responsible for the presenting patients' symptoms.
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PMID:The role of diagnostic arthroscopy in the management of temporomandibular joint dysfunction. 196 Jul 86

An outbreak of measles among a predominantly unvaccinated and susceptible Amish population in Lebanon County, Pennsylvania, offered the opportunity to test the hypothesis that secondary cases in households are more severe than primary cases because the former have more intense exposure and receive a greater virus inoculum. Of 130 measles cases reported between April and June 1988, 119 (92%) constituted a study of disease severity. Severity was assessed by determining frequency and duration of symptoms, length of any hospitalization, and number of days in bed. In a univariate analysis, fewer secondary cases had conjunctivitis (relative risk [RR], 0.67; 95% confidence interval [CI], 0.48-0.96) and headache (RR, 0.37; CI, 0.15-0.86), but more had earache (RR, 9.69; CI, 1.8-202.9) compared with primary cases. Secondary cases had a shorter mean duration of coryza (4.0 vs. 5.0 days, Student's t test, P = .08). However, a logistic regression model that matched by family and controlled for age and sex indicated that there were no significant differences in measles severity among primary and secondary cases in households.
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PMID:Measles among the Amish: a comparative study of measles severity in primary and secondary cases in households. 198 59

Lyme disease is a systemic illness caused by the spirochete Borrelia burgdorferi and transmitted by the bite of a tick in the Ixodes ricinus complex. While the illness is often associated with a characteristic rash, erythema migrans, patients may also present with a variety of complaints in the absence of the rash. The otolaryngologist may be called upon to see both groups of patients, with any number of signs and symptoms referable to the head and neck, including headache, neck pain, odynophagia, cranial nerve palsy, head and neck dysesthesia, otalgia, tinnitus, hearing loss, vertigo, temporomandibular pain, lymphadenopathy, and dysgeusia. We review our institutional experience with 266 patients with Lyme disease, 75% of whom experienced head and neck symptoms. We also summarize the diagnostic and treatment modalities for this illness.
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PMID:Otolaryngologic aspects of Lyme disease. 204 38


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