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

1. Cluster headache is a severe unilateral head or facial pain, which lasts for minutes or hours, commonly associated with ipsilateral lacrimation and blockade of the nostril. It usually recurres once or more daily for a period of weeks or months, separated by intervals of freedom. The sphenopalatine ganglion seems to play a very important role in its pathology, 2. We created a technic of alcohol infiltration of this ganglion through a supra-zygomatic way, based on the research of the maxillary nerve by neurostimulation and the bone contact with the pterygoid process. 3. We observed a relief of pain and parsympathetic disturbances in more than 85% of our 120 cases, with a follow up between 6 months and 4 years. 4. Results obtained are discussed and analysed in connection with the definition of cluster headache. (Acta anaesth. belg., 1981, 32, 101-107).
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PMID:Cluster headache and sphenopalatine block. 729 8

Inflammation of the upper respiratory tract if frequently contiguous with the ICA and the HN in the neck. If severe, the inflammation of itself may occlude or directly extent into the ICA wall. The resulting scar produces a fixed relationship between artery and nerve that is vulnerable to lymph node enlargement, by head position, or blood pressure elevation. Trauma in the absence of scar may result in intimal injury of the ICA. Hypoglossal carotid entrapment may give rise to arterial stricture or diaphragm formation, microembolism, dissecting aneurysm, and arterial occlusion. Hypoglossal palsy with hemiatrophy of the tongue, unilateral headache, facial pain, or sympathetic disturbance of the upper face are less common than carotid or vertebral basilar symptoms. The diagnosis of HCE depends on understanding the pathological anatomy, hemodynamics, and mechanics of its production and aggravation. Patient history is important and close attention should be given to a history of tonsillitis, abscesses of the neck, unilateral headache, facial or orbital pain, and symptoms related to activity or elevation of blood pressure. The judicious use of noninvasive hemodynamic evaluation, EEG, neurotologic studies, CT scan, and CT dynamic scanning has been of value in diagnosis before surgery and in the documentation of hemodynamic benefit after surgery. Surgical reconstruction has been successful in the relief of ICA obstruction due to HCE and of associated symptoms and disability.
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PMID:Hypoglossal carotid entrapment syndrome. 730 1

Aneurysms of the carotid arteries are relatively rare and can present difficult diagnostic problems. They may occur anywhere along the course of the carotid artery in its cervical route, petrous portion, or intracranial extension. The associated clinical findings may range from a simple neck mass to a variety of neurologic deficits. Symptoms of headache, facial pain, tinnitus, vertigo, epistaxis, hoarseness, and dysphagia may require otolaryngologic evaluation. The high morbidity and mortality associated with the natural history of carotid aneurysms makes their early detection essential. Although these lesions have been a subject of great interest in the neurological and neurosurgical literature, surprisingly little has been written to bring them to the attention of otolaryngologists. A review of the literature and an assessment of 10 cases of extracranial carotid aneurysms treated at the University of Pennsylvania in the past 10 years form the basis of this report. Patients with aneurysms involving various portions of the carotid system are presented to illustrate the numerous head and neck manifestations these lesions produce. Differential diagnosis, etiology, natural history, and current management of carotid aneurysms are discussed.
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PMID:Carotid artery aneurysms: an otolaryngologic perspective. 738 5

A rating scale based on methods used in medical and behavioral science was modified for specific assessment of the function of the masticatory system. Eleven common activities of daily living were recorded on a scale rated from 0 to 10. Thirty-one patients (23 women and 8 men) who had exhibited facial pain and/or headache for a duration of at least one year participated. Test-retest coefficients of reliability for the patients' assessment of pain and discomfort on two different occasions two weeks apart were high and varied (with the exception of one question) between r = 0.67 and r = 0.92. The correlations between the patients' own estimations and that which one member of the family made were high and varied (with the exception of one question) between r = 0.78 and r = 0.92.
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PMID:A scale for measuring the activities of daily living (ADL) of patients with craniomandibular disorders. 759 29

A self-administered questionnaire consisting of 21 questions, diagrams for chief pain location, and a digital pain scale was used prospectively to sort 92 patients with orofacial pain into three categories: (1) musculoligamentous (ie, temporomandibular disorders); (2) neurologically based (ie, migraine, trigeminal neuralgia, tension-type headache, cluster headache, and atypical facial pain); and (3) dentoalveolar pain. Sensitivity, specificity, as well as negative and positive predictive values suggest that this questionnaire may be used reliably to identify patients with orofacial pain that fits the above-described pain categories without prior knowledge of the clinical diagnosis. Digital pain scale findings indicated that on presentation, pain level could not be correlated with any particular pain category, but when using this scale to describe past pain experience, patients with neurologically based pain selected the highest digital pain scale values up to six times more frequently than patients with musculoligamentous or dentoalveolar pain. Patients with musculoligamentous or dentoalveolar pain selected the lowest digital pain scale values up to 15 times more frequently than those with neurologically based pain. Although this questionnaire may be used for initial categorization of pain, there is still no substitute for a thorough history and clinical examination.
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PMID:Differentiation between musculoligamentous, dentoalveolar, and neurologically based craniofacial pain with a diagnostic questionnaire. 767 Apr 23

Atypical facial pain is a residual category for otherwise unclassifiable pain syndromes in the facial region. In 35 patients (31F, 4M) with a mean age of 53.2 +/- 14.9 years and a chronic facial pain syndrome we tested the new diagnostic criteria of the International Headache Society (IHS). There was a marked female preponderance, vague description of symptoms and a long history of incorrect diagnoses. A high number of invasive procedures (3.5 +/- 3.0 (1-13)) were performed in this group. In agreement with the IHS criteria, an operation or injury to the face was a suspected cause in 43%. In contrast to the IHS criteria, our patient sample had dysaesthesiae (63%), bilateral occurrence (37%), remission periods (57%), pain attacks (23%) and superficial as well as deep pain. The IHS classification is insufficient to separate atypical facial pain from other primary headache and facial pain syndromes. We suggest a modified version of the IHS criteria for atypical facial pain.
Cephalalgia 1993 Apr
PMID:Atypical facial pain--application of the IHS criteria in a clinical sample. 768 54

Patients with facial pain, without overt dental disease, are often seen in both medical and dental practice. The differential diagnosis includes (a) cluster headache, in which patients have severe unilateral pains lasting 30 to 120 minutes that respond to verapamil, corticosteroids or lithium; (b) migraine, in which attacks are longer and are often accompanied by nausea and visual disturbance, and can be managed using anti-inflammatory analgesics, with or without metoclopramide, or sumatriptan, although frequent attacks are best suppressed by continuous propranolol or pizotifen; (c) trigeminal neuralgia, knifelike unilateral pains usually responsive to carbamazepine; and (d) temporal arteritis, a steadier pain very responsive to corticosteroids. There is no evidence that continuous 'idiopathic facial pain' is a result of malocclusion (i.e. the way in which the teeth fit together), and its aetiology remains obscure, although there is some biochemical evidence linking it to depression. Many patients respond to simple analgesia and firm reassurance from the physician, although antidepressant therapy (e.g. nortriptyline or dothiepin) is often of great value.
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PMID:Orofacial neuralgia. Diagnosis and treatment guidelines. 769 15

The aim of this study was to evaluate the therapeutic effect of occlusal adjustment on symptoms and signs of craniomandibular disorders (CMD), including headaches, after 3 and 6 months. Fifty patients were selected and randomly assigned to a treatment (T) or a control (C) group. All patients in the treatment group were subjected to occlusal adjustment, whereas the controls were comforted only. Pre- and post-treatment assessment of subjective symptoms and clinical signs was made by a dentist not performing the occlusal adjustment. There was significant improvement in overall subjective symptoms within the T group at the 3- and 6-month follow-up visits, but a statistically significant difference between groups was found at the 3-month follow-up only. With regard to changes in frequency of facial pain a significant deterioration was reported within the C group, which resulted in a significant difference between groups at the 6-month follow-up. No other significant differences were found within or between groups at the follow-ups with regard to the variables investigated. In conclusion, the results from this study that occlusal adjustment is a treatment modality with a statistically significant short-term effect on symptoms of CMD of muscular origin and superior to counseling.
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PMID:Occlusal adjustment in patients with craniomandibular disorders including headaches. A 3- and 6-month follow-up. 774 Sep 33

In order to examine whether, in patients with different types of headache and craniofacial pain, MMPI and STAI scores are significantly different before and after treatment, 114 patients with tension-type headache (n = 34), atypical facial pain (n = 20), temporomandibular joint dysfunction (n = 36), migraine (n = 16), cluster headache (n = 4), chronic paroxysmal hemicrania (n = 2), trigeminal neuralgia (n = 2) were examined. A pain index was calculated (0-10) which quantified pattern, duration and frequency of pain. The Italian MMPI (356 item abbreviated version) and the STAI tests were administered before and after treatment. A paired t-test was used to assess pre- and post-treatment differences, and multiple regression analysis was employed to examine whether such differences correlated with the improvement in the pain index. In the total group after treatment, there was a significant reduction of certain MMPI scores (Hs, D, Hy, Pa, Pt, Sc, Si) and of STAI 1 and 2 scores. Separate analysis confirmed this among women but not among men. No relation was found between MMPI and STAI changes and the degree of improvement as assessed through the pain index. Clinical improvement leads to normalization of MMPI profiles and STAI scores in women. The psychometric data before treatment were not predictive for treatment outcome.
Cephalalgia 1994 Oct
PMID:Personality characteristics before and after treatment of different head pain syndromes. 782 97

Lyme disease is an important consideration in the differential diagnosis of patients seen by the otolaryngologist. Facial paralysis is the most common sign. The otolaryngologist may also see patients with temporal mandibular joint pain, cervical lymphadenopathy, facial pain, headache, tinnitis, vertigo, decreased hearing, otalgia and sore throat. The incidence is increasing and known to be endemic to certain areas of the United States and abroad. This paper reviews the various ways Lyme disease appears to the otolaryngologist. Three cases along with a discussion including epidemiology, vector, animal host relationship, clinical manifestations and pathophysiology are included. The literature is reviewed and the treatment discussed.
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PMID:Lyme disease: a review for the otolaryngologist. 782 75


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