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

We review the literature on the application of electromyographic (EMG) biofeedback to tension-related headaches, back and shoulder pain, and temporomandibular joint (TMJ) pain and present clinical treatment data on 18 patients with tension headaches, eight patients with back and shoulder pain, and six patients with TMJ pain. Electromyographic tension levels declined in all groups of patients; pain declined significantly in 12 of 18 patients with tension headaches and one of eight back pain patients, and decreased slightly in three headache patients, three back and shoulder pain patients, and two patients with TMJ pain. Conclusions suggest that EMG biofeedback is generally more effective in treating tension headaches, but much less effective in the treatment of back, shoulder, or jaw pain, although the numbers of patients are small in the latter two groups.
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PMID:Electromyographic biofeedback for pain related to muscle tension. A study of tension headache, back, and jaw pain. 14 23

The erythrocyte sedimentation rate (ESR) is a frequently used but nonspecific indicator of inflammation or infection. Clinicians often check an ESR in patients with symptoms of headache, facial or jaw pain, and visual loss, as an aid in the diagnosis of temporal arteritis. We present two patients with these complaints, who did not have temporal arteritis, nor any other inflammatory condition or infection, but had ESRs near or above 100 mm/h, leading to diagnostic confusion. An occult nephrotic syndrome, with or without renal insufficiency, can cause such a highly elevated ESR, and was discovered in these patients.
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PMID:Renal causes of elevated sedimentation rate in suspected temporal arteritis. 128 54

Pharmacological coronary vasodilation induced by dipyridamole is often used in association with thallium-201 myocardial scintigraphy to evaluate the presence and prognostic significance of coronary artery disease. Because dipyridamole acts by blocking the cellular uptake of adenosine, we investigated the usefulness of direct intravenous administration of adenosine, a physiological substance with an exceedingly short (less than 2 seconds) plasma half-life, to induce maximal controlled coronary vasodilation in conjunction with 201Tl scintigraphy. We studied 89 patients (44 men and 45 women; mean age, 64 +/- 10 years [SD]) who were unable to perform an exercise test and were referred for evaluation of suspected coronary artery disease. The intravenous infusion of adenosine began at an initial rate of 50 micrograms/kg/min and was increased by stepwise increments every minute to a maximal rate of 140 micrograms/kg/min. 201Tl was injected intravenously after 1 minute at the highest infusion rate, followed by immediate and delayed (4 hour) tomographic imaging. At the highest infusion rate, adenosine induced a significant (p less than 0.001) decrease in systolic (8.7 +/- 19.3 mm Hg) and diastolic (6.7 +/- 9.4 mm Hg) blood pressures as well as a significant (p = 0.0001) increase in heart rate (14.5 +/- 11.0 beats/min). Side effects occurred in 83% of the patients but resolved spontaneously within 1 or 2 minutes after discontinuing the adenosine infusion. Chest, throat, or jaw pain were the most frequent symptoms and occurred in 57% of the patients. Headache (35%) and flush (29%) were also common. Ischemic electrocardiographic changes occurred in 12% of the patients, and transient first-degree atrioventricular block occurred in 10%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnosis of coronary artery disease by controlled coronary vasodilation with adenosine and thallium-201 scintigraphy in patients unable to exercise. 236 18

Safety, tolerance, and pharmacology of 9-beta-methylcarbacyclin calcium (ciprostene calcium) was investigated in healthy male volunteers. This stable prostacyclin analogue was infused intravenously into groups of 12, 11, and three volunteers for three, six, and eight hours, respectively, in doses up to 480 ng/kg/min. Based on the tolerance data obtained, a single-blind, placebo-controlled study was conducted. Seven subjects were infused for 8 hr/d for three days with ciprostene at a maximum dose of 160 ng/kg/min and seven subjects received placebo. One subject from each group did not complete the infusion schedule, and they were not included in the final analysis. During infusion of ciprostene, consistent changes in blood pressure and heart rate did not occur. Most frequent adverse drug reactions consisted of headache, restlessness, nausea, perspiration, flushing, and jaw pain. As compared with placebo, ADP-induced platelet aggregation was inhibited during the infusion period (P = .048). Significant (P = .04) elevations of platelet cyclic AMP were observed in subjects during infusion of ciprostene. Pre- versus postinfusion routine laboratory evaluations, fibrinogen concentration, antiplasmin activity, and plasminogen and template bleeding times remained unchanged. Placebo- and drug-treated subjects had a daily postinfusion shortening of euglobulin clot lysis time (ECLT). The preinfusion minus postinfusion ECLT for ciprostene subjects on days 2 and 3 (133 and 118 min, respectively) compared with placebo (239 and 217 min) suggest a trend to increased fibrinolytic activity. Based on the outcome of this trial, it is estimated that ciprostene is about 15 times less potent than prostacyclin.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Tolerance and pharmacology of ciprostene, a stable epoprostenol (prostacyclin) analogue in humans. 300 77

Epoprostenol (Prostacyclin) has been studied with various success in patients with peripheral vascular disease (PVD). We investigated the tolerance of a new, stable prostacyclin derivative ciprostene (9-beta-methyl carbacyclin) in 9 PVD patients. The drug was infused intravenously for 8 hours a day, once a week for 4 consecutive weeks, at a dose of 120 ng/kg/min. There were 6 men and 3 women with a mean age of 63 years (42-78). The PVD was verified by arteriography (9 patients) and by clinical findings. Patient #9 was lost to follow up after the first infusion and, consequently, was excluded from further evaluation. In patient #5 with a history of arrhythmias, the last ciprostene infusion had to be discontinued at 4.5 hours due to arrhythmias but his data were included into the evaluation. The cardiac disturbances were not judged to be ciprostene-related. Patients were followed monthly for 3 months after last infusion. Ciprostene was well tolerated although it produced adverse medical events (AMEs); most of them were rated as mild. The most frequent were those typical of prostacyclin: headache, facial flushing and warmth, body warmth, jaw pain and sleepiness. No consistent changes in blood pressure and heart rate were observed. One patient who initially had 9 ischemic ulcers underwent transmetatarsal amputation at month 4. The absolute and relative claudication time was measured by treadmill. As compared to baseline, the absolute claudication time increased significantly at week 2 and 4 of the infusion period and also at the end of month 3, but not at the end of month 4.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ciprostene in patients with peripheral vascular disease (PVD). An open-label, tolerance trial. 306 80

Atypical facial pain or neuralgia and lower-half headache are confusing terms and should be discarded. Recurrent unilateral, throbbing, frontal headaches should be referred to as facial migraine. Patients whose trigeminal branches have been subjected to repeated surgical procedures and who have relentless unilateral face-jaw pain should be classified as having chronic traumatic trigeminal neuralgia. Effective treatment is available provided surgical manipulations cease.
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PMID:Chronic traumatic trigeminal neuralgia. 708 50

Clinical investigations of temporomandibular disorders require objective, repeatable methods for screening diseased subjects from non-diseased control subjects. This study evaluated whether information gathered from a short, public domain questionnaire was useful in distinguishing temporomandibular disorder subjects (n = 216) from non-temporomandibular disorder controls (n = 69) and tension-type headache subjects (n = 22). The questionnaire consisted of eight questions relating to jaw pain (i.e., location of pain, precipitating factors, and temporal pattern of pain) and five questions relating to jaw function (i.e., joint noises, locking, and difficulty in opening). There were five possible answers to each question which ranged from 0 (no symptoms) to 4 (unbearable or constant symptoms). The total scores for the eight pain questions and the five jaw function questions were used to determine the questionnaire's sensitivity and specificity in each group, and ROC curves were plotted to identify the best cutoff point for disease presence or absence. Results showed that the questionnaire reliably distinguished between the control group and temporomandibular disorder group with 90.3%-97.7% sensitivity and 95.7%-100% specificity at cutoff values between 5 and 9. These results support the use of the questionnaire as a primary screening tool for general practice and as a supplementary screening tool for clinical temporomandibular disorder studies. However, results also showed that the questionnaire was unable to distinguish easily between TMD subjects and temporalis region tension-type headache subjects.
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PMID:Validity of a brief questionnaire in screening asymptomatic subjects from subjects with tension-type headaches or temporomandibular disorders. 792 38

The authors present and comment on 18 cases of Giant-cell arteritis observed in an Internal Medicine Department between 1984 and 1991 with emphasis on clinical aspects and diagnostic considerations, on the occult presentation forms and, finally, on two cases with peripheral neuropathy. The clinical manifestations were: headache (78%), general non-specific symptoms (78%), polymyalgia rheumatica (61%), sudden blindness (33%), local temporal signs (28%), jaw pain (24%), articular complaints (17%) and peripheral neuropathy (12%).
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PMID:[Giant cell arteritis (Horton's disease): report of 18 cases]. 848 67

In order to discover the prevalence of signs and symptoms of temporomandibular disorders (TMD) in Japan, and the difference in the prevalence among various sex and age groups in the Japanese population, 672 individuals (304 males and 368 females, age range 20-92 years) were selected randomly in Okayama City, Japan, and were investigated by means of questionnaires and clinical examinations. The reported frequency of symptoms was: TMJ sounds 24%, facial-TMJ-jaw pain 11%, headache 27%, teeth clenching 30%, and grinding 34%. The percent frequency of the following signs was: impaired mouth opening 5%, clicking 46%, reciprocal clicking 20%, crepitus 19%, TMJ tenderness 6%, and masticatory muscle tenderness 21%. The subjects with TMJ clicking were more frequently females than males. TMD signs and symptoms were found to be common in all age groups, but they were fewer in the older than in the younger age group. The younger-aged subjects with clicking appeared with significant frequency, whereas crepitus was populated with significant frequency by the oldest age group.
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PMID:Temporomandibular disorders in the adult population of Okayama City, Japan. 894 71

Forty-three patients who underwent arthroscopic surgery for arthrogenous TMD were polled concerning the effect of surgery on the symptoms of headache, neck pain, shoulder pain, dizziness and tinnitus. Statistically significant levels of symptom reduction were recorded for all symptoms polled. This indicates that a substantial number of significant symptoms are produced by the influence of temporomandibular joint pathology on central neural processes. A model for the affect of temporomandibular joint pathology on cervical and masticatory musculature is proposed. This data implies that we cannot use muscle tenderness, hypertonicity and/or pain to differentiate arthrogenous from myogenous temporomandibular disorders. The characteristics of a population of whiplash onset TMD patients were compared to other TMD populations. The results indicate that whiplash induced TMD may differ from insidious onset TMD and even other trauma onset TMDs by prevalence of neck pain, intensity of neck pain and probability of concurrence of neck pain, shoulder pain, headache and jaw pain. These symptoms resolved within 24 hours of arthroscopic temporomandibular joint surgery indicating that the temporomandibular joint pathology was the perpetuating force behind, if not the cause of, these symptoms.
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PMID:A retrospective evaluation of the impact of temporomandibular joint arthroscopy on the symptoms of headache, neck pain, shoulder pain, dizziness, and tinnitus. 908 76


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