Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two female patients, one with chronic paroxysmal hemicrania and one with hemicrania continua, had a continuously high requirement of indomethacin, ie, > or = 225 mg per day, for 4 and 7 years, respectively. In the hemicrania continua patient, a right (symptomatic side) C7 root affection due to disc herniation was demonstrated. Removal of the disc relieved the arm pain completely, and reduced the head pain and indomethacin requirement considerably initially. The other patient suffered from the unremitting form of chronic paroxysmal hemicrania with right-sided attacks from the age of 16. Indomethacin, 200 to 250 mg per day generally kept the headache at bay, but during exacerbations, especially during menstrual periods, the dosage transitorily had to be increased to 250 to 350 mg per day. A CT scan with contrast at aged 18 (1987) was negative. In 1992, she started having new symptoms, including numbness on the ipsilateral side of the face and arm and difficulty swallowing. An MR scan showed a meningioma originating in the roof of the cavernous sinus on the symptomatic side. The meningioma was surgically removed. The postoperative indomethacin requirement was reduced, but only transiently. Patients with chronic paroxysmal hemicrania (CPH) and hemicrania continua (HC) with a continuously high indomethacin requirement may have grave additional disorders and should consequently be followed closely.
Headache 1995 Jun
PMID:CPH and hemicrania continua: requirements of high indomethacin dosages--an ominous sign? 763 24

Two female patients, one suffering from CPH in non-remitting form, and the other from hemicrania continua, in the pre-chronic (non-continuous) stage are described. Both were followed through transitions to other stages: the CPH patient was followed from the non-remitting stage to a longlasting remission, and lastly back to another chronic stage. Indomethacin was effective in all the symptomatic stages. The hemicrania continua patient was followed from the non-continuous to the continuous stage. Indomethacin was effective in both stages. These observations provide further evidence that the non-chronic and chronic ("remitting" and "non-remitting") stages of CPH belong together. The same seems to apply to the two stages of hemicrania continua, the "continuous" and the "non-continuous" stages.
Headache
PMID:Chronic paroxysmal hemicrania (CPH) and hemicrania continua: transition from one stage to another. 829 93

We report a child with chronic paroxysmal hemicrania beginning at 3 years of age with more than 2 years of daily episodes. Indomethacin produced total relief. An ipsilateral, occipital hemorrhagic infarction, probably predating the headaches, may have contributed to their pathogenesis. This is an unusually early onset and persistent chronic paroxysmal hemicrania of possible symptomatic type.
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PMID:Chronic paroxysmal hemicrania in a young child: possible relation to ipsilateral occipital infarction. 840 64

The clinical features of idiopathic stabbing headache ("jabs and jolts syndrome") were studied in 38 patients who were diagnosed throughout a 1-year period. Mean age at the onset of symptoms was 47.1 years +/- 14.5 (SD), and a clear female preponderance was demonstrated (female/male ratio = 6.6). Painful attacks were ultrashort, i.e. virtually all attacks in more than two thirds of cases lasted only one second. The frequency of attacks varied immensely, ranging from 1 attack per year to 50 attacks daily. The pain paroxysms usually occurred with an irregular or sporadic temporal pattern. The localization of painful attacks was reported frequently as unifocal, usually in the orbital area, but also multifocal patterns were observed, the attacks frequently changing location from one area to the next. The majority of attacks occurred spontaneously, and accompanying phenomena were reported only rarely. Indomethacin treatment (75 mg daily) seemed to have a complete or partial effect in most patients treated as such (n = 17).
Cephalalgia 1996 Apr
PMID:Idiopathic stabbing headache (jabs and jolts syndrome) 866 81

Indomethacin is the drug of first choice in chronic paroxysmal hemicrania with clear relief of pain as a diagnostic criterion. In a few cases, indomethacin is not tolerated because of side effects. Therefore, the efficacy of carbamazepine, verapamil, sumatriptan, acetylsalicylic acid, and oxygen as drugs in the prophylactic or acute treatment of chronic paroxysmal hemicrania was studied in a prospective open trial with 10 patients suffering from chronic paroxysmal hemicrania. The trial results, in accordance with a review of the literature, suggest that acetylsalicylic acid (and probably naproxen and diclofenac) and verapamil are the most effective drugs of second choice in chronic paroxysmal hemicrania. The efficacy of sumatriptan in this condition needs still to be clarified, although there is evidence for partial efficacy. Carbamazepine and oxygen did not show any significant influence on chronic paroxysmal hemicrania.
Headache
PMID:Alternatives in drug treatment of chronic paroxysmal hemicrania. 878 75

Indomethacin-responsive headaches can present in the orofacial region. According to the classification of headache by the International Headache Society, indomethacin-responsive headaches include chronic paroxysmal hemicrania, hemicrania continue, benign cough headache, benign exertional headache, and sharp, short-lived headache pain syndrome. The mechanism by which indomethacin produces its therapeutic effects in these headache disorders remains speculative. A review of indomethacin-responsive headaches and eight cases in which the presenting symptom was orofacial pain are reported. Because these headache disorders are rare but may present as facial pain, they should be considered in the differential diagnosis of orofacial pain. A comprehensive evaluation prior to performing irreversible treatments is essential when an idiopathic facial pain presents to the dental clinician.
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PMID:Benign indomethacin-responsive headaches presenting in the orofacial region: eight case reports. 899 27

A 31-year-old woman had left-sided miosis, ptosis, and hypopigmented iris probably since birth. At 22, she developed intermittent headaches, always in the left frontotemporal region. These headaches lasted from 1 to 2 days and recurred every 1-2 months. Pain attacks were pressing-pulsatile in character, moderate in intensity, and frequently accompanied by nausea, vomiting, and moderate phono- and photophobia. Various treatment alternatives, such as conventional analgesics and ergotamine failed to improve the attacks. Pizotifen was partially effective. The results of pupillometry and evaporimetry studies were consistent with a 3rd neuron sympathetic hypofunction on the symptomatic side. Autonomic studies and clinical features were consistent with a congenital Horner's syndrome. Conceivably, a sympathetic hypofunction may play a role in the pathogenesis of such headache or in its lateralization. Indomethacin and sumatriptan both seemed to provide absolute pain relief. Some clinical features, the fact that the IHS criteria for migraine are fulfilled and that sumatriptan is efficient, demonstrate the similarity to migraine. The coexistence of strict unilaterality of pain and the probable, complete response to indomethacin indicate a similarity to hemicrania continua in its remitting form. Further information on the effect of sumatriptan in hemicrania continua will help clarify the position of this case vs. hemicrania continua. At this stage, it is probably not possible to classify this case properly.
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PMID:Congenital (?) Horners syndrome and ipsilateral headache. 921 66

The aim of this study was to review the advances in cough, exertional and sexual headaches. We perform a critical analysis of the literature and of our experience with 72 patients. About one-half of patients having cough headache will have benign cough headache. The remaining half suffer from Chiari type I malformation. Benign cough headache begins typically in men above age 50, while symptomatic cough headache begins under 50 and appears with the same frequency in both sexes. Indomethacin is the treatment of choice of benign cough headache, but has no effect in symptomatic cases, which respond to suboccipital craniectomy. Although also showing male predominance, exertional and sexual headaches begin under age 50. Subarachnoid bleeding due to aneurism is the most frequent etiology for exertional and sexual headaches. Cough headache and exertional headache are separate clinical entities, whereas exertional headache and sexual headache seem to be different expressions of the same clinical entity. These data allow, in addition, the clinical differentiation between benign and symptomatic cough headache.
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PMID:[Headaches due to cough, exertion and sexual intercourse]. 949 59

Intracerebral vascular reactivity induced by the nitric oxide (NO) donor isosorbide dinitrate (IDN, 5 mg sublingually) is more major and longer-lasting in migraine patients who develop delayed headache in response to the drug. The headache is purportedly due to neuronally-mediated vascular mechanisms. Indomethacin inhibits prostaglandin synthesis, which is involved in NO generation. Indomethacin also decreases cerebral blood flow by constricting precapillary resistance vessels. In the present study, the hemodynamic effects of indomethacin were evaluated in migraine patients and healthy controls by means of transcranial Doppler monitoring. Indomethacin caused a significant decrease in mean flow velocity in the middle cerebral artery. This was an additional effect to the mean velocity decrease induced by IDN. The interactions between the two drugs suggest that their effects on cerebral hemodynamics (and pain) may be of relevance both in understanding the role of NO in migraine pathogenesis and in evaluating symptomatic treatments for migraine attacks.
Cephalalgia 1998 Nov
PMID:Indomethacin increases the effect of isosorbide dinitrate on cerebral hemodynamic in migraine patients: pathogenetic and therapeutic implications. 987 80

1. The purpose of this study was to investigate the mechanism of nicotine-evoked relaxation of the guinea-pig isolated basilar artery and to study the effects of drugs associated with the aetiology or treatment of migraine on the nicotine response. 2. The guinea-pig isolated basilar artery, pre-contracted with prostaglandin F2alpha (PGF2alpha), in the presence of atropine (3 microM) and guanethidine (3 microM), relaxed on addition of nicotine (0.1 mM) in approximately 50% of preparations. The responses to nicotine were of short duration and blocked in preparations pre-treated for 10 min with capsaicin (1 microM) and are therefore probably a consequence of the stimulation of trigeminal C fibre terminals. 3. Responses to nicotine were reduced in the presence of 5-carboxamidotryptamine, 5-hydroxytryptamine and sumatriptan in that order of potency. This is consistent with a 5-HT1 receptor mechanism. These agonists evoked small additional contractions in vessels pre-contracted with PGF2alpha. 4. Indomethacin (0.3-10 microM), aspirin (10-30 microM), and nitro-L-arginine methyl ester (L-NAME, 0.1 mM) reduced nicotine-evoked relaxation of the basilar artery, suggesting the involvement of both nitric oxide and cyclo-oxygenase products in this response. 5. Progesterone (1 microM) markedly reduced the response to nicotine, a possible reflection of the ion channel blocking activity of high concentrations of this compound. 6. The guinea-pig basilar artery is a preparation in which the effects of drugs on responses to stimulation of trigeminal nerve terminals can be studied in vitro and may thus be of interest in assessing the actions of drugs used in treatment of headache.
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PMID:The inhibition of nicotine-evoked relaxation of the guinea-pig isolated basilar artery by some analgesic drugs and progesterone. 1019 81


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