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)

The course of the illness in a six-year-old boy is reported. His recurrent headaches led to the detection of arterial hypertension (170/135 mmHg). Clinical and histological examination revealed neurofibromatosis von Recklinghausen. A bilateral paraumbilical murmur hinted at a renovascular form. Arteriography showed an aneurysm of the right renal artery and multiple bilateral intrarenal stenoses and aneurysmatic dilatations. Under conservative treatment with Propranolol and Dihydralazine blood pressure remained almost normal over two years. 38 paediatric cases of renovascular hypertension in childhood reported in the literature are analyzed with regard to clinical manifestation, morphology and localisation of the renovascular lesions.
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PMID:[Renovascular hypertension in neurofibromatosis von Recklinghausen (author's transl)]. 41 39

We studied whether small doses of propranolol given orally have an effect on headaches that are associated with intravenous cyclosporine therapy. In seven patients who had severe cephalalgia associated with intravenous cyclosporine post-bone marrow transplant, oral propranolol promptly relieved the symptoms in four patients. Intravenous propranolol was not effective in one patient who was unable to take oral medications. Propranolol should be considered as an alternative to chronic narcotics in patients with headaches due to cyclosporine.
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PMID:Propranolol for the treatment of cyclosporine-induced headaches. 151 Dec 58

Migraine patients seem to suffer from a continuous autonomic imbalance. Sympathetic instability, expressed by enhanced low frequency fluctuations, which exists during the headache free intervals, was observed in our previous study by spectral analysis of heart rate (HR) fluctuations. Propranolol--a beta adrenoceptor antagonist, is widely used in migraine prophylaxis. In order to specify and quantitate propranolol efficacy in migraine, spectral analysis of heart rate fluctuations was performed on 10 migraine patients before and during the treatment with propranolol. They were compared to 10 healthy control patients and 6 migraine patients who were treated for several months with propranolol and then discontinued the medication. The analysis was carried out on a 24h Holter ECG recording, which was performed for each subject during a headache free interval. Short 256 sec subtraces, taken every 30 min from the 24h ECG signal, were submitted to A/D conversion, R wave detection and computation of heart rate power spectrum. Propranolol achieved a marked effect, when comparing the power spectra of HR fluctuations in treated versus untreated migraine patients. A strong reduction (to normal level) in the low frequency HR fluctuations in the range below 0.1 Hz., was apparent in patients treated with propranolol. Subjects who had received propranolol in the past and discontinued the drug, displayed a carry-over effect of reduced fluctuations even 2-3 months after its discontinuation. It seems that the propranolol efficacy in migraine is associated with the mechanism of stabilizing the fluctuations within the frequency band related to sympathetic activity, hereby moderating the vascular instability in migraine.
Headache 1992 Apr
PMID:Propranolol in the prophylaxis of migraine--evaluation by spectral analysis of beat-to-beat heart rate fluctuations. 158 34

According to widely accepted theory, migraine is a self-limited neurogenic sterile inflammation characterized by initial cerebral vasoconstriction, subsequent extracranial and intracranial vasodilation, sterile inflammation, and secondary muscle contraction. It is characterized by recurrent attacks of headache, usually unilateral and accompanied by nausea, vomiting, and, often, other symptoms. Frequency, duration, and intensity of attacks are widely variable. Migraine affects more women than men, and is often related to menses. Patients with classic migraine experience visual or neurologic prodromes, but vague "premonitions" occur in both classic and common migraine. Precipitating factors include foods, alcohol, medications, visual stimuli, changes in routine, and stress. The first-line agent for abortive therapy is ergotamine; corticosteroids are indicated for prolonged headache. Propranolol is recommended for daily prophylactic therapy, and alternatives include calcium channel blockers, nonsteroidal anti-inflammatory agents, and tricyclic antidepressants.
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PMID:Strategies for migraine management. 189 57

Migraine is a common disorder in children with a prevalence of 2.5% under seven years of age, 5% in those between the ages of seven and puberty and in postpuberal females it may be as prevalent as 10%. It is transmitted as an autosomally dominant trait and is frequently caused by precipitating factors. The vascular theory which stated that the aura was due to an intracranial vessel constriction and that the headache was due to an extracranial vasodilation has now be questioned due to new clinical and experimental data. Recently it is believed to be due to an unstable inherited serotonigenic neurotransmission which favors an increase in the frequency of neuronal discharge of the mid-brain raphe. Included is a classification and the diagnostic headache criteria used by the International Headache Society (1988). Treatment for migraine can be: a) abortive and b) preventive. Propranolol at a dosage of 2 mg/kg per day taken divided into three has shown to be the most beneficial in the prevention of migraine headaches. Certain calcium channel blockers, particularly flunarizine seem to have prophylactic value.
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PMID:[Migraine. Various current concepts]. 222 17

The abuse of the combination drug containing butalbital 50 mg, aspirin 325 mg and caffeine 40 mg (or BAC), is commonly recognized by headache specialists as causing headaches. Despite this widespread problem, there is not a published treatment regimen for the BAC detoxification of patients. I describe such a protocol which was used four times in three patients. These patients fulfilled the diagnostic criteria of the IHS Headache Classification for headaches induced by chronic substance abuse (8.2) and analgesics abuse headache (8.2.2). These patients took between 150 and 420 BAC/month for 2-15 years. Two patients had previously undergone inpatient detoxification. One patient unsuccessfully tried detoxification twice as an outpatient. All patients were required to have psychological support prior to hospitalization for this protocol. BAC was discontinued. A pentobarbital challenge test corroborated butalbital dosage. The patients were given phenobarbital and caffeine which were tapered over several days. Dihydroergotamine (DHE) with metoclopramide was used (Raskin). Propranolol 60 mg bid was started. No narcotics were permitted. After hospital discharge, patients were allowed to continue subcutaneous DHE, as needed. One patient restarted BAC use after 8 months without it. The other two patients were still BAC free 18 and 14 months after detoxification.
Headache 1990 Jul
PMID:A protocol for butalbital, aspirin and caffeine (BAC) detoxification in headache patients. 222 99

Propranolol is an established agent in migraine prophylaxis. Uncontrolled studies have suggested an action in the acute attack. We present the first double-blind placebo controlled study of propranolol in 27 unselected patients with common (migraine without aura) and classical (migraine with aura) migraine. There were 23 pairs of headaches in the 14 patients who completed the study. No difference was found, when the data were analysed by headache pair or by patient, in severity duration and subjective assessment of efficacy between those treated in an attack with propranolol 40 mg and placebo.
Cephalalgia 1990 Oct
PMID:Propranolol in acute migraine: a controlled study. 227 92

A multicenter, randomized, double-blind, comparative study was conducted in 274 patients with mild to moderate hypertension to assess the impact of nitrendipine and propranolol on quality of life. After placebo baseline, 136 patients were given nitrendipine (5-20 mg b.i.d.) and 138 were given propranolol (40-120 mg b.i.d.). Quality of life was evaluated at baseline, weeks 6-10, and weeks 14-18 of the maintenance period. At weeks 6-10, the nitrendipine group became significantly more vigorous (p less than 0.01) and less fatigued (p less than 0.05) than the propranolol group. Propranolol subjects noted decreased problems of trembling hands (p less than 0.01) and alcohol use (p less than 0.05) than the nitrendipine subjects. No other significant differences between groups in mood states, troublesome conditions (insomnia, headaches, and loss of appetite), or sexual satisfaction were noted at this visit, and patient willingness to continue study medication was marginally significantly higher (p less than 0.1) in the nitrendipine group than in the propranolol group. At weeks 14-18, the propranolol subjects perceived significantly decreased problems with the "felt worried, tense, and drank alcohol to cope" factor (p less than 0.05); however, there were no differences between groups at this visit for Profile of Mood States (POMS) scores, sex life variables, or medication preference. Based on within-group analysis, the propranolol group perceived a reduction in partner sexual satisfaction (p less than 0.05). Overall, nitrendipine seemed to be better tolerated than propranolol.
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PMID:Comparison of quality of life on nitrendipine and propranolol. 246 71

We conducted a randomized open-labeled study of nifedipine versus propranolol for the initial prophylaxis of migraine. Propranolol was effective in 67% of patients (12/18) and well tolerated. Nifedipine was effective in only 30% of patients (6/20). The lack of overall efficacy of nifedipine was attributable to a high incidence of side effects, including an unusual symptom complex resembling erythromelalgia. These side effects led 45% (9/20) of the nifedipine patients to withdraw from the study within two weeks. By contrast, no patient (0/18) withdrew from the study within the first 2 weeks of propranolol therapy. We conclude that nifedipine is not an agent of first choice for the prophylaxis of migraine.
Headache 1989 Apr
PMID:Nifedipine versus propranolol for the initial prophylaxis of migraine. 265 67

The clinical efficacy of flunarizine and of propranolol for the prevention of migraine attacks was assessed in a multicenter double-blind study lasting four months which was preceded by a single-blind placebo period of one month. For both drugs, more than half of the patients judged the effect to be good or very good. When considering the patients' daily logs, both drugs produced a significant reduction of the number of attacks. Propranolol furthermore significantly reduced the severity of attacks and the number of analgesics used during the attacks. In both groups no severe side effects were observed.
Headache 1989 Apr
PMID:Flunarizine and propranolol in the treatment of migraine. 265 68


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