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 case is described of a 23-year-old female patient presenting with unilateral proptosis, headaches, and transient epiphora. Surgery revealed an encapsulated tumour composed exclusively of spindle-shaped cells within a richly vascularised myxoid stroma. Immunohistochemical staining showed focal positivity for smooth muscle actin, vimentin, and glial fibrillary acidic protein. These combined findings are interpreted as providing evidence of a myoepithelioma, which may be regarded as a monomorphic adenoma consisting solely of myoepithelial cells. To our knowledge this is only the second report of such a tumour in the lacrimal gland.
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PMID:Myoepithelioma of the lacrimal gland: report of a case with spindle cell morphology. 132 39

Electrodermal responses (as a measure of sweating) and vascular responses to irritation of the eye were investigated in 11 cluster headache patients and, for comparison, in another 24 patients with a confirmed site of lesion in the cervical sympathetic pathway. Seven of the cluster headache patients had ocular and thermoregulatory signs of a postganglionic sympathetic lesion. In these patients, and in six of seven patients with a postganglionic sympathetic lesion from some other cause, the electrodermal response to ocular stimulation was far greater on the denervated side of the forehead than on the sympathetically intact side. This pathological response can be explained by lacrimotor fibres branching into vacant sympathetic sudomotor pathways. The response could account for excessive forehead sweating during attacks of cluster headache, in spite of the presence of Horner's syndrome, because parasympathetic outflow to the lacrimal glands increases during attacks. In patients with diminished sympathetic vasomotor outflow, the vascular response to ocular irritation was also greater on the denervated side of the forehead than on the sympathetically intact side, irrespective of the site of the lesion. The excessive vascular response in sympathetically denervated skin could be caused by adaptive supersensitivity to peptides such as vasoactive intestinal polypeptide, which is known to be released from parasympathetic terminals. The same mechanism might augment vasodilatation during attacks of cluster headache.
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PMID:Pathological sweating and flushing accompanying the trigeminal lacrimal reflex in patients with cluster headache and in patients with a confirmed site of cervical sympathetic deficit. Evidence for parasympathetic cross-innervation. 142 97

The 'idiopathic' dacryostenosis has not yet been cleared up in its aetiological aspects. For further explanation of aetiology and pathomechanisms an experimental, anatomical study was made. Its object was to define the angles and measurements within the bony lacrimal structures and to establish possible connections between the development of the postsaccal stenosis and certain bony constellations of the lacrimal system. The main goal of these examinations was to determine the angle between the lacrimal fossa and the main direction of the nasolacrimal canal, as well as the angles which are found in the course of the nasolacrimal canal. Macerated half skulls obtained from anatomical dissection courses were used for this study. After cleaning the bony lacrimal passages, the distal orifice of the nasolacrimal canal was closed with bone wax. The canal and the lacrimal fossa were filled with epoxy resin. After hardening the preparations were radiographed in order to make sure that the whole system was completely filled with resin. Then the surrounding bone was removed chemically and the resin casts were laid free. They were photographed and the photographs were traced and measured. A trigonometric method was then used for constructing the maximum angle between the lacrimal fossa and nasolacrimal canal. This angle was mainly directed dorsomedially and showed a considerable amount of variation. A bony system with a large angle increases the possibility of acquiring a postsaccal dacryostenosis. The bony angle is one of many factors facilitating an ascending inflammation in the lacrimal mucosa. Clinically we have to differentiate the acute, fresh dacryocystitis from the chronic, recurrent dacryocystitis. The main symptoms are epiphora, pain and inflammation in the medial canthal area and headache. The most important diagnostic examinations are the slitlamp examination of the eyelids, of the lacrimal puncta and of the anterior segment of the globe, the 'lacrimal punctum excursion test', the diagnostic rinse of the lacrimal passages, the dacryocystography and the rhinological examination. The result of a successful treatment of the acute, beginning dacryocystitis is to open the incomplete, transitory, distal stenosis of the nasolacrimal duct. The stenosis is caused by an ascending inflammation from the nose and by the swelling of the lacrimal mucosa. The blockage can be solved by massage after application of vasoconstrictory drops. The therapy of a complete, postsaccal lacrimal stenosis always has to be a dacryocystorhinostomia externa ('Toti-operation'). The Kaleff-Hollwich modification proved successful and is extended by a fibrin sealing method.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The postsaccal, idiopathic dacryostenosis--experimental and clinical aspects. 378 Mar 77

Complications from mydriatic and cycloplegic drugs are rare compared with their extensive use. Adverse effects are often related to dosage or other factors. The ocular complications include increased intraocular pressure, pigmentation of the conjunctiva and cornea, pigment in the anterior chamber, lacrimal duct blockage, macular edema, corneal endothelium damage, hyperemia, allergy, discomfort, and blurred vision. The systemic complications are those common to sympathomimetic and parasympatholytic drugs and include tachycardia, hypertension, headache, faintness. pallor, trembling, excessive sweating, palpitations, arrhythmias, confusion, hallucinations, drowsiness, ataxia, flushed skin, high fever, dysarthria, thirst, dry mouth, convulsions, disorientation, nervousness, coma, and death. An understanding of all possible side effects is of paramount importance to those using these drugs in the treatment of anticholinesterase poisoning. This review is intended as a ready reference to the adverse effects of mydriatic and cycloplegic drugs.
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PMID:Mydriatic and cycloplegic drugs: a review of ocular and systemic complications. 703 29

Neuralgia of the trigeminus (NT) is the most common of cranial nerve neuralgias. Its diagnosis is entirely clinical and its most common form of presentation is well understood. Questions of differential diagnosis can emerge with certain entities such as atypical trigeminal neuralgia, short-duration unilateral neuralgiform cephalea of the trigeminus (SUNCT) arising from injection to the conjunctival, lacrimal or other glands, cluster headache, chronic paroxymal hemicrania, pain arising in the teeth and myofacial pain syndrome. The three main causative factors of NT are compression of the nerve root by an artery in the prepontine space, thereby creating an area of demyelinization, compression of the nerve by a tumor, and multiple sclerosis. The first is the most common of the three. NT can be classified as essential in 10 to 30% of patients. Recent advances in magnetic resonance (MR), and its advantages over other imaging systems, have made MR the diagnostic method of choice. The first treatment is medical and the basic drugs involved can be considered classic. Other therapies have been suggested in recent years, however, and should probably be studied further. Two substances stand out among those proposed: tocainide, an antiarrhythmic drug, and pimozide, an antipsychotic. Surgical treatment of NT can address either the cause (tumor or vascular compression) or symptoms, the latter being indicated when medical treatment fails. Surgery can be performed on peripheral nerves, on the gasserian ganglion and on the posterior fossa. The indications, outcomes and possible complications are quite different for each approach, making choice controversial.
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PMID:[Diagnosis and treatment of the patient with trigeminal neuralgia]. 930 3

Subjective and autonomic responses to visual stimulation and facial pain were investigated in 10 migraine sufferers and 21 'non-headache' control subjects. Ratings of glare- and light-induced pain were greater in migraine sufferers than control subjects. In migraine sufferers, glare ratings increased during painful mechanical stimulation of the nasal ala, the side of the nose and the back of the neck. Glare ratings decreased in both groups during painful stimulation of the chin. Light-induced pain increased during painful stimulation of all four sites in migraine sufferers, but not control subjects. Increases in forehead pulse amplitude during painful mechanical stimulation were greater bilaterally in migraine sufferers than in control subjects, consistent with loss of inhibitory influences on vascular reactions in the face. Visual stimulation facilitated lacrimation when the nasal ala was pinched, but visual stimulation coupled with pain elsewhere in the head and neck did not. The lacrimal response to combined nasal ala and visual stimulation was absent on the symptomatic side in patients with unilateral headache, indicating local parasympathetic deficit in migraine. These findings suggest that migraine is associated with loss of inhibitory subcortical processes which normally suppress sensations of glare and light-induced pain, and which may also suppress vasodilator responses to facial pain. Loss of inhibitory pain-control mechanisms could interact in a vicious circle with autonomic disturbances during migraine.
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PMID:Photophobia and autonomic responses to facial pain in migraine. 936 75

Sarcoidosis is a systemic granulomatous disease of unknown etiology that has a wide variety of clinical manifestation. Lung involvement may slowly undergo pulmonary fibrosis. Chronic sarcoid arthritis is a rare, usually non destructive arthropathy; may be a mono, oligo or polyarthritis. Knees, ankles, shoulders, wrists and small joint of the hands and feet may be involved. It can involve skin, eyes, exocrine glands such as salivary and lacrimal glands, and many other tissues. We describe the case of a 77 years old woman with a history of rhinopharyngitis with epistaxis and chronic laryngitis since youth; a dry mouth and throat, a erythematous, infiltrative skin lesion in the forehead and in the nape of the neck, a purple lesion of the left ear and nose, skin dystrophy of the hands from 30 years before. She underwent an operation for a left femoral fracture with hemotransfusion 14 years ago. Then she developed a polyarthritis of the small joints of the hands (II, III and IV right DIP, I, III, e V left DIP; III and V bilateral PIP), knees, tarsi, toes and left elbow. An HCV chronic hepatitis was discovered 6 years before. She is affected by productive cough, dysphonia, dyspnoea at rest, fever, headache and asthenia for over 5 years. Laboratory examination revealed leukopenia, HCV hepatitis with anti HCV, HCV-RNA, transaminases elevated and cryoglobulinemia. HCV may be involved in the etiopathogenesis of rheumatic diseases, lung fibrosis and may moreover contribute to the onset or progression of sarcoidosis; the possible pathogenesis is discussed.
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PMID:[Chronic polyarthritis in a patient affected by sarcoidosis and chronic HCV infection. Case report and review of the literature]. 1210 83

A comparative randomised double masked multicentric clinical trial has been conducted to find out the efficacy and safety of a herbal eye drop preparation, itone eye drops with artificial tear and placebo in 120 patients with computer vision syndrome. Patients using computer for at least 2 hours continuosly per day having symptoms of irritation, foreign body sensation, watering, redness, headache, eyeache and signs of conjunctival congestion, mucous/debris, corneal filaments, corneal staining or lacrimal lake were included in this study. Every patient was instructed to put two drops of either herbal drugs or placebo or artificial tear in the eyes regularly four times for 6 weeks. Objective and subjective findings were recorded at bi-weekly intervals up to six weeks. Side-effects, if any, were also noted. In computer vision syndrome the herbal eye drop preparation was found significantly better than artificial tear (p < 0.01). No side-effects were noted by any of the drugs. Both subjective and objective improvements were observed in itone treated cases. So, itone can be considered as a useful drug in computer vision syndrome.
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PMID:Comparative randomised controlled clinical trial of a herbal eye drop with artificial tear and placebo in computer vision syndrome. 1460 80

A 17-year-old boy presented with a left upper lid swelling, headaches and diplopia. An orbital computerized tomography (CT) scan showed a mass in the left lacrimal fossa eroding bone and extending into the temporalis fossa and intracranially. An urgent biopsy without curettage was carried out and showed Langerhans cell histiocytosis. He was otherwise well and no other lesion was found. He was therefore observed and reviewed regularly. During follow-up it was noted that the mass was reducing in size. Five months after the initial biopsy a further procedure, involving curettage and an intralesional steroid, was carried out at a tertiary referral center. Histology of the material obtained showed no remaining evidence of Langerhans cell histiocytosis. Spontaneous resolution of orbital Langerhans cell histiocytosis has been described clinically and radiologically. This is the first case of spontaneous resolution to be confirmed histologically.
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PMID:Biopsy-confirmed spontaneous resolution of orbital langerhans cell histiocytosis. 1576 15

Since its introduction into clinical medicine in 1980, botulinum toxin has become a major therapeutic drug with applications valuable to many medical sub-specialties. Its use was spearheaded in ophthalmology where its potential applications have expanded to cover a broad range of visually related disorders. These include dystonic movement disorders, strabismus, nystagmus, headache syndromes such as migraine, lacrimal hypersecretion syndromes, eyelid retraction, spastic entropion, compressive optic neuropathy, and, more recently, periorbital aesthetic uses. Botulinum toxin is a potent neurotoxin that blocks the release of acetylcholine at the neuromuscular junction of cholinergic nerves. When used appropriately it will weaken the force of muscular contraction, or inhibit glandular secretion. Recovery occurs over 3 to 4 months from nerve terminal sprouting and regeneration of inactivated proteins necessary for degranualtion of acetylcholine vesicles. Complications are related to chemodenervation of adjacent muscle groups, injection technique, and immunological mechanisms.
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PMID:Botulinum toxin in ophthalmology. 1721 88


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