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

An outbreak of lymphocytic choriomeningitis (LCM) associated with pet hamsters adquired through nationwide distributor was recognized in New York in February 1974. In upstate a New York, 57 cases occurred in a four-month period. Complete information was obtained on 49 patients ranging in age from 3 to 70 years. Characteristic findings included fever (90%), headache (85%), and severe myalgia (80%). Typically, laboratory findings consisted of a normal blood cell count and cerebrospinal fluid with mononuclear leukocyte pleocytosis and moderate hypoglycorrhacia. Al patients had contact with hamsters from one distributor. Most of the hamsters were acquired in mid to late December 1973, but some as late as March 1974. From each of eight families in which hamsters were available, at least one hamster had detectable complement-fixing antibodies for LCM. Infection rates within families varied with location and type of hamster cage; open cages and cages situated in common living areas were associated with highest infection rates (45% and 52%, respectively). Severity of illness was not associated with direct contact with hamsters. Onset of illness occurred between 8 and 90 days after initial exposure to hamsters.
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PMID:Lymphocytic choriomeningitis outbreak associated with pet hamsters. Fifty-seven cases from New York State;. 117 41

This report describes a patient with primary alveolar hypoventilation who, after 2 yr of successful treatment with nocturnal oxygen, developed severe hypoxemia and hypercapnia during sleep, morning headaches, and daytime fatigue. Sleep studies demonstrated prolonged periods of hypoventilation and apnea without evidence of upper airway occlusion. Therefore, a phrenic nerve stimulator was implanted to allow pacing of the diaphragm during sleep. However, diaphragm pacing was accompanied by paradoxical movement of the rib cage and upper airway occlusion during sleep, and was unsuccessful in maintaining adequate ventilation. Therefore, the patient underwent a tracheostomy after which diaphragm pacing maintained adequate nocturnal ventilation; however, paradoxical movement of the rib cage persisted. The induction of upper airway occlusion as a result of diaphragm pacing, in contrast to the absence of occlusion during spontaneous breathing, highlights the importance of the normal temporal coordination of inspiratory activation of the upper airway muscles and diaphragm. The findings have important implications for the pathogenesis of obstructive sleep apneas in general.
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PMID:Upper airway occlusion induced by diaphragm pacing for primary alveolar hypoventilation: implications for the pathogenesis of obstructive sleep apnea. 697 4

Chemical dependence is a leading cause of morbidity and death in the United States. At least 20% of patients seen by primary care physicians in both the outpatient and inpatient setting are chemically dependent. Up to 90% of these patients go undiagnosed by their primary physicians. Chemical dependence is defined as a chronic, progressive illness characterized by the repeated and persistent use of alcohol or drugs despite negative health, family, work, financial, or legal consequences. Primary care physicians are in an ideal position to detect chemical dependence at its earliest stages, when irreversible medical consequences and death are most likely preventable. Alcohol is the most common drug of abuse. Improving the rate of recognition of chemical dependence depends on being familiar with the constellation of physical, mental, and social indicators. Early medical manifestations of alcoholism common in the primary care setting include: gastric complaints, elevated blood pressure, palpitations, traumatic injuries, headaches, impotence, and gout. Early psychosocial manifestations common in both alcohol and drug dependence include anxiety, depression, insomnia, persistent relationship conflicts, work or school problems, and financial or legal problems. Particularly useful laboratory indicators of alcoholism include elevated levels of GGT and MCV, both displaying high specificity, with the GGT level being the most sensitive. Similarly specific laboratory tests for drug dependence are not available. Any patient presenting with any of the above medical, psychosocial, or laboratory manifestations should be screened for chemical dependence. The CAGE questionnaire for alcoholism, a four-question test, is particularly well suited to the primary care setting, where it can be administered in fewer than 60 seconds. The CAGE has demonstrated high sensitivity (in the 80% range) and specificity (approximately 85%) for alcoholism. Comparably convenient instruments do not yet exist for drug dependence, although a 28-item instrument, the DAST (Drug Abuse Screening Test), has demonstrated high sensitivity and specificity for drug abuse.
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PMID:Early recognition of chemical dependence. 846 47

What are the earliest indications of cancer? What prompts an apparently healthy person to suspect that 'something may be wrong'? The first manifestations may involve a growing awareness of neuronal dysfunction, such as headaches, dizziness, physical degeneration or vision abnormalities. While denial may extend the time between the patient's appreciation of the health hazard, particularly if the indications are subtle, a sudden decline in vision may be one of the most readily perceived, and provide the strongest stimulation to seek medical help. Cancer-induced neuropathies are rare but provide much information on the genesis of a defined group of autoimmune reactions, and the biological mechanisms involved. The secondary effects of neoplasia, collectively termed paraneoplasia, are often the first indication of cancer. Sudden weight loss is one of the most recognised early signs, and is known to result from biochemical effects on tissues distant from the site of the growth. More recently, immunologic phenomena have been implicated in a series of different paraneoplasia. Examples, such as Lambert-Eaton myasthenic syndrome (LEMS), paraneoplastic cerebellar degenerations (PCD) and cancer-associated retinopathy (CAR) can be identified immunologically through the detection of autoantibody reactions with defined proteins. Interest in the clinical significance of paraneoplastic-associated immunologic reactions increased following the recognition of their strong disease association; PCD patients produce autoantibodies reactive with brain proteins, LEMS patients with muscle components and CAR patients with ocular antigens. Blood tests designed to detect these unusual autoantibody reactions are now in commercial use to identify different forms of paraneoplasia, sometimes before the neoplasm responsible has been identified. The cause of paraneoplasia-related autoimmune reactions has, in some cases, been traced to the patient's cancer, an immunologic connection based upon research findings and published reports of biopsies and cultures that actively express the key proteins involved in cancer-associated organ-specific hypersensitivity.
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PMID:Cancer-induced retinal hypersensitivity. 891 51

Respiratory muscle weakness may be the sole cause of dyspnea or may aggravate dyspnea due to another respiratory disease, and is often difficult to recognise clinically. The assessment of respiratory muscles should follow a graded approach using tests of increasing complexity. Clinical examination should look for dyspnea, orthopnea, morning headache, daytime somnolence, fatigability, tachypnea, abdominal, or rib cage paradox, and amyotrophy. Imaging is useful in diagnosing diaphragmatic paralysis using chest radiograph, fluoroscopy or ultrasound. In cases of moderate to severe respiratory muscle weakness, lung volumes show reduced vital capacity and total lung capacity. Measuring the change in vital capacity from sitting to supine position is useful since it shows a 25-50% fall in cases of diaphragmatic paralysis. The specific and classical tests of respiratory muscle strength are maximum inspiratory and expiratory pressures (MIP and MEP) sustained during one second against near complete occlusion. Sniff nasal inspiratory pressure (SNIP) is a new and easier test of inspiratory muscle strength. Normal values obtained with these simple tests rule out clinically significant respiratory muscle weakness. In case of doubt, more complex and invasive tests can be used such as transdiaphragmatic pressure and magnetic stimulation of the phrenic nerves.
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PMID:[Evaluation of respiratory muscles]. 975 85

Children with hypertension, seizures, lethargy, encephalopathy, headache, and occipital blindness are reviewed. After undergoing antihypertensive therapy, most children improve. Some patients have a similar syndrome associated with chemotherapy, transplantation, transfusion, or human immunodeficiency virus-1 (HIV-1) infection. These latter children can develop symptoms with only minimal or no discernible elevations in blood pressure and improve, in the case of cancer-associated encephalopathy, after discontinuing chemotherapy. The reported children with this distinctive clinical condition are compared to adults with reversible posterior leukoencephalopathy syndrome. Since both gray and white matter are involved, we had suggested previously that the name be changed to (reversible) occipitoparietal encephalopathy syndrome. However, reversible posterior leukoencephalopathy has been used in the adult population and probably should be employed in children for the sake of uniformity, since both children and adults have the same clinical presentation and presumably a similar pathophysiology for the encephalopathy syndrome. The diagnosis is confirmed by reversible posterior abnormalities seen on T2-weighted brain magnetic resonance imaging, and by the presence of either headache, altered mental status, seizures, or visual disturbances.
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PMID:Hypertensive encephalopathy, reversible occipitoparietal encephalopathy, or reversible posterior leukoencephalopathy: three names for an old syndrome. 1034 93

Efavirenz is a non-nucleoside reverse transcriptase inhibitor that is used in the treatment of the HIV-1 variant. Adverse central nervous system side effects such as headache, dizziness, insomnia, fatigue, severe depression and suicidal ideation are noted in patients receiving efavirenz. In this study, the effects of efavirenz on changes in behaviour and on some pro- and anti-inflammatory cytokines in Wistar rats were studied to assess whether efavirenz causes depressive symptoms via the cytokine network and, if so, whether antidepressant therapy known to attenuate the effects of pro-inflammatory cytokines could prevent these changes. The efavirenz-treated rats displayed spatial memory deficits in the Morris water maze. These rats also appeared to be more susceptible to stress than the other groups as seen by an increase in the latency to emerge in the home cage emergence test following the stress of the Morris water maze. The concentrations of pro-inflammatory cytokines interleukin-1 beta and tumour necrosis factor-alpha were also significantly higher in the efavirenz group. The antidepressant paroxetine reduced the susceptibility to stress and prevented such an increase in pro-inflammatory cytokines. It is concluded that efavirenz induces depressive-like behaviour in the rat and a susceptibility to stress, which are accompanied by an increase in pro-inflammatory cytokines. These symptoms are partially alleviated by chronic treatment with paroxetine.
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PMID:Efavirenz induces depressive-like behaviour, increased stress response and changes in the immune response in rats. 1616 8

We report a rare case of severe facial pain and headache due to cervical spondylosis successfully treated by surgical intervention. A 48-year-old woman had been suffering from severe left side facial pain and headache since she was 44 years old. Analgesics were not effective. At 48 years of age, a magnetic resonance imaging of the cervical spine revealed a degenerated disk at the C5/6 level with encroachment on the foramina and the cord. Anesthetic blockade to the C5/6 facet joint was effective, but was temporary. After the anterior decompression and stabilization using a titanium cage, the pain disappeared completely and has not recurred through 1 year of follow up. This report indicates that lower cervical root compression may cause cervicogenic headache, which can be treated effectively by surgical intervention.
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PMID:[Cervicogenic headache caused by lower cervical spondylosis]. 1943 99

Approaches to ventrally located intramedullary lesions of the upper cervical spine can be extremely challenging. We present a custom-tailored, minimally invasive anterior approach to a ventrally located, intramedullary cavernous hemangioma with partial lateral corpectomy of C2, complete resection of the lesion and subsequent reconstruction. A 20-year-old woman presented with the history of progressive numbness of the left upper and lower extremities and some episodes of severe headaches was referred to magnetic resonance imaging: Here, an intramedullary lesion with typical radiological features for a cavernous malformation at the ventral surface of the spinal cord at the C2 level was detected. The surgical procedure was performed under general anesthesia and electrophysiological monitoring (somatosensory-evoked potentials (SEP), muscle motor-evoked potentials (MEP), and D-wave recording). Complete resection of the cavernous malformation was achieved and reconstruction of the cervical spine was performed using a custom-tailored cage. Intraoperative neuromonitoring during resection, revealed a transient MEP loss, but unchanged D-wave and SEP recordings indicated unchanged neurological outcome. Early clinical follow-up of the patient revealed no new neurological deficits. At 3-month follow-up, there was some improvement of the sensory function. This custom-tailored minimally invasive anterior approach to a ventrally located intramedullary cavernous malformation with partial C2-corpectomy describes a possible and successful approach to ventrally located intramedullary lesions of the upper cervical spinal cord. Additionally, the hereby-described approach is not related to cervical instability.
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PMID:Custom-tailored minimally invasive partial C2-corpectomy for ventrally located intramedullary cavernous malformation. 2356 96

Orofacial pain may be a symptom of diverse types of cancers as a result of local or distant tumor effects. The pain can be presented with the same characteristics as any other orofacial pain disorder, and this should be recognized by the clinician. Orofacial pain also can arise as a consequence of cancer therapy. In the present article, we review the mechanisms of cancer-associated facial pain, its clinical presentation, and cancer therapy associated with orofacial pain.
Curr Pain Headache Rep 2015 Aug
PMID:Cancer and Referred Facial Pain. 2608 59


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