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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Animal and clinical pharmacological studies show in certain vascular beds a biphasic action [potentiation and inhibition of serotonin (5-HT) responses] of some anti-migraine drugs, such as ergotamine, methysergide and more recently Org GC 94. Potentiation occurs at therapeutic drug concentrations. The present investigations seem to support the 5-HT theory of migraine and other essential headaches. In this theory, anti-migraine drugs, such as ergotamine, methysergide, pizotifen, and Org GC 94 could reduce the occurrence of pain in migraine and other esscutial headaches by acting as partial agonists tending to correct a deficiency of central 5-HT concentrations or turnover.
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PMID:Clinical and animal pharmacology of migraine: new perspectives. 97 97

Experiments were carried out in order to further delineate the pathophysiology of the fall of plasma 5-hydroxytryptamine (5-HT) during a migraine attack. Platelets from normal subjects were incubated with 14C-labelled 5-HT, and the release of 5-HT was measured following exposure of these platelets to plasma taken from migraine patients during an attack or at headache-free intervals. Plasma taken during attacks released significantly more 5-HT. It is concluded that factor(s) exist in the serum during migraine attacks, which can cause 5-HT release from normal platelets. The identification of this factor may be important.
Pain 1976 Sep
PMID:Release of platelet 5-hydroxytryptamine by plasma taken from patients during and between migraine attacks. 102 4

Transcutaneous administration of a slightly painful electrical stimulus was employed in the management of migraine and other forms of headache in 35 patients with various pictures of pain. Stimulation during crisis led to its total disappearance in 6 subjects with migraine. A relatively high percentage of successes was noted in the remaining patients, with persistence up to 8 months. The theory of "gate control" is cited to explain this effect. Stress is laid on the particular suitability of the method in the management of chronic headache, since it is not associated with either dependence or toxic medicamentous effects.
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PMID:[Transcutaneous nervous stimulation in the treatment of hemicrania and other forms of headache]. 108 1

Available evidence indicates that serotonin located within platelets--or lack of it--does not precipitate migraine attacks, and that intravenously administered serotonin is beneficial in migraine. On this premise, it is not likely that the beneficial effect of intravenously administered serotonin is due to replacement of lost intracellular serotonin. If serotonin is effective in relieving migraine pain, this is probably due to extracellular serotonin acting on the cardiovascular system. In other words, serotonin-induced relief in migraine is probably caused by the pharmacological properties of the amine--it probably acts as a drug and not by replacement. The serotonin changes in migraine are probably not primary, but caused by the disease process. Platelets may nevertheless be of importance in the pathogenesis of migraine, and serotonin may be of even more interest. However, interest in platelet serotonin will probably be diminishing in the future.
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PMID:The significance of blood serotonin levels in migraine. A critical review. 114 99

The author reviews the pertinent literature and the results of own investigations in migraine. EEG changes in migraine are observed in nearly 50% of cases during attacks as well as in the periods free of pains. Most investigations were done in the periods between attacks. The H response characteristic of migraine was found by the author in 25% of cases only. Focal changes were present in 30% of cases. They were not related to the side of the pain, its duration and the form of migraine. Seizure activity was never observed. The author regards isolation of the so-called dysrhythmic form of migraine as not justified. EEG changes suggest--according to the author--that migraine is a primary cerebral and only secondarily a vascular disorder.
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PMID:[Electroencephalographic studies in migraine]. 115 64

Acupuncture techniques, primarily self-administered acupressure, were evaluated as symptomatic treatment for the pain of migraine, histamine cephalgia, and tension headaches. A twenty-four month study was conducted with a general neuropsychiatric outpatient practice of more than 500 patients, seen for more than 5000 outpatient visits; more than 200 patients had significant headache symptomatology. Appropriate pharmacologic, dietary and psychotherapeutic treatments were administered for underlying metabolic, neurologic and psychiatric disorders. The results of the study indicated that acupuncture techniques were reasonably effective in relieving the pain of migraine and tension headaches. Auto-acupressure replaced outpatient prescriptions for analgesics, ergotamine preparations, steroids, propanolol or methysgeride. The value of auto-acupressure was enhanced by its easy availability of application and lack of toxic effects.
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PMID:Treatment of headache pain with auto-acupressure. 125 62

Forty-eight hours after undergoing a successful right carotid endarectomy a patient complained of headache in and behind the right eye radiating to the temple and forehead. The onset of headache was sudden, and the pain was severe and throbbing. After three weeks of regular four- to eight-hour attacks each day the headaches gradually became less frequent. Two months after operation they had disappeared completely. Headache as a complication of endarterectomy is rare, but typically it is vascular and subsides spontaneously in one to six months. If a predisposition to migraine were a precipitating factor many more cases would be expected. No possible explanation for for headache after carotid prearterectomy can account adequately for its apparent rarity.
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PMID:Headache after carotid endarterectomy. 127 21

Studies of regional cerebral blood flow in migraine with aura have shown that the aura phase is associated with hypoperfusion in the cortical area which relates topographically to the clinical symptoms. Thus, the previously hypoperfused area becomes hyperperfused. However, there is no strict association between hyperperfusion and headache. The mode of hypoperfusion propagation recalls the circulatory manifestations of experimental cortical spreading depression. In addition, there are no focal cerebral blood flow abnormalities in migraine without aura. During the headache phase of migraine, dilation of both the large extra- and intracranial arteries takes place. A bulk of biochemical evidence has suggested that the pain in migraine is caused by blood vessels which are dilated and sensitized by circulating pain-producing substances e.g. bradykinin, serotonin and histamine (sterile inflammation). Recently, perivascular trigeminal fibres (trigeminovascular system) which, when stimulated, release sensory peptides (substance P and the calcitonin gene-related peptide) capable of provoking marked vasodilation and plasma extravasation (neurogenic inflammation) have been identified. Thus, the activation of the trigeminovascular system is probably involved in the vasodilatative and nociceptive phenomena of the migraine attack. The finding of a reduced endorphinergic brain tonus in migraine patients supports the hypothesis of a central nociceptive derangement in migraine. Nonetheless, the exact relationship between vasodilation and headache remains to be defined. However, the potent antimigraine effectiveness of sumatriptan--an agonist of the serotonin receptors which selectively constricts dilated arteries during the migraine attack--once again stresses the fact that serotonin is probably the crucial factor in the link between vasodilation and headache.
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PMID:[The pathogenetic bases of hemicrania]. 129 98

After thousands of painful long-lasting migraine or extremely violent cluster headache attacks no one has yet traced histological inflammatory or degenerative alterations of the interested tissues able to explain such dreadful pain. Therefore it has seemed logical to include these pains among the unjustified aimless, non finalized types of pain. Furthermore, clinical characteristics of automatism, explosiveness and the course of these pains resemble other aimless pains like those of organic deafferentation (phantom pain) which appear in a desensitized limb after denervation or even in amputated subjects. Intense and long lasting pains in opioid abstinence, mainly located in the chest and in the hip, also have all the characteristics of aimless pain. Idiopathic cephalic pain, together with deafferentation or opioid-abstinence pain, seems to be due to a dysafferentation which, through different channels, follows an analogous mechanism. This mechanism seems to be due to a deficit of autoanalgesia which in both organic deafferentation (phantom limb) and in opioid-abstinence can be related to the disuse of afferences' modulation. In idiopathic headache such a failure of autoanalgesia is likely to be due to a genetic, idiopathic mechanism. Headaches are characterized by a clear deficiency of autoanalgesia which may manifest itself not only at the level of the cephalic segment, which is so rich in afferences, but it may even involve the whole body. Even if pain is the compulsory phenomenon to diagnose headache, one must consider that migraine is a symptomatic triad in which vegetative and emotional phenomena also emerge. These phenomena are interindependent and not interdependent as each of them may appear as a first manifestation of an attack; one must therefore consider the possibility of a "unicum movens". Serotonin was taken into consideration because of its action which interests all or nearly all vegetative-emotional pain transmitting pathways. Today's identification of four types and various sub-types of 5-HT receptors has revealed the extraordinary eclecticism of this transmitter which within migraine's clinical expression underscores that migraine sufferers are characterized by a marked sensitivity to all the drugs capable of acutely or chronically interacting with serotonin metabolism and binding with many serotonin receptor types and sub-types. So even if the migraine sphinx still proposes its enigma, researchers--with their incurable curiosity--may not only find more and more accurate and effective medication for many human beings but also start penetrating a mystery, a great challenge to human imagination.
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PMID:[Noci-autonomic-affective automatism, the physiopathological essence of hemicrania. The serotonin theory as a guiding principle in the labyrinth of interpretations]. 129

Dissecting aneurysms of cerebral arteries are unusual causes of stroke. The carotid system is the commonest site of this pathology, the vertebral arteries are less involved and dissection of the basilar artery is rare. The authors report three cases of arterial dissection of the vertebrobasilar system, two of the vertebral arteries and one of the basilar artery. An extensive review of the literature is presented. The clinical picture of dissection of vertebrobasilar system was inespecific but pain was a prominent symptom, though had not occurred in the site of the arteries involved. The pain was suggestive of subarachnoid hemorrhage. Associated or risk factors were mild trauma, migraine and high blood pressure. The angiographic findings were suggestive, however just the "double lumen" has been considered pathognomonic. The prognosis is variable. It was benign in case 3, left sequela in case 2, and case 1 rebleed fatally.
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PMID:[Intracranial dissecting aneurysms of the posterior circulation: report of 3 cases and review of the literature]. 130 14


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