Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0392326 (discomfort)
 22,423 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Performance in migraine with and without visual aura, non-specific headache and headache-free control groups was measured using a visual search task. Data from groups with high and low visual discomfort were also gathered. No pattern, 2 c/deg, 15 c/deg and a grey field were used in different background conditions. Presentation of patterned backgrounds slowed performance for all groups with the 2 c/deg pattern producing greatest interference. Performance of headache groups did not differ from that of the control group in any condition. The high visual discomfort group responded significantly more slowly than other groups with the 2 c/deg background. It was concluded that the presence of visual discomfort, reported on an everyday basis was a better indicator of heightened sensory sensitivity than the occurrence of migraine with or without aura.
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PMID:The influence of pattern interference on performance in migraine and visual discomfort groups. 1116 99

We aimed to estimate primary sensory evoked potential (EP) amplitude, amplitude-intensity functions and habituation in migraine patients compared with healthy control subjects and to investigate the possible relation to check size, sound and light discomfort thresholds, and the time to the next attack. Amplitudes of cortical visual evoked potentials (VEP, check size 8' and 33'), cortical long latency auditory evoked potential (AEP NIP1; 40, 55 and 70 dB SL tones) and brainstem auditory evoked potential (BAEP wave IV-V; 40, 55 and 65 dB SL clicks) were recorded and analysed in a blind and balanced design. The difference between the response to the first and the second half of the stimulus sequence was used as a measure of habituation. Twenty-one migraine patients (16 women and five men, mean age 39.3 years, six with aura, 15 without aura) and 22 sex- and age-matched healthy control subjects were studied (18 women and four men, mean age 39.5 years). Low sound discomfort threshold correlated significantly with low levels of BAEP wave IV-V amplitude habituation (r = -0.30, P = 0.05). VEP an AEP amplitudes, habituation, and amplitude-intensity function (ASF) slopes did not differ between groups when ANOVA main factors were considered. Control group VEP habituation was found for small check stimuli (P = 0.04), while potentiation was observed for medium sized checks (P = 0.02). The eight migraine patients who experienced headache within 24 h after the test tended to have increased BAEP wave IV-V ASF slopes (P = 0.08). This subgroup did also have a significant VEP habituation to small checks (P = 0.04). No correlation was found between different modalities. These results suggest that: (i) VEP habituation/potentiation state and brainstem activatio state may depend on the attack-interval cycle in migraine; (ii) VEP habituation/ potentiation may depend on spatial stimulus frequency; (iii) phonophobia (and possibly photophobia) may depend more on subcortical (brainstem) function than on cortical mechanisms; (iv) low cortical preactivation in migraine could not be confirmed; (v) EP habituation and ASF analysis may reflect sensory modality-specific, not generalized, central nervous system states in migraine and healthy control subjects.
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PMID:Visual, long-latency auditory and brainstem auditory evoked potentials in migraine: relation to pattern size, stimulus intensity, sound and light discomfort thresholds and pre-attack state. 1116 10

Questions about discomfort or pain produced by various stimuli (e.g., light, sound, exercise, neck movements) are currently used to differentiate between various primary headache disorders. In order to evaluate the usefulness of differences in sensitivity to physical stimuli in headache diagnosis, the answers to a questionnaire about sensitivity to various stimuli were compared in 68 patients with migraine, 45 with tension-type headache, 46 with cluster headache, and 23 patients with cervicogenic headache, and in 71 controls. Even among controls, a high proportion reported that many of these stimuli could elicit some degree of discomfort or pain. Without headache, migraineurs differed from the other patients with headache and controls mainly in their increased sensitivity to light. With headache, patients with tension-type headache were the least sensitive and migraineurs were the most sensitive to all stimuli, except for stimuli stemming from neck movements, to which patients with cervicogenic headache were most sensitive. Migraineurs also reported the highest degree of sensitivity regarding aggravation and provocation of headache. However, the most striking finding was that all patient groups, cluster headache in particular, became significantly more sensitive with headache than without headache to almost all stimulus categories. This may indicate that these headaches share important pathogenetic mechanisms. The fact that no headache had a very specific sensitivity profile may point to weaknesses of present headache classification systems.
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PMID:Sensitivity to various stimuli in primary headaches: a questionnaire study. 1097 72

The response of different visual discomfort groups to a range of spatial frequencies at threshold and suprathreshold was investigated. In experiment 1, a paired-comparison task was conducted. The high visual discomfort group judged a spatial frequency of 4 cycles deg-1 as the most perceptually distorted and somatically unpleasant to view. The moderate and low visual discomfort groups judged 8 and 12 cycles deg-1 as more perceptually and somatically unpleasant to view than lower spatial frequencies. In experiment 2, the spatial contrast-sensitivity function (CSF) for the high visual discomfort group was depressed for spatial frequencies between 1 and 12 cycles deg-1 in comparison with the moderate and low visual discomfort groups. When these same spatial frequencies were modulated at 6 Hz, CSFs were the same for all groups. These results are discussed in relation to a failure of inhibition across spatial-frequency channels in the high visual discomfort group. This may be explained by a more generalised parvocellular system processing deficit. Possible similarities between some forms of migraine and visual discomfort are highlighted.
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PMID:Visual discomfort: the influence of spatial frequency. 1143 Feb 42

Two experiments that investigate automatic and conscious attention among migraine and visual discomfort groups are reported. The prediction of a heightened sensory sensitivity producing a processing speed advantage in migraine was tested. In Experiment 1, an automatic attention task was conducted. There was no effect of migraine group, but the high visual discomfort group responded significantly more slowly than the low visual discomfort group when 16 distractors were presented. In Experiment 2, a conscious visual attention task was conducted. No processing-speed advantage was found for migraine groups. In all conditions, the high visual discomfort group performed significantly more slowly than other groups. It was concluded that heightened sensory sensitivity could not explain the processing speed advantage found previously in migraine but may explain the processing speed disadvantage found for the high visual discomfort group. Results are discussed in terms of disordered sustained attention in the high visual discomfort group.
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PMID:Visual search in migraine and visual discomfort groups. 1170 43

The author describes a range of contraceptive methods, and their side effects, which may be acceptable for new parents. The methods are the oral contraceptive pill, Norplant, Depo-Provera, and intrauterine devices (IUD). Natural methods and permanent contraception are options described in insets. The author notes that differences in the effectiveness rates among available types of oral contraceptive pills are small enough not to merit consideration when deciding which kind of pill may be appropriate. Combination birth control pills are taken daily at the same time for 21 out of 28 days. Combination pills are not recommended for women with a history of hypertension or other cardiovascular diseases, thrombophlebitis, migraine headaches, diabetes, active gallbladder disease, or mononucleosis. Any hormonal method may be particularly risky for smokers over age 35. The mini-pill, containing a smaller amount of progesterone and no estrogen, is taken every day and is also on a 28-day cycle. Containing no estrogen, the mini-pill is often recommended for women who are nursing, who are over age 35, or who suffer from hypertension or migraines. Both adverse and positive side effects may be experienced from use. Norplant is the brand name of a contraceptive system which releases progesterone from under the skin of a woman's upper arm over the course of a five-year period. The system has a theoretical effectiveness rate of more than 99%, although the duration of effectiveness may be less than five years in overweight women. The most common side effect is irregular bleeding, and removal is often a longer and more difficult procedure than insertion. The most commonly used injectable hormonal contraceptive is Depo-Provera, a progesterone solution which works for up to three months. The majority of users experience some side effects. Finally, IUDs are highly effective and need to be replaced only every 1-10 years depending upon how they are made. Women typically experience discomfort during IUD insertion, and they should not be used by women under age 20 years, who have never had children, or who have ever had a pelvic infection.
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PMID:Birth control for new parents. 1229 Aug 91

There are conflicting reports in the literature concerning the neuropsychological functioning of migraine headache patients. The finding in some studies that migraineurs performed more poorly than healthy controls led to the hypothesis that chronic migraine may result in subtle but persistent cerebral dysfunction. Reports describing acute and between-headache neurophysiological disturbances in migraineurs lent support to this hypothesis. To elucidate the cognitive status of these patients, we administered a brief neuropsychological battery to 60 individuals with migraine headache (HA), nonheadache chronic pain (PAIN), or mild traumatic brain injury (MTBI). The PAIN group was included to test the hypothesis that cognitive difficulty in migraineurs might result from the discomfort, depression, medications, etc. often associated with chronic pain, rather than from brain dysfunction. The MTBI patients were considered a useful comparison for the migraineurs because their level of impairment was also expected to be mild, at worst. A MANOVA, with three cognitive index scores as the dependent variables, revealed that the three groups differed significantly. Follow-up contrasts demonstrated that the MTBI group was significantly more impaired on the memory index compared to the HA and PAIN groups, which did not differ from each other. The use of two different normative-based cutoffs to identify individuals who were impaired on the test battery revealed that the frequency of impairment within the two groups of pain patients, but not the MTBI patients, was within normal limits. Thus, the results did not support a link between migraine headache and cognitive impairment.
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PMID:Neuropsychological functioning in migraine headache, nonheadache chronic pain, and mild traumatic brain injury patients. 1459 May 92

Symptoms of Restless Legs Syndrome (RLS) can begin in childhood and persist into adulthood. To our knowledge, no one has done a systematic review of the literature to determine if the descriptions of 'growing pains' are consistent with the diagnosis of childhood RLS. Our group and that of Ekbom have noted that childhood onset RLS can be misdiagnosed as 'growing pains'. We therefore reviewed the work of seven groups of authors that addressed 'growing pains' as an isolated phenomenon in order to determine whether the descriptions of 'growing pains' were consistent with the clinical features of RLS. We found no consistent pattern in the descriptions even when articular pain was excluded. Thus, it is unlikely that all patients with 'growing pains' have RLS and it is likely that 'growing pains' is a heterogeneous disorder. The aforementioned authors were not looking for features unique to RLS and descriptions of the complete symptom complex of RLS are usually lacking. Further complicating the data are problems with methodology, e.g. in some studies small children and their parents were asked to retrospectively recall remote and infrequent events, and in other studies, articular pain was not adequately ruled out. Inconsistent with the hypothesis that RLS and 'growing pains' are the same are the high association of 'growing pains' with migraine headaches and abdominal pain. However, from this background emerge subsets of patients with 'growing pains' that are described as having one, some, or all of the following features consistent with the diagnosis of RLS: symptoms that are primarily in the legs, the patients rub their legs to get relief of the discomfort, the symptoms are worse at night, sleep disturbance is present and the discomfort is sometimes accompanied by motor restlessness A non-painful form of 'growing pains' has even been described. Ekbom and Brenning, a contemporary of Ekom, directly addressed the relationship between 'growing pains' and RLS. Ekbom felt that 'growing pains' and RLS were probably different since 'growing pains' disappear after childhood and one of his patients described her childhood 'growing pains' as being different from the sensory discomfort of her adult onset RLS. However, Brenning showed that RLS-like features in adulthood and a previous history of 'growing pains' in childhood occurred far more frequently in the parents of children with 'growing pains' than in control parents. More work needs to be done on the potential relationship between 'growing pains' and RLS.
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PMID:Is there a subpopulation of children with growing pains who really have Restless Legs Syndrome? A review of the literature. 1459 26

The aim of this study was to determine whether trigeminal nerve discharge associated with painful stimulation of the temple would intensify symptoms of motion sickness in migraine sufferers. If so, this would support the notion that symptoms such as nausea and headache interact with each other during attacks of migraine. Symptoms of motion sickness were rated at 2 min intervals during 15 min of optokinetic stimulation in 27 migraine sufferers and 23 age- and sex-matched controls. To document changes in frontotemporal blood flow, pulse amplitude was monitored with photoelectric pulse transducers. To induce facial pain, ice was applied to the temple for 30 s, three times at 4 min intervals during optokinetic stimulation. On another occasion, pain was induced during optokinetic stimulation by immersing the non-dominant hand in 2 degrees C ice water for 30 s, three times at 4 min intervals. On a third occasion, measures were obtained during optokinetic stimulation alone. Migraine sufferers rated themselves as being generally more susceptible to motion sickness than controls. In addition, symptoms of motion sickness provoked by optokinetic stimulation were greater in migraine sufferers than in controls. Painful stimulation of the temple intensified nausea and headache during optokinetic stimulation, whereas painful stimulation of the hand did not. Since nausea also intensifies facial pain during motion sickness, nausea and headache may reinforce each other in a vicious circle. In the absence of painful stimulation, increases in pulse amplitude during optokinetic stimulation were greater in migraine sufferers than controls, possibly because the discomfort associated with motion sickness triggered extracranial vasodilatation in migraine sufferers as part of a fight-or-flight (defense) response. Extracranial vasodilatation did not differ between migraine sufferers and controls when ice was applied to the temple or hand during optokinetic stimulation, implying that the additional discomfort associated with painful stimulation of the head and hand evoked a defense response in controls. These findings suggest that a mechanism which boosts extracranial neurovascular reflexes to stress and which heightens symptoms of motion sickness, increases susceptibility to migraine.
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PMID:Facial pain increases nausea and headache during motion sickness in migraine sufferers. 1549 9

Cutaneous allodynia, pain resulting from application of a non-noxious stimulus to normal skin, is a recently described symptom of migraine, with a potential role in directing optimal treatment for migraine attacks. Manifestations of cutaneous allodynia include discomfort when combing the hair, shaving, and wearing glasses, contact lenses, earrings or tight clothing. The exact mechanism by which a migraine attack is triggered is not known, but it has been theorised that, in some patients, once the attack has begun, central neurons can propagate information about the pain process without the need for further external stimuli. This process is termed central sensitisation. The trigeminal nerves, which innervate intracranial and extracranial tissues, account for head pain and other symptoms in migraine. The first-order neurons in the trigeminal ganglion receive input from the dural blood vessels, which is transmitted to second-order neurons in the trigeminal brain stem nuclear complex and is finally sent to the third-order neurons in the thalamus. Studies in humans and animals have shown that migraine pain progresses along this neural pathway, with throbbing head pain occurring early in the attack (sensitisation of first-order neurons), followed by central sensitisation and cutaneous allodynia within the referred pain area (second-order) and finally extracephalic allodynia (third-order). The data also indicate that once central sensitisation is established in the second- and third-order neurons, migraine treatment designed to prevent the initiation of central sensitisation can lessen the pain to some extent but cannot reverse it. Thus, treatment affecting the initiation of central sensitisation should be administered immediately after the onset of migraine pain to prevent intracranial hypersensitivity and the establishment of allodynia. The serotonin 5-HT(1B/1D) agonist anti-migraine agents (the 'triptans') block meningeal nociceptor transmission at presynaptic sites in the dorsal horn. Studies have shown that triptan therapy can abort pain prior to the development of central sensitisation, but not after allodynia has been established. Therefore, in the subset of patients who report symptoms of cutaneous allodynia with migraine attacks, early initiation of triptan therapy is currently the best intervention to achieve rapid, complete and sustained pain relief.
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PMID:Central sensitisation and cutaneous allodynia in migraine: implications for treatment. 1672 88


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