A time series analysis of daily hassles and mood changes in the 3 days before the migraine attack.

Daily hassles, mood changes, and sleep quality in the 3 days preceding migraine attacks were prospectively studied and compared with migraine-free control days. Nineteen female migraine patients, aged 20 to 49 years, kept a 10-week diary four times per day and produced complete data on daily hassles (incidence and stressfulness), mood (alert, tense, irritable, annoyed, depressed, and tired), sleep quality, and migraine. Significant results indicated increased hassles, particularly in the 24 premigraine hours; psychological arousal (increased irritability, annoyance, and tenseness), predominantly from 60 to 24 hours before the attack; repeated fatigue in the 60 premigraine hours, with a peak immediately before the attack; and a sharp decrease in sleep quality in the night preceding the attack.

Changes in daily hassles, mood, and sleep in the 2 days before a migraine headache.

Objective: The determination of the changes in the incidence and stressfulness of daily hassles as well as in the mood states: alert, tense, irritable, annoyed, depressed, and tired and in the quality of sleep in the 2 days before a migraine headache.

Design: Prospective cohort study.

Setting: Private headache practice.

Molecular characterization and T-cell-stimulatory capacity of Mycobacterium leprae antigen T5.

A Mycobacterium leprae lambda gt11 clone designated T5 has previously been selected with sera from tuberculoid leprosy patients. Sequence analysis of this clone revealed the presence of two overlapping open reading frames (ORFs) present on the two cDNA strands. The first ORF codes for the serologically recognized antigen, which was fused with the lacZ gene in the lambda gt11 clone.

Symptomatology and pathogenesis of migraine.

Migraine is a paroxysmal disorder of which headache is the central symptom. The headache is generally so intense that it is associated with other symptoms, such as nausea, vomiting, photo- and phonophobia. In so-called classic migraine or migraine with aura, the headache is preceded by transient focal neurological symptoms, generally referred to as aura symptoms.

Idiopathic stabbing headaches lasting a few seconds.

Four cases of idiopathic stabbing headache subjectively perceived as lasting several seconds are reported. The classification of the International Headache Society suggests that these headaches typically last "a fraction of a second". The perception of such brief pains may be difficult to quantitate and, therefore, the duration of the headache should not be used as a strict diagnostic criteria.

Non-compliance with follow-up and improvement after treatment at a headache center.

Two telephone surveys were conducted at a major headache center into patient compliance with follow-up and perceived treatment efficacy. The first survey addressed compliance with the recommendation to follow-up after the initial evaluation. Of a group of 316 consecutive patients, 40.

Familial cluster headache: occurrence in three generations.

We report the occurrence of cluster headache in three generations of one family: an 8-year-old boy with primary chronic cluster headache, his 42-year-old father with secondary chronic cluster headache, and his 73-year-old paternal grandfather with episodic cluster headache.

Episodic and chronic paroxysmal hemicrania.

Chronic paroxysmal hemicrania has gradually become a well-established headache entity. However, the fact that the condition can also occur episodically is less well known. Both episodic and chronic paroxysmal hemicrania respond well to treatment with indomethacin.

Headaches in patients with traumatic lesions of the cervical spinal cord.

We established the occurrence of headache in a group of 20 patients with traumatic transections of the cervical spinal cord. All but two patients had complete sensory lesions at levels varying from C2-3 to C7-8. Only three patients claimed to have no headaches at all although one of them had nuchal pains with fever.

Overlap of migraine and tension-type headache in the International Headache Society classification.

Using questionnaire data from two recent surveys, headache sufferers were classified as having either migraine, episodic, or chronic tension-type headache using the International Headache Society criteria. Of 410 subjects with a headache history of 2 years or more, 147 or 35.9% were assigned Code 1.

Treatment of chronic tension-type headache with hypnotherapy: a single-blind time controlled study.

We investigated the effectiveness of a special hypnotherapy technique in the treatment of chronic tension-type headache. A waitinglist control group was used to control for the changes in headache activity due to the passage of time. The results showed significant reductions in the number of headache days (p less than 0.

Hypothesis: serotonin-1C receptor activation in migraine: an alternative point of view with therapeutic implication.

Brewerton's observation that meta-chlorophenylpiperazine, the major metabolite of trazodone, with high affinity and intrinsic activity for the serotonin-1C receptor precipitates migraine headaches in subjects with a personal and/or family history of migraine, prompted Fozard and Gray to postulate that activation of serotonin-1C receptors plays a significant role in the initiation of the attack. Little note was taken, however, of the significant delay between administration of meta-chlorophenylpiperazine and the onset of the headaches. This delay prompts another hypothesis, that the vasoconstrictive action of this substance, as it wears off leads to rebound vasodilation, precipitating migraine.

Myocardial ischemia related to ergot alkaloids: a case report and literature review.

Ergotamine tartrate and methysergide are widely used headache treatments with important vasoconstrictive properties. We report a 31-year-old man with cluster headaches who developed severe, prolonged myocardial ischemia following combination therapy with ergotamine tartrate and methysergide. We reviewed the cardiovascular complications of each agent alone and in combination.

A questionnaire survey of muscular symptoms in chronic headache. An age- and sex-controlled study.

In a questionnaire survey we determined the prevalence and intensity of muscular symptoms in a group of chronic headache sufferers as compared with age- and sex-matched controls. The muscular symptoms studied were tightness and soreness of the neck, shoulder, and jaw muscles. Muscle tightness was reported significantly more frequently in the headache than in the control group, but only for the neck muscles (48.

Reading problems in adult chronic headache sufferers.

In a questionnaire survey we determined the prevalence of problems with reading, at present as well as in the past, in adult chronic headache sufferers as compared with age- and sex-matched controls. The reading problems inquired about were those with reading in general, reading quickly, prolonged reading and reading comprehension. The subjects were also asked about present and past problems with writing, concentrating, performing mathematics and overall learning.

Headache and family history.

In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency.

Angiographic changes suggestive of vasospasm in migraine complicated by stroke.

A 30-year-old woman with a history of common migraine developed a permanent left homonymous hemianopia during a typical headache. CT scan demonstrated a right posterior cerebral infarction and angiography showed irregular narrowing of the ipsilateral posterior cerebral artery, suggestive of vasospasm. In the case no risk factors for atherosclerotic stroke were present except for smoking, and no other causes of stroke could be found.

Diagnosis and management of cluster headaches.

Cluster headaches are vascular headaches that predominantly affect males and occur frequently, with cyclic regularity. Treatment is predominantly pharmacological in nature and is divided into symptomatic and prophylactic relief. This article discusses the pathogenesis, clinical features, and current prophylactic and symptomatic treatments used with cluster headaches.

Migraine associated with periorbital ecchymosis.

Two patients are reported who developed periorbital ecchymosis in association with migraine. The association is rare, having only been reported in the literature almost a century ago. The possible mechanism of the occurrence of periorbital ecchymosis in migraine is discussed.

A controlled study of visual symptoms and eye strain factors in chronic headache.

In a questionnaire survey we determined the prevalence of visual symptoms and eye strain factors in a group of chronic headache sufferers as compared with age- and sex-matched controls. The visual symptoms studied were those not specific for headache, i.e.

The migraine aura as a cause of avoidance behavior.

Two patients are reported in whom the occurrence of migraine aura led to the development of avoidance behavior. In both patients the migraine aura was given a significance of doom by a previous experience. The avoidance behavior represented an attempt of the patients to deal with the visual disturbance.

Prophylactic treatment of cluster headache with verapamil.

An open study of verapamil in cluster headache is reported. Forty-eight patients participated in the study of whom 33 (= 69%) improved more than 75%. No significant differences in response were observed between episodic and chronic cluster headache.