Headache
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Comparative Study
Exteroceptive suppression of temporalis muscle activity in various types of headache.
Exteroceptive suppression (ES) of temporalis muscle activity, particularly the multisynaptic ES2, has been reported to be significantly reduced in tension type headache, but not in migraine. We re-evaluated the methods of optimally analysing the single shock technique and its intra- and inter-individual variability in 26 normal subjects. ⋯ With the methods used here and when patients with absent ES2 were excluded, mean duration of ES2 was not significantly different between the various groups. It seems therefore necessary, in spite of increased discomfort for patients, to use complementary methods, such as averaging 16-32 responses and applying various stimulation sets, if one wants to increase the potency of temporalis ES2 as a diagnostic and pathophysiologic tool in headache.
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Autonomic impairment in migraine is well documented. In order to evaluate the autonomic control in migraine, spectral analysis of heart rate fluctuations was performed on ten migraine patients, drug-free and during the inter-headache phase. They were compared to nine healthy controls and eight tension headache patients. ⋯ The enhancement at low frequencies fluctuations only, a frequency range known to be related to vasomotor control, suggests that the migraine patients are characterized by a clear sympathetic instability. This finding supports the hypothesis that migraine is of neural origin and is consistent with the observation of large variations in regional cerebral flow. Spectral analysis of heart rate fluctuations allows us to specify and quantitate this autonomic imbalance and may provide a useful tool for the evaluation of drug therapy in migraine.
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Comparative Study
Ice cream headache--site, duration, and relationship to migraine.
To examine the characteristics of cold-induced headaches in a group of migraine patients, to compare these with their usual migraine headaches and with cold-induced headaches in a control population. ⋯ These findings confirm that cold stimulation of the palate or pharynx commonly produces a headache. In contrast to previous studies, our results suggest that the 'ice cream headache' is less common in migraine patients than the general population. A similar pattern of headache was produced in both migraine patients and controls, and apart from the few for whom an ice cream headache may trigger a migraine, the ice cream headache seems not to have any special significance for migraine patients.