Headache
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Clinical Trial
Chronic paroxysmal hemicrania and hemicrania continua. Interval between indomethacin administration and response.
The interval between indomethacin dosage and clinical response was assessed in hemicrania continua (n = 12) and chronic paroxysmal hemicrania (n = 11) sufferers. The number of trials per patient ranged from 1 to 30. At the time of testing, the patients had "considerable" pain after discontinuation of the drug. ⋯ In most patients (10 in both groups), the indomethacin effect was complete within 24 hours, and frequently within 8 hours. It is suggested that interindividual differences in dosage and timing to abolish the headaches may be due to different bioavailability or individual sensitivity. Recommendations on indomethacin testing in unilateral headaches are given.
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Comparative Study
Responders and nonresponders to autogenic training and cognitive self-hypnosis: prediction of short- and long-term success in tension-type headache patients.
The present study was conducted to determine whether demographic variables, medical status variables, and psychological measures at pretreatment were related to pain reduction immediately following behavioral treatment for headache and at a 6-month follow-up. The study sample consisted of 156 subjects, who were selected for participation in a behavioral outcome study on the efficacy of autogenic training and cognitive self-hypnosis training. A Headache Index based on pain diaries constituted the main outcome measure. ⋯ At pretreatment, the responders perceived more pain control than the nonresponders. None of the other pretreatment differences between responders and nonresponders proved to be significant. The main conclusion that could be drawn from this study was that pain reduction, in the short- and long-term, cannot be predicted with any accuracy by demographic and medical status variables or scores for psychological distress, personality traits, coping strategy use, and pain appraisals.
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The relationship between headaches and sleep disturbances is complex and difficult to analyze. Both symptoms may have causal relations, or may be associated in the same patient with mutual reinforcements. We studied 25 patients presenting with morning or nocturnal headaches. ⋯ Data were also analyzed in terms of simple models linking headache and sleep disturbances. Such an approach allowed the identification of several modes of mutual interaction. In summary, morning or nocturnal headaches are frequent indicators of a sleep disturbance and their presence might justify polysomnography, and the use of simple clinical models may be useful for understanding the complex relationship between headache and sleep.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of frontal electromyographic biofeedback training, trapezius electromyographic biofeedback training, and progressive muscle relaxation therapy in the treatment of tension headache.
This study is the first systematic examination of a trapezius EMG biofeedback training regimen with tension headache sufferers. It evaluated the differential effects of three psychophysiological treatments for tension headache: (1) a standard 12-session frontal EMG biofeedback training regimen (n = 8), (2) a 12-session upper trapezius EMG biofeedback training regimen (n = 10), and (3) a standard seven-session progressive muscle relaxation therapy regimen (n = 8). ⋯ The three treatments did not differ on secondary measures of headache improvement (number of headache-free days, peak headache activity, and medication index). Implications for the psychophysiological treatment of tension headache, as well as future research directions, are discussed.