Cephalalgia : an international journal of headache
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A controversial entity, Eagle's syndrome, is reviewed. After an anatomical description of the maxillo-vertebro-pharyngeal region we summarize the causative, diagnostic and therapeutic aspects of the syndrome. ⋯ We believe that the term "Eagle's syndrome" is legitimate only in the first case and in those "atypical" painful head and neck conditions related to an elongated styloid process and relieved by styloidectomy. We believe Eagle's syndrome deserves consideration in the International Headache Classification.
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Comparative Study
Cerebral blood flow velocities are reduced during attacks of unilateral migraine without aura.
It has been disputed whether or not large intracranial arteries are dilated during migraine attacks. In order to answer this question the present transcranial Doppler study focused on side-to-side differences of middle cerebral artery blood velocity during unilateral attacks of migraine without aura in 25 patients. Blood velocity in the middle cerebral artery was lower on the headache side (59 cm/s) than on the non-headache side (65 cm/s) during the migraine attack. ⋯ The difference (headache side minus non-headache side) was on average -6.1 cm/s during attack compared to -0.4 cm/s outside of attack (p = 0.01). Assuming that rCBF is unchanged during attacks of migraine without aura, our results suggest a 9% increase in middle cerebral artery lumen (cross-sectional area) on the affected side during unilateral attacks of migraine without aura. The findings, however, do not necessarily mean that arterial dilatation is the only or even the most significant cause of pain.
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The contingent negative variation (CNV) amplitudes of 16 subjects with migraine without aura were studied during pain-free intervals and during attacks and the results were compared with those of 22 healthy subjects. In 32 trials the CNV amplitudes were calculated for (a) "total interval", (b) "early CNV component", (c) "late CNV component", and (d) habituation. ⋯ Healthy subjects as well as subjects studied during the attack showed a significant habituation whereas migraine subjects studied during pain-free intervals did not. This suggests that the higher CNV amplitude in migraine patients studied between pain-free attacks may be due in part to impaired habituation.