Cephalalgia : an international journal of headache
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Fluctuation of estrogen levels across the menstrual cycle influences migraine headache. In this study, 53 women documented prospectively the incidence and severity of headache daily for an average of three menstrual cycles. Seven of the women met the criteria established by the International Headache Society for migraine with or without aura, while the remaining 46 women failed to do so. ⋯ Both groups experienced an increase in severe headaches during the perimenstrual phase. The PMS women peaked on the day prior to menstruation, while the non-PMS women peaked on the first day of menstruation. There did not appear to be an overall difference in the reporting of mild headache across the cycle between women with or without PMS.(ABSTRACT TRUNCATED AT 250 WORDS)
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We report two patients with ipsilateral attacks of cluster headache and chronic paroxysmal hemicrania. The first patient, a 33-year-old man, started having attacks of chronic cluster headache at the age of 27. At 33, they were replaced by typical attacks of ipsilateral chronic paroxysmal hemicrania which showed a dramatic improvement with indomethacin 150 mg daily. ⋯ At 44, he experienced ipsilateral typical attacks of chronic paroxysmal hemicrania, and two months later attacks of cluster headache. Under verapamil 240 mg daily, attacks of cluster headache disappeared, but those of chronic paroxysmal hemicrania increased in frequency until indomethacin 150 mg daily was added. These observations suggest a close relationship but not a similarity between cluster headache and chronic paraoxysmal hemicrania, and show the practical therapeutic interest of maintaining this distinction.
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Comparative Study
Topographic analysis of steady-state visual evoked potentials (SVEPs) in the medium frequency range in migraine with and without aura.
Topographic analysis of SVEPs in the medium frequencies range was performed in 30 migraineurs without aura, 20 migraineurs with aura and in 20 control subjects. The mean absolute power values of the fundamental component F1, the subharmonic F1/2 and the first harmonic F2, corrected by logarithmic transformation, were computed in each group and then compared using Student's t-test. The interhemispheric coherence of the F1 component was also evaluated. ⋯ Migraine with aura patients had a reduced interhemispheric coherence mostly of 12 Hz and 15 Hz F1 components in frontal and temporo-parietal regions. Results of the study confirm abnormalities of SVEPs in migraineurs with and without aura. These consist of widespread increases of F1 components in the medium frequency range over the temporo-parietal regions.
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In November 1990 a nationwide survey of migraine was conducted in France on a representative sample of residents aged 15 years and older. The diagnosis of migraine was based on the International Headache Society (IHS) classification. In a previous study, we validated a diagnostic algorithm which classifies headache sufferers as IHS migraine, "borderline" migraine, possible migraine and non-migrainous headache. ⋯ Age, gender and occupation were found to be risk factors for migraine. Neither frequency and duration of attacks nor length of time of disease differed with gender. Expressed intensity of attacks, however, was greater in females.
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We investigated whether experimentally determined, suprathreshold pain sensitivity of pericranial musculature in patients with tension-type headache differs from that of migraine patients or from that of healthy subjects. Furthermore, we looked to see whether differences could be found in the effects of experimental pain induction on EMG activity of pericranial musculature and whether subgroups could be discovered with higher and lower pericranial pain sensitivity within the three diagnostic groups in terms of neurophysiological, psychological and clinical variables. In 20 patients with tension-type headache, 23 patients with migraine without aura, and 29 healthy individuals experimental pain was induced in the temporal muscle by mechanical pressure; pain sensitivity in the entire metrically subdivided suprathreshold pain sensitivity range was measured. ⋯ The results indicate that significant differences in the examined groups are found not in pain perception but in the processing or reaction to experimental headache stimuli. In patients with tension-type headache subgroups evolve based on pericranial pain sensitivity with quantitatively and/or qualitatively impaired reactions; for this reason diagnostic grouping according to the IHS classification seems to be pathophysiologically relevant. The intraindividual phasic comparison of pain reactions appears to be more important than the absolute interindividual tonic comparison.