Cephalalgia : an international journal of headache
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The personality inventory for children (PIC), which is similar in structure to the MMPI and hence free from subjective interpretation, is applicable to children from 6 to 16 years of age. We used it in 40 children with common migraine aged 8 to 14 years and in 40 controls comparable in age, sex, and socioeconomic status. Although the migraine subjects did not emerge as globally different from the controls, they presented significantly higher scores on the Somatic concern, Depression, and Anxiety scales, irrespective of sex. These results underline the value of PIC in the diagnostic assessment of childhood migraine.
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Case Reports
The sweating anomaly in cluster headache. Further observations on the underlying mechanism.
We describe a patient with a typical history of cluster headache for more than 18 years. During the first approximately 10 years of his disease, the pain was right-sided, and pupillometric and evaporimetric measurements indicated a sympathetic deficiency on this same side. However, for the next greater than 6 years, his pain was consistently left-sided, although the signs of sympathetic dysfunction still were more marked on the right side. ⋯ The view that two separate lines of symptom production lead to the pain and the autonomic phenomena seems to be supported by this case history. The cluster headache syndrome may also be a bilateral disorder, with only the weight of balance pointing one way or the other. Finally, the autonomic test results of this patient could reflect an autonomic "scar" in the previous headache side.
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Comparative Study Clinical Trial Controlled Clinical Trial
Tizanidine in the management of trigeminal neuralgia.
In a double-blind study the efficacy and tolerability of tizanidine was compared with those of carbamazepine in the management of trigeminal neuralgia. Six patients were allocated to treatment with tizanidine and six to carbamazepine. ⋯ Among the efficacy factors used, the visual analog scale (VAS) and the overall efficacy as assessed by patients and investigator turned out to be the most appropriate. The results indicate that tizanidine was well tolerated, but the effects, if any, were inferior to those of carbamazepine.
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L-Tryptophan (L-TP) has been used in migraine and other pain conditions. The mechanism underlying the analgesic effect is still partly undefined. In this study the effects of subchronic administration of L-5-hydroxytryptophan (L-5HTP) (with and without carbidopa) on plasma beta-endorphin (beta-EP) levels and subjective pain threshold and tolerance were investigated in seven healthy volunteers. ⋯ L-5HTP plus carbidopa induced an increase in beta-EP significantly (p less than 0.05) greater than that induced by L-5HTP alone. Neither the subjective pain threshold and tolerance nor the RIII threshold was modified by either treatment. Our data seem to point to the existence of a complex linkage between plasma opioid levels and pain perception.