Der Schmerz
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Sixty-five patients (51 women, 14 men), who were 41.9 years on average, suffered from combination headache (migraine and tension headache) and were under therapy with propranolol and amitriptyline-N-oxide. The following predictive factors were tested with regard to the success of therapy: age, sex, duration of the migraine and tension headache illness, and frequency of use of analgesic and ergotamine preparations. ⋯ Both the migraine treatment and the tension headache were standardized and headache records were kept. The statistical procedure used permitted clear differentiation between responders and non-responders, but these predictive factors did not make it possible to distinguish a subgroup of potential responders.
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Since the beginning of the history of man migraine has been described in all civilizations. It would therefore seem helpful if migraine were to be classified, for diagnostic reasons and in order to study the scientific hypotheses, according to the manifold clinical symptoms, as well as the lack of typical pathophysiological, morphological and biochemical findings. ⋯ On the basis of this classification, the individual forms of migraine are described from the viewpoint of the clinical symptoms. The classification of the International Headache Society represents a good basis for reclassifying headaches, which is still under discussion.
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Many types of headache that occur in the form of attacks show a notably high incidence at certain times of the day. Attacks are often accompanied by emotional instability, irritability, exhaustion and other impairments of well-being. The cause for the frequent daytime occurrence of attacks is not clear. ⋯ These findings show that headache sensitivity follows circadian patterns. Daytime variations, however, are only significant for sensitivity to high intensities. Thus these results may explain, in part, why violent attacks of pain occur predominantly at night and in the early morning.