History Of Migraine Headaches Research Articles

Cyclic vomiting syndrome

For the last century, empiric therapy has been used to treat the relentless vomiting and resulting dehydration associated with cyclic vomiting syndrome. Despite its unknown pathogenesis, in the last decade, uncontrolled trials of various antimigraine and antiemetic agents have demonstrated rates of efficacy of 40% to 90%. Antimigraine agents are used to prevent or abort episodes, whereas antiemetic agents are used to attenuate symptoms during episodes. A positive family history of migraine headaches renders the patient more likely to respond to antimigraine therapy. In addition to antimigraine therapy, antiemetic sedative/anxiolytic, neuroleptic and gastroinestinal prokinetic agents may be useful.

Physical therapy for migraine-related vestibulopathy and vestibular dysfunction with history of migraine.

To assess the efficacy of physical therapy for patients with a diagnosis of migraine-related vestibulopathy (MRV) or vestibular dysfunction with a history of migraine headache. Retrospective case series Thirty-nine patients were identified through a retrospective chart review, 14 with a diagnosis of MRV and 25 with migraine headache. The patients were treated with a custom-designed physical therapy exercise program for a mean of 4.9 visits over a mean duration of 4 months. Patients completed the Dizziness Handicap Inventory (DHI), the Activities-Specific Balance Confidence Scale (ABC), and the Dynamic Gait Index (DGI), reported the number of falls they had experienced in the past 4 weeks, and rated the severity of their dizziness on an analogue scale of 0 to 100 at initial evaluation and at discharge. Significant differences were seen before and after therapy in each of the outcome measures used. The average decrease in DHI score was 12 points (P < .01). ABC scores increased an average of 14 points (P < .01). Subjects increased their DGI scores an average of 4 points (P < .01). The number of patients reporting more than one fall decreased by 78% at discharge. (P < .05). Baseline symptoms of dizziness decreased an average of 11 points (P < .05). Patients with MRV and migraine headache demonstrated improvement in physical performance measures and self-perceived abilities after vestibular physical therapy.

Corrugator supercilii muscle resection and migraine headaches.

This study was conducted to determine whether there is an association between the removal of the corrugator supercilii muscle and the elimination or significant improvement of migraine headaches. Questionnaires were sent to 314 consecutive patients who had undergone corrugator supercilii muscle resection during endoscopic, transpalpebral, or open forehead rejuvenation procedures. The patients were queried as to whether they had a history of migraine headaches and, if so, whether the headaches significantly improved or disappeared after surgery. If the answer was affirmative, then the patients were further questioned about the duration of the improvement or cessation of the headaches and the relationship to the timing of the surgery. After an initial evaluation of the completed questionnaires, a telephone interview was conducted to confirm the initial answers and to obtain further information necessary to ensure that the patients had a proper diagnosis based on the International Headache Society criteria for migraine headaches. The charts of the patients who had migraine headaches were studied to ascertain and classify the type of surgery they had undergone. Patient demographics were reviewed, and the results were statistically analyzed. Of the 314 patients, 265 (84.4 percent) either responded to the questionnaire, were interviewed, or both responded to the questionnaire and were interviewed. Of this group, 16 patients were excluded because of the provision of insufficient information to meet the International Headache Society criteria, the presence of organic problems, and other exclusions mandated by study design. Thirty-nine (15.7 percent) of the remaining 249 patients had migraine headaches that fulfilled the Society criteria. Thirty-one of the 39 (79.5 percent) with preoperative migraine noted elimination or improvement in migraine headaches immediately after surgery (p < 0.0001; McNemar), and the benefits lasted over a mean follow-up period of 47 months. When the respondents with a positive history of migraine headaches were further divided, 16 patients (p < 0.0001; McNemar) noticed improvement over a mean follow-up period of 47 months, and 15 (p < 0.0001; McNemar) experienced total elimination of their migraine headaches over a mean follow-up period of 46.5 months. When divided by migraine headache type, 29 patients (74 percent) had nonaura migraine headaches. Of these patients, the headaches disappeared in 11 patients, improved in 13 patients, and did not change in five patients (p < 0.0001). Ten patients experienced aura-type headaches, which disappeared or improved in seven of the patients and did not change in three of the patients (p < 0.0001). This study proves for the first time that there is indeed a strong correlation between the removal of the corrugator supercilii muscle and the elimination or significant improvement of migraine headaches.

Congenital Horner’s syndrome resulting from agenesis of the internal carotid artery

ObjectiveTo report a patient with agenesis of the right internal carotid artery associated with ipsilateral, congenital Horner’s syndrome. DesignCase report. MethodsA 30-year-old woman, with a past history of migraine headaches, underwent neuro-ophthalmologic and neuroradiologic evaluation for transient visual obscurations and congenital Horner’s syndrome. ResultsA right, third-order neuron Horner’s syndrome was confirmed with 1% hydroxyamphetamine topical drops. Cranial magnetic resonance imaging revealed an absent right internal carotid artery flow void, computed tomography demonstrated absence of the right carotid canal, and cerebral angiography confirmed absence of the right internal carotid artery. No atheromatous lesions were found and the results of coagulation studies were normal. ConclusionsAgenesis of the internal carotid artery is a rare cause of congenital Horner’s syndrome. The cause of transient visual blurring in the current patient remains unproven.

Detailed examination of fenfluramine-phentermine users with valve abnormalities identified in Fargo, North Dakota

Although several studies have reported on valve abnormalities among users of fenfluramine or dexfenfluramine, detailed information on these subjects has not been provided, limiting the ability to understand who may be at risk for valve abnormalities and to generate hypotheses about the etiology and pathogenesis of these abnormalities. This study was a detailed medical record review of 18 previously reported users of fenfluramine and phentermine, all with valve abnormalities on echocardiogram and 2 with surgical pathology. Both clinical characteristics and medication use were recorded by trained abstracters using a standardized data collection form. Two subjects (11%) had other possible etiologies of valve disease: a history of rheumatic fever and prescribed ergotamine. Three subjects (17%) had a history of migraine headaches and 4 (22%) had murmurs noted before using fenfluramine. Use of medications that may affect serotonin receptors was common: ergotamine (1 subject, 5%), selective serotonin reuptake inhibitors (6, 33%), sumatriptan (2, 11%), and mirtazapine (1, 5%). Prior medication and nonmedication allergies were recorded in 6 (33%) and 3 (17%) subjects, respectively. All subjects had symptoms possibly due to fenfluramine or phentermine side effects. This study raises the hypotheses that valvular heart disease among fenfluramine users may be less common than previously estimated, that serotonin excess may play a role in valve pathology, and that a patient’s response to anorexigens and other medications may serve as a marker for increased risk. Further study is needed to test these hypotheses.

A non-prescription analgesic alleviated migraine headache pain and symptoms

Lipton RB, Stewart WF, Ryan RE , et al. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain. Three double-blind, randomized, placebo-controlled trials. Arch Neurol1998 Feb;...

Is There an Association between Migraine Headache and Open-angle Glaucoma?: Findings from the Blue Mountains Eye Study

To determine whether an association exists between migraine headache history and open-angle glaucoma (OAG). Population-based, cross-sectional study. Subjects were 3654 people aged 49 or older; 82% of permanent residents from an area west of Sydney participated. All participants underwent an interview and a detailed eye examination, including automated perimetry and stereo optic disc photography. Open-angle glaucoma was diagnosed in subjects with matching typical glaucomatous visual field defects and pathologic optic disc cupping, independent of intraocular pressure level. The diagnosis of migraine history (typical or nontypical) was based on participant responses to specific questions, consistent with International Headache Society criteria. Open-angle glaucoma prevalence increased exponentially with age, with rates of 0.4%, 1.3%, 4.7%, and 11.4% among persons aged less than 60 years, between 60 and 69 years, between 70 and 79 years, and 80 years or older, respectively. The frequency of reporting a past history of typical migraine headache declined with increasing age, with rates of 23.1%, 16.2%, 12.8%, and 10.4% for corresponding age groups. For all age groups combined, there was no significant association between typical migraine headache and OAG (odds ratio [OR], 1.3; 95% confidence interval [CI], 0.8-2.2), after multivariate adjustment. However, after stratifying into 10-year age groups, increased odds for OAG were found for people giving a history of typical migraine headache and aged 70-79 years (OR, 2.5; 95% CI 1.2-5.2), after adjusting for variables found associated with glaucoma. This association was marginally stronger for high-pressure OAG cases (OR, 2.7; 95% CI, 1.1-5.6). These data suggest the possibility of an association between history of typical migraine headache and OAG, which could be modified by age.

Familial vestibulopathy

Three patients who presented with episodic vertigo followed by gait imbalance and oscillopsia had profound bilateral vestibular loss despite normal hearing. All had a parent with similar findings. The patients, their affected parent, and multiple other family members had a history of migraine headaches, although several of the latter had normal vestibular function. Acetazolamide stopped or markedly decreased the frequency of vertigo attacks in the three patients treated but had little effect on the chronic vestibular loss. This is the first report of a dominantly inherited bilateral vestibulopathy associated with normal hearing.

Mitral Valve Disease Associated With Long-term Ergotamine Use

A 43-year-old woman with symptoms and signs of congestive heart failure and intermittent claudication was found to have moderately severe mitral stenosis and regurgitation, as well as severe bilateral upper and lower extremity arterial occlusive disease. She had a history of migraine headaches and had abused ergotamine tartrate (Cafergot) chronically for more than 20 years. Only rare instances of valvular heart disease have been associated with chronic ergotamine toxicity, with the majority of previously reported cases based on auscultatory findings alone.

Transient Global Amnesia and the Amnestic Syndrome

Transient global amnesia is an unusual form of the amnestic syndrome in that it is completely reversible in most patients. The etiology of transient global amnesia is poorly understood, although involvement of the medial temporal lobe is most likely. The literature suggests that once an underlying structural lesion has been ruled out, cases can be divided into three groups: patients with a past history of migraine headaches, those who have no obvious underlying precipitating factors, and those with associated neurologic deficits during a spell and risk factors for cerebrovascular disease. Patients in the first group tend to have attacks at an earlier age and to have an increased recurrence rate but, like those in the second group, have a good prognosis. Patients in the third group often have onset later in life, and as many as 10% may have a stroke or dementia. Whether or not this is a higher incidence than should be expected in persons of this age group has not been determined. Although sophisticated testing may show persistence of the memory defect, most patients eventually recover completely.

Stroke and migraine in the Oxfordshire Community Stroke Project.

A total of 323 cases of first-ever stroke were registered in the first 2 years of the Oxfordshire Community Stroke Project. Of these patients, 244 (76%) had a stroke due to cerebral infarction. There was a past history of migraine headaches in 56 (17%) of the 323 cases of stroke and in 44 (18%) of the 244 cases of cerebral infarction. A past history of migraine headaches was no commoner in patients with stroke due to cerebral infarction than in those with stroke due to intracranial haemorrhage. One hundred and seventy-three (71%) patients with cerebral infarction had at least one risk factor for ischaemic stroke; the frequency of such risk factors was similar in patients with and without a history of migraine. In 7 (3%) of the 244 patients the cerebral infarction was presumed to be "migrainous"; however, only 3 of these 7 (1.2% of the 24) were free of risk factors for ischaemic stroke. If all 7 cases were considered migrainous, the incidence rate of first migrainous cerebral infarction was 3.36 per 100,000 per year (95% confidence limits 0.87-5.86). If only the 3 patients who were free of risk factors were included, the incidence was 1.44 per 100,000 per year (95% confidence limits 0-3.07).

Possible platelet syndrome suggested in early stroke

Neurologists in Detroit have found a group of young patients with stroke whose ischemic events seem to be caused by platelets that aggregate too easily. Some of these patients also have a history of migraine headaches and most come from families with histories of migraine headaches or early heart attacks and stroke. Treating these patients with a drug regimen that inhibits platelet aggregation and having them stop smoking cigarettes has proved to be successful therapy so far for preventing further strokes. <h3>Young Patients and Sticky Platelets</h3> These findings were reported at the Ninth International Joint Conference on Stroke and Cerebral Circulation, Tampa, Fla, by neurology resident Patti L. Holliday, MD, of the Wayne State University School of Medicine, Detroit. Holliday, fellow neurology resident John Buday, MD, and John Gilroy, MD, chair, Department of Neurology, have identified 15 persons between the ages of 9 and 47 years (mean age, 26 years)

Prazosin Treatment of Ergotamine-Induced Peripheral Ischemia

SEVERAL recent reports in the literature have recommended intravenous or intra-arterial sodium nitroprusside administration for the treatment of severe ergotamine-induced peripheral ischemia.^1-4Most treatments, prior to sodium nitroprusside, have been unsuccessful. Because of the similarities of action of prazosin and sodium nitroprusside,^5,6a trial of prazosin hydrochloride in the treatment of ergotism seemed reasonable. Peripheral ischemia of all four extremities and claudication of the right arm and leg were successfully treated with prazosin given orally. <h3>Report of a Case</h3> A 42-year-old woman was referred because of absent pulses and unobtainable blood pressure. She had a seven-year history of migraine headaches for which she had been taking suppositories containing 2 mg of ergotamine tartrate and 100 mg of caffeine (Cafergot) once weekly. During the 12 months before admission, the patient had used two suppositories daily (total dose of ergotamine, 28 mg weekly). In 1976 the patient had been examined

Hypnotic treatment for migraine headaches.

Abstract 2 patients with a long clinical history of migraine headaches were treated with hypnosis coupled with the hand-warming technique of Sargent, Green, and Walters (1973). Both patients were followed up (1 for 12 months and 1 for 9), and the treatment was extremely effective in reducing the intensity, frequency, and duration of their migraine headaches.

Neurological catastrophe related to oral contraceptives.

THE POSSIBILITY of a relationship between oral contraceptives and neurologic disease has been under discussion since about 1961, and there are a goodly number of significant clinical reports. Autopsy studies of pertinent neurologic cases, however, have been scarce, especially in this country. The observation to be reported here may shed some light on an important problem. Report of a Case The patient was a 26-year-old white woman who had a long standing history of migraine headaches for which she never received medication. She had been taking an oral contraceptive agent (Norethindrone with mestranol [Norinyl]) from April 15, 1966 until the time of her death. She was in her usual state of good health, when on the evening of Feb 20, 1967, while eating, she developed nausea, vomiting, headache, speech difficulty and inability to communicate properly. She was noted to have a left hemiparesis. The patient fell at some point

TRANSIENT AMAUROSIS IN ONE EYE WITH SIMULTANEOUS DILATATION OF RETINAL VEINS. IN ASSOCIATION WITH A CONGENITAL ANOMALY OF THE OPTIC NERVE HEAD.

The occurrence of intermittent blindness in one eye associated with coincident and transient dilatation of the retinal veins was recently reported for the first time. 1 Just a few days prior to the publication of this extensively investigated case, I observed a similar phenomenon in a 34-year-old male patient and obtained the stereophotographs which accompany this report. It is interesting that the first two cases of this readily observed phenomenon were recognized independently within such a brief period of time. Report of Case The patient had noted transient and often complete loss of vision in his left eye as long as he could remember. There was no history of maternal disease, birth injury, or childhood disease involving the eyes. No other members of the family had similar symptoms, nor was there a family history of migraine headache or other neurologic disease. The patient considered the right eye to be his