In 334 patients with idiopathic Parkinson's disease, deterioration in mental status paralleled severity of bradykinesia, postural instability, and gait difficulty. Tremor was relatively independent of the other cardinal signs and was associated with relative preservation of mental status, earlier age at onset, family history of parkinsonism, and more favorable prognosis. There seem to be at least two Parkinson's subgroups: one with postural instability and gait difficulty and another with tremor as the dominant feature.

To examine a possible relationship of essential tremor to Parkinson's disease (PD), 130 patients with essential tremor were studied. Twenty-five patients had both essential tremor and PD. These 25 patients were matched for age and duration of PD symptoms with 25 patients who had idiopathic PD. Bradykinesia, postural instability, and gait difficulty were more severe in the patients with idiopathic PD. Degree of tremor, rigidity, and functional disability did not differ in the two groups. The prevalence of PD in the population with essential tremor was 24 times greater than expected. This study suggests that some patients with essential tremor have a genetically increased risk for PD.

SYNOPSIS Clinical research during the past four years in this and other laboratories has demonstrated therapeutic effectiveness of three different calcium channel blockers in the prophylaxis of migraine and cluster headaches. The drugs are nimodipine, nifedipine and verapamil. Clinical observations and cephalic hemodynamic responses correlated before and during treatment with nimodipine show extremely low incidences for development of tolerance and/or side effects plus normal glucose tolerance and calcium dependent insulin secretion before and during nimodipine therapy. The results confirm potent and highly selective calcium entry blockade of cephalic smooth muscle receptors by nimodipine. Nifedipine and verapamil showed less therapeutic effectiveness in controlling headaches, higher incidence for development of tolerance and side‐effects with less consistent cephalic hemodynamic changes. Taken together these observations during treatment of migraine and cluster with calcium antagonist support Wolff's theory of vascular head pain.

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SYNOPSIS For the past 6 years, patients with headaches followed and treated by this laboratory have undergone ateach visit serial measurements of regional cephalic blood flow (rCBF) with neurological and medicalexaminations, direct interviews and completion of questionnaires regarding type, frequency, presence andseverity of head pain. Of 369 patients referred with recurrent headaches, 324 were classified classic,common, or complicated migraine, either alone or in combination with muscle contraction headaches(mixed headaches) and 45 were considered to have pure muscle contraction headaches. For purposes ofthis report, patients with cluster headaches were excluded. Forty‐two percent (136) complained ofheadaches at the time or rCBF measurements. Of these 136, 60 cases had paired CBF measurementsduring headache and when headache‐free and comprise the case material analyzed. Most headaches (61%)occurred during the initial visit. During spontaneous migraine headaches, rCBF increases (hyperemia)were present among 58% of patients classified as classic migraine, 53% classified as common migraine,25% classified as complicated and 31% classified as mixed. Cephalic blood flow values were reducedduring prodromes of classic migraine. Patchy zones of oligemia and hyperemia appeared at the onset ofheadache. Cephalic hyperemia usually returned to normal values a few days after headaches subsided.During headache, 32% of the patients showed gross dysautoregulation with paradoxical flow increasesduring 100% oxygen inhalation. Results are consonant with a vascular pathogenesis for prodromes andheadaches of migraine.