Observations on 500 Cases of Migraine and Allied Vascular Headache

Selby, George; Lance, James W.

doi:10.1136/jnnp.23.1.23

Cited by 558 publications

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“…2). These results concur with those of Klee [4] and Selby and Lance [10]. But the frequency was rather less than that reported by Klee [4] (see Introduction).…”

Section: Groups Of Interrelationship Between Visual Disturbances and supporting

confidence: 92%

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Migraine with aura: visual disturbances and interrelationship with the pain phase. Vågå study of headache epidemiology

2006

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In the Vågå study of headache epidemiology, 1838 or 88.6% of the available 18–65-year-old inhabitants of the commune were included. Everyone was questioned and examined personally by the principal investigator (OS). There were 178 cases of various types of visual disturbances during the migraine attack, which corresponds to 9.7% of the study group. The prevalence among females was 11.9% and among males 7.4%; female/male ratio was 1.70, as against 1.05 in the total Vågå study population. By far the most frequently occurring visual disturbance pattern was (A) 1. Visual disturbances → 2. pain-free interlude → 3. pain phase (in 78% of the cases). Other frequent patterns were: (B). Visual disturbances, but no pain phase (24%); and: (C) 1. Pain phase → 2. visual disturbances (23%). Evidently, in the solitary case, there might be more than one visual disturbance pattern. The most frequently occurring solitary visual disturbances were: scintillating scotoma (62%) and obscuration (33%); but also more rare ones were identified, like anopsia, autokinesis (movement of stationary objects), tunnel vision and micropsia. Among the non-visual aura disturbances, paraesthesias and speech disturbances were the most frequent ones. The prevalence of migraine with aura seemed to be considerably higher than in similar studies. This also includes studies that have been carried out with a face-to-face interview technique.

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“…2). These results concur with those of Klee [4] and Selby and Lance [10]. But the frequency was rather less than that reported by Klee [4] (see Introduction).…”

Section: Groups Of Interrelationship Between Visual Disturbances and supporting

confidence: 92%

“…It is remarkable that in 62% and 31% in the "primary" and "secondary" series, respectively, visual disturbances occurred during the pain phase. Also, Selby and Lance [10] frequently found painphase visual phenomena, i.e., in 22 of 59 cases (37%).…”

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confidence: 91%

Migraine with aura: visual disturbances and interrelationship with the pain phase. Vågå study of headache epidemiology

2006

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“…In the development of ASC, alternative scoring strategies were evaluated but did not alter the results. 23 The validation process defined the following categories based on the ASC CA scores: no allodynia (0-2), mild (3-5), moderate (6)(7)(8), and severe (9 or higher).…”

Section: Assessment Of Allodyniamentioning

confidence: 99%

Prevalence and characteristics of allodynia in headache sufferers

et al. 2008

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Objective: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population. Methods:We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids.Results: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score ≥9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression. Conclusions:Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.Central sensitization, an increased excitability of spinal and medullary dorsal horn neurons resulting from ongoing input from C-fiber nociceptors, may lead to cutaneous allodynia (CA), a neurologic condition characterized by pain elicited by ordinary nonnociceptive stimulation of the skin. 1,2 During migraine, facial CA is likely to be a clinical manifestation of sensitization at the level of the trigeminal nucleus caudalis. 3,4 In clinic-based studies, most migraineurs develop CA during the course of an attack. 5-8 In migraine, CA has been proposed as a predictor of poor response to triptan therapy 8 as well as a risk factor for disease progression. 9Address correspondence and reprint requests to Dr. Marcelo E. Bigal, Global Director, Scientific Affairs, Neuroscience, One Merck Drive, P.O. Box 100, Whitehouse Station, NJ 08889-0100 Marcelo_Bigal@merck.com. * Members of the AMPP Advisory Group are listed in the appendix. Here, we used the ASC-12 to assess the prevalence and severity of CA in subjects with various types of primary headaches in the general population. Because CA has been recently suggested as a risk factor for migraine progression, we hypothesized ...

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“…Alguns autores, no entanto, encontraram este pico entre 20 e 29 anos 11,12 . Stewart e col. 10 acreditam que estes achados mais tardios se devem provavelmente a erros de memória dos pacientes.…”

Section: Discussionunclassified

“…Nossos achados sobre os sintomas acompanhantes são similares aos da literatura 3,[7][8][9]11,[16][17][18] . Nós observamos que náusea, foto e fonofobia ocorrem na maioria dos ataques de enxaqueca, nos pacientes que têm estes sintomas.…”

Section: Discussionunclassified

Características clínicas da enxaqueca sem aura

Queiroz

Rapoport

Sheftell

1998

Arq. Neuro-Psiquiatr.

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RESUMO -Um estudo aprofundado das características clínicas da enxaqueca sem aura (ESA) revela alguns dados interessantes. Um questionário foi respondido por 200 pacientes que preenchiam os critérios da Sociedade Internacional de Cefaléia para ESA. O pico do início da enxaqueca foi entre 10 e 19 anos de idade. A cefaléia era restrita a um lado em 19%. Era exclusivamente bilateral em 9%. A maioria (86,2%) dos pacientes que descreveram cefaléias em um único local localizou-a na área fronto-temporal. Cervicalgia estava associada aos ataques de enxaqueca em 70,5% e dor facial em 73,5%. O caráter latejante foi notado por 81%. Todos os pacientes descreveram a cefaléia como moderada a severa. Somente 55% disseram que a dor era agravada por atividades físicas rotineiras. Náusea ocorreu em 91%, foto e fonofobia em 77% e vômitos em 50%. Este olhar detalhado na ESA demonstra a grande complexidade dos seus sintomas.PALAVRAS-CHAVE: cefaléia, enxaqueca, enxaqueca sem aura. Clinical characteristics of migraine without auraABSTRACT -A detailed study of the clinical characteristics of migraine without aura (MOA) reveals some interesting data. A questionnaire was returned by 200 patients who met the International Headache Society criteria for MOA. The peak of onset of migraine was between 10 and 19 years of age. The headache was sidelocked in 19%. It was exclusively bilateral in 9%. The majority (86.2%) of the patients who described headaches in only one site located them in the fronto-temporal area. Neck pain was associated with migraine attacks in 70.5% and face pain in 73.5%. A pounding quality was noted by 81%. Every patient described the headache as moderate to severe. Only 55% stated that it was aggravated by routine physical activity. Nausea occurred in 91%, photo and phonophobia in 77%, and vomiting in 50%. This close look at MOA uncovers a great complexity of symptoms.KEY WORDS: headache, migraine, migraine without aura.O Comitê de Classificação das Cefaléias, da Sociedade Internacional de Cefaléia (SIC), definiu em 1988 1 a enxaqueca sem aura (ESA) com maior clareza que a prévia classificação, do comitê Ad Hoc do Instituto Nacional de Doenças Neurológicas e Cegueira 2 . No entanto, os critérios diagnósticos da ESA ainda merecem revisão, como proposto por diversos estudiosos [3][4][5] . Existem muitos aspectos da dor de cabeça e sintomas acompanhantes que precisam ser mais bem estudados.Embora um questionário possa não ser a ferramenta ideal para o diagnóstico das cefaléias 6 , ele é uma boa maneira de avaliar a sintomatologia dos pacientes já diagnosticados como enxaquecosos. Até o momento, não há nenhum teste laboratorial que estabeleça o diagnóstico de enxaqueca. O diagnóstico é baseado na presença de um número mínimo de diversos sintomas subjetivos.O objetivo deste estudo é detalhar e quantificar algumas manifestações clínicas desta complexa síndrome.

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Observations on 500 Cases of Migraine and Allied Vascular Headache

Cited by 558 publications

References 14 publications

Migraine with aura: visual disturbances and interrelationship with the pain phase. Vågå study of headache epidemiology

Migraine with aura: visual disturbances and interrelationship with the pain phase. Vågå study of headache epidemiology

Prevalence and characteristics of allodynia in headache sufferers

Características clínicas da enxaqueca sem aura

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