The Use of Histamine in the Treatment of Specific Types of Headaches

Horton, Bayard T.

doi:10.1001/jama.1941.02820050021005

Cited by 135 publications

(32 citation statements)

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“…Acute treatment Horton [15] was the first to describe a case report with the beneficial effect of intravenous ergotamine in the acute treatment of CH. Later, other routes of administration were proposed, such as rectal, oral, sublingual, or inhalation.…”

Section: Ergot Derivativesmentioning

confidence: 99%

Serotonergic Agents in the Management of Cluster Headache

Lambru

Matharu

2011

Curr Pain Headache Rep

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Cluster headache is a highly disabling primary headache disorder, characterized by unilateral headache attacks occurring in association with cranial autonomic symptoms. Serotonergic agents, such as the ergot alkaloids, have traditionally been used for the acute and preventive treatment of cluster headache and other primary headaches. Although it initially was thought that their efficacy was due solely to the vasoconstriction of extracranial cerebral vessels, new mechanisms of action of these drugs have been ascertained as a consequence of advances in elucidation of the pathogenesis of primary headaches and the development of triptans. This article reviews the current knowledge about serotonergic agonists and antagonists used in the management of cluster headache, focusing on their mechanisms of action and on the possible role of serotonin system dysfunction in this complex disorder.

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Section: Ergot Derivativesmentioning

confidence: 99%

Serotonergic Agents in the Management of Cluster Headache

Lambru

Matharu

2011

Curr Pain Headache Rep

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“…The active periods are associated with an increased sensitivity to various vasodilator stimuli: attacks can be elicited with alcohol [13], nitroglycerin [7], and histamine [14], with onset occurring 20 to 50 minutes after intake. During remission, nitroglycerin is ineffective [2].…”

Section: The Pathophysiologic Puzzlementioning

confidence: 99%

Hypothalamic involvement and activation in cluster headache

May

Goadsby

2001

Current Science Inc

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Cluster headache is an episodic form of primary neurovascular headache that is both severe and relatively rare. It is characterized by episodes of headache with cranial parasympathetic activation and sympathetic impairment that come in bouts, or clusters. Its pathophysiology can be divided into understanding the attack phenotype and the biotype of the periodicity. Acute attacks of cluster headache are marked by trigeminal nerve-mediated pain and with cranial autonomic activation, trigeminal-autonomic cephalalgia; an activation that characterizes the phenotype of a group of headaches. The signature feature of cluster headache is its periodicity, the daily cycle of attacks when the patient is in an active bout, or the circumannual, or other period, cycling that distinguishes the on period from the off period. Functional brain imaging with positron emission tomography and structural imaging with voxel-based morphometry have identified an area in the posterior hypothalamic gray as key in understanding cluster headache. This area is subtly enlarged in its gray matter volume, active during an acute cluster headache but inactive when patients are challenged between bouts. Cluster headache is likely to be a form of primary neurovascular pain whose phenotypic expression relies on the trigeminal-autonomic reflex, with a biotype determined by the brain area, the posterior hypothalamus, in which the lesion seems to be located. Understanding both the phenotypic expression and the biotype will, respectively, enable better acute attack treatments and better preventative management of this horrible form of headache.

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“…, 8 Origin of histamine provocative test and histamine desensitization.8 In the first case of histaminic cephalgia which I studied in 1937, I used both alcohol and histamine as provocative agents. With the patient under controlled environmental conditions (without food, room temperature 78° F, humidity 40 per cent) 1 ounce (30 ml) of alcohol was given by mouth.…”

Section: Provocative Testsmentioning

confidence: 99%