Chronic Paroxysmal Hemicrania: X. On the Autonomic Involvement

In four patients with chronic paroxysmal hemicrania, two of whom could precipitate attacks mechanically, various autonomic function tests were carried out in connection with attacks. Not all features could be studied in all patients, Forehead sweating and temperature were measured. Sweating, tearing, and nasal secretion were studied after systemic atropine administration, which reduced attack-related sweating, tearing, and nasal secretion markedly. Intra-ocular pressure was measured before and after the topical administration of an alpha-receptor blocking agent, thymoxamine. After topical thymoxamine no definite intra-ocular pressure increase occurred during precipitated attacks. In attacks precipitated by head movements, forehead sweating occurred seconds (up to 30 sec) before the pain. This study indicates that at least in some CPH cases, forehead sweating is not caused by the pain. Nor is the pain secondary to increase in intra-ocular pressure. The thymoxamine experiments seem to indicate that alpha-receptors in some way may be connected with the intra-ocular pressure increase during attack.

Download Full-text

Chronic Paroxysmal Hemicrania: Salivation, Tearing and Nasal Secretion

Cephalalgia ◽

10.1046/j.1468-2982.1984.0401025.x ◽

1984 ◽

Vol 4 (1) ◽

pp. 25-32 ◽

Cited By ~ 6

Author(s):

C Saunte

Keyword(s):

Salivary Glands ◽

Nasal Secretion ◽

Test Battery ◽

The Other ◽

Paroxysmal Hemicrania ◽

Control Group ◽

Innervation Pattern ◽

Autonomic Functions ◽

Chronic Paroxysmal Hemicrania ◽

The One

Autonomic functions have been studied in seven patients with chronic paroxysmal hemicrania (CPH). A test battery comprising tearing, salivation and nasal secretion was employed. Under basal conditions these parameters did not differ significantly from those in a control group. After stimulation with pilocarpine the patients responded rather inhomogeneously. This test battery may therefore help find and classify subgroups of these types of patients. During attacks, there is a clear discrepancy between minimal salivation on the one hand and the marked increase in tearing, nasal secretion and sweating on the other. CPH attacks may be associated with an increased firing of sympathetic impulses to the different organs. In the event of a uniform type of autonomic firing taking place during attack, these findings may suggest a different innervation pattern for the salivary glands compared to the other glands involved. The innervation pattern of these secretory organs may seem to be more intricate and sophisticated than hitherto assumed.

Download Full-text

Chronic Paroxysmal Hemicrania. VI. Precipitation of Attacks. Further Studies on the Precipitation Mechanism

Cephalalgia ◽

10.1046/j.1468-2982.1982.0204211.x ◽

1982 ◽

Vol 2 (4) ◽

pp. 211-214 ◽

Cited By ~ 18

Author(s):

Ottar Sjaastad ◽

David Russell ◽

Carsten Saunte ◽

Ivar Hørven

Keyword(s):

Carotid Arteries ◽

Internal Carotid ◽

Head Movements ◽

Paroxysmal Hemicrania ◽

External Compression ◽

Chronic Paroxysmal Hemicrania ◽

The Common ◽

Head Flexion ◽

Internal Carotid Arteries ◽

Symptomatic Side

In four of the approximately 40 cases of chronic paroxysmal hemicrania (CPH) that are known so far, attacks that are similar to the spontaneous ones may be precipitated by head movements or pressure against certain points in the neck. Head flexion was used as the precipitation procedure in a 34-year-old female who was studied several times in the course ot five years. Attacks occur within 5-40 sec, and the pain is preceded by tearing and conjunctival injection. External rubbing or external compression of the common and internal carotid arteries on the symptomatic side did not produce attacks. The combination of head flexion and external compression of the common or internal carotid arteries on the symptomatic side invariably produced an attack of usual severity and within the usual time. This investigation would seem to render unlikely the possibility of a primary vascular mediation of the signal from the neck to the ocular region. Sympathetic fibres are the likely mediators of the impulses from the neck to the ocular area.

Download Full-text

AN OPEN-LABEL CLINICAL TRIAL TO PROVE THE EFFICACY OF HIRUDOTHERAPY IN REDUCING THE INCREASED INTRA-OCULAR PRESSURE IN GLAUCOMA

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj0609072021 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1358-1361

Author(s):

Jeena N.J.

Keyword(s):

Intraocular Pressure ◽

Conventional Treatment ◽

Treatment Method ◽

Open Label ◽

Intra Ocular Pressure ◽

Leech Therapy ◽

Disease Condition ◽

Before And After ◽

Ocular Pressure ◽

Cardinal Feature

Glaucoma is a chronic disease condition prevalent globally leading to blindness. It results in optic neuropathy which is very difficult to manage. An increase in intraocular pressure is a cardinal feature in most cases. This study aims at lowering the intraocular pressure by leech therapy, which is a conventional treatment method described in Ayur- veda. Leech therapy was conducted in the selected patients and intraocular pressure before and after treatment were recorded. The study showed clinically and statistically significant changes in the intraocular pressure. Keywords: Leech therapy, glaucoma, intraocular pressure

Download Full-text

Personality Characteristics Before and After Treatment of Different Head Pain Syndromes

Cephalalgia ◽

10.1046/j.1468-2982.1994.1405368.x ◽

1994 ◽

Vol 14 (5) ◽

pp. 368-373 ◽

Cited By ~ 19

Author(s):

F Mongini ◽

F Ibertis ◽

E Ferla

Keyword(s):

Tension Type Headache ◽

Paroxysmal Hemicrania ◽

Separate Analysis ◽

Temporomandibular Joint Dysfunction ◽

Pain Syndromes ◽

Psychometric Data ◽

Before And After ◽

Chronic Paroxysmal Hemicrania ◽

Craniofacial Pain ◽

Type Headache

In order to examine whether, in patients with different types of headache and craniofacial pain, MMPI and STAI scores are significantly different before and after treatment, 114 patients with tension-type headache (n = 34), atypical facial pain (n = 20), temporomandibular joint dysfunction (n = 36), migrainene (n = 16), cluster headache (n = 4), chronic paroxysmal hemicrania (n = 2), trigeminal neuralgia (n = 2) were examined. A pain index was calculated (0–10) which quantified pattern, duration and frequency of pain. The Italian MMPI (356 item abbreviated version) and the STAI tests were administered before and after treatment. A paired t-test was used to assess pre- and post-treatment differences, and multiple regression analysis was employed to examine whether such differences correlated with the improvement in the pain index. In the total group after treatment, there was a significant reduction of certain MMPI scores (Hs, D, Hy, Pa, Pt, Sc, Si) and of STAI 1 and 2 scores. Separate analysis confirmed this among women but not among men. No relation was found between MMPI and STAI changes and the degree of improvement as assessed through the pain index. Clinical improvement leads to normalization of MMPI profiles and STAI scores in women. The psychometric data before treatment were not predictive for treatment outcome.

Download Full-text

Effects of a .BETA.-Adrenergic Blocking Agent Timolol on Intra Ocular Pressure Responses Induced by Stimulation of Cervical Sympathetic Nerve in the Cat.

The Tohoku Journal of Experimental Medicine ◽

10.1620/tjem.195.219 ◽

2001 ◽

Vol 195 (4) ◽

pp. 219-225 ◽

Cited By ~ 3

Author(s):

Akira Naito ◽

Hiroshi Izumi ◽

Keishiro Karita ◽

Makoto Tamai

Keyword(s):

Sympathetic Nerve ◽

Blocking Agent ◽

Beta Adrenergic ◽

Intra Ocular Pressure ◽

Ocular Pressure ◽

Cervical Sympathetic ◽

Adrenergic Blocking ◽

Cervical Sympathetic Nerve ◽

Stimulation Of

Download Full-text

Dose, Efficacy and Tolerability of Long-Term Indomethacin Treatment of Chronic Paroxysmal Hemicrania and Hemicrania Continua

Cephalalgia ◽

10.1046/j.1468-2982.2001.00287.x ◽

2001 ◽

Vol 21 (9) ◽

pp. 906-910 ◽

Cited By ~ 61

Author(s):

JA Pareja ◽

AB Caminero ◽

E Franco ◽

JL Casado ◽

J Pascual ◽

...

Keyword(s):

Hemicrania Continua ◽

Paroxysmal Hemicrania ◽

Chronic Paroxysmal Hemicrania ◽

Indomethacin Treatment

Download Full-text

Chronic Paroxysmal Hemicrania. VII. Mechanical Precipitation of Attacks: New Cases and Localization of Trigger Points

Cephalalgia ◽

10.1046/j.1468-2982.1984.0402113.x ◽

1984 ◽

Vol 4 (2) ◽

pp. 113-118 ◽

Cited By ~ 11

Author(s):

Ottar Sjaastad ◽

Carsten Saunte ◽

JR Graham

Keyword(s):

Posterior Part ◽

Transverse Process ◽

Trigger Points ◽

Paroxysmal Hemicrania ◽

Sensitive Area ◽

Manual Pressure ◽

Chronic Paroxysmal Hemicrania ◽

Local Tenderness ◽

Symptomatic Side

Two new chronic paroxysmal hemicrania patients are described. In both, attacks can be precipitated mechanically by applying firm manual pressure to certain sensitive points on the neck, i.e. in the C2 area, in the transverse processes of the C4–C5 vertebrae, or beneath the posterior part o15 the skull on the symptomatic side. The most sensitive area seems to be the transverse process of C4–C5. Susceptibility to this type of attack is dependent on the flow of spontaneous attacks; attacks are easily precipitated in a phase with multiple spontaneous attacks, but are not readily precipitated otherwise. Under indomethacin protection, local tenderness is clearly diminished and attacks cannot be precipitated.

Download Full-text