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  • 1
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: An involvement of vestibulocochlear functions has been assumed to occur in migraine even in headache-free intervals. To obtain further information on this subject, we investigated an unselected group of patients with various forms of migraine (n=94) and cluster headache (n=8) during pain-free periods by means of electronystagmography (ENG). The investigation showed a normal ENG in all patients with cluster headache and in 85 (90.4%) patients with migraine. Five patients showed increased occurrence of horizontal deviations, indicating an impairment of vigilance. A pathological ENG was observed in only four patients, of whom one with “basilar migraine” showed a disturbance of central vestibular functions. Based on the employed methods, it is concluded that vestibular dysfunctions, and in particular those of central origin, are not common in cluster headache and in migraine-with the possible exception of basilar artery migraine.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The case of a 69-year-old woman with chronic paroxysmal hemicrania (CPH) is presented in whom cerebral perfusion was investigated using the flow tracer 99mTc-hexamethyl propylenamino oxime (HMPAO) and single photon emission tomography (SPECT). There was a bilateral hypoperfusion in the fronto-parietal region between attacks-without medication as well as under effective treatment with verapamil. During an attack, however, SPECT investigation showed a normal cerebral perfusion. Further investigation is required to find out whether these SPECT findings are due to primary alterations of brain perfusion in CPH or are only of epiphenomenological nature. The observed effectiveness of verapamil in the prophylactic treatment of CPH should be verified in a greater number of patients.
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  • 3
    ISSN: 1468-2982
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Acetazolamide, a carbonic anhydrase inhibitor, has proved to be useful in the assessment of “vasodilatory capacity” in cerebrovascular disease. To obtain further information on the nature of interictal low-flow regions in migraine, we reinvestigated 20 asymptomatic patients suffering from migraine with aura (n = 15) or without aura (n = 5) and who had either minor (n = 12) or marked (n = 8) regional hypoperfusion when examined in a previous 99mTc-HMPAO SPECT investigation. These patients received acetazolamide IV prior to tracer application. In 14/20 cases regional hypoperfusion resolved. Three patients with migraine with aura had less pronounced regional hypoperfusion compared to baseline. No change in baseline hypoperfusion was detectable in three older patients. No further decreases in flow were measured. In contrast to patients with cerebrovascular ischemia, in whom acetazolamide usually enhances low-flow regions, vasodilatory capacity appears intact in most migraine patients with interictal regional hypoperfusion. Thus, the “acetazolamide test” might be useful in the differential diagnosis of migraine with aura from transient cerebrovascular ischemia.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1437-2320
    Keywords: Cerebral perfusion ; migraine ; SPECT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Migraine is considered to be a functional neurological disorder. In classical migraine (headache associated with prodromal visual field disturbances) and migraine accompagnée (headache associated with transient neurological symptoms), disturbances of cerebral blood flow and amine metabolism are thought to be pathogenetic factors. However, conventional methods of neuroimaging (CAT, NMR) usually do not yield any pathological findings in patients. Since123I-iodoamphetamine (123I-IMP) crosses the intact blood brain barrier,123I-IMP-SPECT is used for the assessment of cerebral perfusion in various neurological diseases, including functional disorders. 123I-IMP-SPECT was performed on 5 patients with classical migraine and 18 patients with migraine accompagnée. At the time of investigation, all patients were symptom-free. Cerebral blood flow was decreased in all patients with migraine accompagnée, and often corresponded to the site of headache as well as to the topography of transient neurological symptoms. This reduction was most obvious in a patient with persisting neurological symptoms. Most patients with classical migraine, however, did not show any alteration of cerebral perfusion. It appears that migraine — and in particular migraine accompagnée — is characterized by a permanent alteration not only of cerebral blood flow but also of neuronal activity. Migraine attacks may occur in connection with exacerbations of preexisting metabolic alterations.
    Type of Medium: Electronic Resource
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