Journal ArticleDOI
Clinical effectiveness of calcium entry blockers in prophylactic treatment of migraine and cluster headaches
TLDR
In this article, a double-blind, cross-over, randomized assignment to high or low dose nimodipine therapy was performed on 35 headache patients with classic (n = 13), common (N = 14) migraine or cluster (N=8).Abstract:
SYNOPSIS
Since Wolff's original proposal regarding the vascular etiology of cyclic head pain, evidence has accumulated that the prodromes of migraine are due to cerebral vasoconstriction and headaches of both cluster and migraine are due to painful dilatation. Theories regarding their pathogenesis include cyclic release of vasoactive substances from platelets and/or other sources (such as serotonin, catecholamines, histamine, acetyl choline, prostaglandins, substance P, endogenous opiates). These substances influence vasomotor receptors bringing about abnormal constriction and/or dilatation. Drugs which modify receptors (such as methysergide, alpha and beta blockers, antihistaminics, anticholinergics, steroids and non-steriodal anti-inflammatory agents) have had some therapeutic success in migraine but provide little benefit for cluster patients. Ca2+ entry blockers (including nimodipine, nifedipine, verapamil) theoretically should diminish cephalic vasoconstriction and -dilatation no matter what their cause. To test this, 35 headache patients with classic (N = 13), common (N = 14) migraine or cluster (N=8) were evaluated by double-blind, cross-over, randomized assignment to high or low dose nimodipine therapy. Within 10 days migraine prodromes became infrequent and after 2–4 weeks headache frequency was significantly reduced for migraine and within 4–6 weeks for cluster. CBF measurements during oxygen inhalation showed reduced cerebral vasoconstrictive responses after high dose nimodipine. Associated muscular contraction headaches were not altered. Nifedipine and verapamil provided equivalent relief for cluster but produced more side effects, and were less effective, than nimodipine in control of migraine.read more
Citations
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Spreading depression: a review of the clinical relevance.
TL;DR: Different evidences and hypotheses which suggest a link between SD and clinical disorders are collected to increase the understanding of SD associated disorders and improve the fundamental research strategies.
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Calcium Channel Blockers
TL;DR: This poster presents a probabilistic procedure to assess the importance of baseline IgE levels in the decision-making process for ART and its applications in medicine and sport.
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Guidelines for the diagnosis and management of migraine in clinical practice
W. E. M. Pryse-Phillips,David W. Dodick,John Edmeads,Marek J. Gawel,R. F. Nelson,RA Purdy,Geoffrey C. Robinson,D. Stirling,I. Worthington +8 more
TL;DR: These guidelines are based on consensus of Canadian experts in neurology, emergency medicine, psychiatry, psychology, family medicine and pharmacology, and consumers and are likely to lead to substantial benefits in both human and economic terms.
Journal ArticleDOI
Double Blind Comparison of Lithium and Verapamil in Cluster Headache Prophylaxis
Gennaro Bussone,Massimo Leone,C. Peccarisi,G. Micieli,Franco Granella,M Magri,G. C. Manzoni,Giuseppe Nappi +7 more
TL;DR: In this paper, the authors conducted a multicenter trial employing a double-dummy, double blind, cross-over protocol, comparing verapamil with the established efficacy of lithium carbonate, in preventing CCH attacks.
Journal ArticleDOI
Migraine and muscle contraction headaches: a continuum
TL;DR: In this article, the authors found that migraine and muscle contraction headaches are similar; rather than being different entities, they may vary in symptom quantities instead of having qualitative differences, and they may have a unipolar distribution.
References
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Journal ArticleDOI
Mechanism of Action of Calcium-Channel-Blocking Agents
TL;DR: The development of drugs that interfere with the entry of Ca++ into cells has provided the basic scientist with powerful new tools for the study of the role of this ion in normal as well as pathologic states.
Book
Cluster Headache: Mechanisms and Management
TL;DR: When you read more every page of this cluster headache mechanisms and management, what you will obtain is something great.
Journal ArticleDOI
Nifedipine in Unstable Angina: A Double-Blind, Randomized Trial
Gary Gerstenblith,Pamela Ouyang,Stephen C. Achuff,Bernadine H. Bulkley,Lewis C. Becker,E. David Mellits,Kenneth L. Baughman,James L. Weiss,John T. Flaherty,Clayton H. Kallman,Michaelene P. Llewellyn,Myron L. Weisfeldt +11 more
TL;DR: The addition of nifedipine to conventional therapy is safe and effective in unstable angina and was particularly marked in patients with ST-segment elevation during angina.
Journal ArticleDOI
Hemodynamic studies within the brain during migraine.
TL;DR: Angiographic studies during the prodromal phase support the hypothesis that vascular dysregulation in the basilar artery, as well as in the carotids, play a substantial role in the pathogenesis of migraine.
Journal ArticleDOI
The effects of a calcium antagonist, nimodipine, upon physiological responses of the cerebral vasculature and its possible influence upon focal cerebral ischaemia.
TL;DR: The threshold levels of blood flow for the development of cortical oedema and for disturbance of ion homeostasis were increased, suggesting that nimodipine interferes with cellular energy metabolism and increases the susceptibility of tissue to ischaemic damage.
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