Video assessment of yawning induced by sublingual apomorphine in migraine.

A double-blind, placebo-controlled study was carried out in 14 migraineous outpatients and 8 control subjects to assess yawning response to 0.25 mg of sublingual apomorphine, a dopamine receptor agonist, by means of an audiovisual technique. Apomorphine induced a significantly higher number of yawns than placebo in both groups of subjects, but the effect was significantly greater in migraine sufferers than in controls. The result seems to confirm the previous reported hyper-responsiveness to pharmacological dopaminergic stimulation in migraine sufferers. Moreover, the audiovisual technique seems to be an appropriate tool to study yawning response in man.

Hypothalamic modulation of nociception and reproduction in cluster headache. I. Therapeutic trials of leuprolide.

A slow-release gonadotropin-releasing hormone (Gn-RH) analogue was administered to 30 males suffering from chronic cluster headache (CH) in a placebo-controlled study with the aim of enhancing neurotransmission in the pain-suppressing systems of the hypothalamus through a feedback action involving neuroendocrine functions too. A significant improvement in the severity of the pain occurred together with the expected lowering of the libido and serum levels of testosterone and luteinizing hormone. We postulate that the benefit of the Gn-RH analogue relates to an impairment of neuronal modulation in cluster headache.

Hypothalamic modulation of nociception and reproduction in cluster headache. II. Testosterone-induced increase of sexual activity in males with cluster headache.

Short-lasting chronic testosterone administration did not change the course of cluster headache in seven chronic sufferers, whereas it enhanced sexual excitement in comparison with male control subjects who received the same treatment. We postulate that the sexual excitement induced in cluster headache sufferers by chronic treatment with testosterone relates to an impairment of neuronal modulation in this disorder.

Intramuscular treatment of migraine attacks using diclofenac sodium: a crossover clinical trial.

This was a double-blind clinical trial, with a crossover design, to compare the efficacy of a non-steroidal anti-inflammatory drug, diclofenac sodium, intramuscularly administered, and placebo in the treatment of migraine attacks. The drug was administered to 40 patients once a day in three consecutive migraine attacks. If pain still remained after 6 h following administration the patient was given a 100 mg diclofenac sodium suppository, in open condition. Evaluation was by a complete medical examination performed by the physician and by the patient completing a specially designed self-assessment card. A total of eight patients dropped out of the trial (all during placebo administration): three due to poor compliance, four for refusal to continue and one because no further migraine attacks developed. Results were analysed after having checked the absence of both period and carry-over effects. In all cases diclofenac sodium was more effective than placebo (P less than 0.01). This was also confirmed by data obtained from the patient self-assessment cards (P less than 0.001) and by preferences expressed by patients at the end of the trial (P less than 0.001). Tolerance to the drug was similar to that of placebo.

Lisuride as a migraine prophylactic in children: an open clinical trial.

Lisuride is an ergot derivative which acts on serotonin and dopamine receptors at both peripheral and central levels. According to the central theory of headache, lisuride is an active prophylactic drug in adult headache sufferers. Because of its activity on dopamine receptors, a hypotensive action has been observed after acute and chronic administration of high doses of the drug in adults. An open trial on 45 migrainous children was carried out, to compare lisuride with pizotiphene treatment. Some 23 children were treated with lisuride and 22 with pizotiphene for 42 days. No statistically significant difference in therapeutic results between the two groups was found. Eight migrainous children were treated with a single oral dose of lisuride (0.0250 mg) and arterial blood pressure was measured before and after the drug. No significant change in either supine or orthostatic blood pressure was recorded in pre-drug and post-drug values. This study shows that lisuride is an effective and well-tolerated prophylactic drug in migrainous children.

Sexuality and headache.

Ten percent of 362 headache sufferers reported sexual arousal during migraine attack. Clinical investigations on sexuality in 16 headache sufferers, according to some studies showing correlations between idiopathic headache and sexual behavior, were performed. Patients responding by questionnaire listed each sexual experience, headache attack, and number of sleeping hours every day for 1 month. In both men and women, the number of coiti, erotic dreams, and sleeping hours were similar in headache sufferers and controls, while the frequency of masturbation was significantly reduced in the former. Sexual excitement and fantasies appeared more often in female headache sufferers than in controls, while the opposite occurred in the male group. Among the clinical analogies between the crises of migraine and morphine abstinence, sexual arousal may be included.