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Biomedical subjects

J N Blau

Publications and source records attributed to J N Blau.

At least 19 recordsLinked to original sources
PubMed1992

Classical migraine: symptoms between visual aura and headache onset.

The gap between the end of the visual aura and headache onset in classical migraine has been called the free interval. In a retrospective study of twenty-five migraineurs who had noted a gap, only three reported feeling normal at that time: twenty-two described alterations in mood, detachment from the environment or other people, fears, disturbances of speech or thought, or somatic symptoms. The interval lasted less than an hour in seventeen of the twenty-two but in five persisted for 1 to 5 hours. These symptoms suggest involvement of the frontal and temporal cortices as well as the hypothalamus; they do not conform to Leão's spreading depression or a vascular mechanism, but are in keeping with a diffuse cerebral process with focal manifestations.

Adult↗
PubMed1992

Migraine: an informative method of communication.

The Keypad Audience Response System can be used to obtain simultaneous information from a large number of people in an audience. Answers to specific questions are transmitted from a keypad (pressed by each participant) to a computer. The results are displayed on a screen within 20 seconds, expressed as percentages of total responses to each question and presented as bar diagrams or pie charts. At a meeting of the British Migraine Association, over 100 migraineurs learned how their attacks differed from, or resembled those of others. The speakers were able to clarify and discuss both questions and answers which confirmed previous findings about attack duration, prodromes, postdromes, effect of pregnancy, oral contraceptives and the menopause. Three new points emerged which merit further study: 1. Hormone replacement therapy aggravated migraine in 42% of women, 27% noted an improvement, and 31% observed no alteration. 2. Twenty-five percent prefer to sit up during an attack. 3. Seven percent reported prolonged attacks (3-7 days). The use of keypads at seminars or lectures is valuable in promoting enthusiastic audience participation, and the understanding of the diverse symptoms and manifestations of a condition. Although observations cannot be extrapolated to a wider population because all audiences are a selected group, new points requiring research may be highlighted.

Adult↗
PubMed1992

Migraine triggers: practice and theory.

The basis of our belief in migraine triggering factors is questioned. To avoid creating migraine-mythology, it is proposed that a trigger for migraine must also cause headache in non-migrainous subjects. This headache-migraine parallelism is examined and if correct, casts doubt on migraine precipitation by cheese, chocolate or allergy. A further weakness of "dietary migraine" is pointed out because the quantity of the trigger consumed, or the time interval between ingestion and the onset of attacks, are rarely mentioned, let alone studied. A difficulty in assessing migraine precipitants is that two factors may act in unison, e.g. stress and not eating. Further an external factor may provoke an attack only if the migraine "milieu intériur" is set appropriately, for example the hormonal state in a woman's menstrual cycle. The value of studying migraine precipitants is two-fold: (1) it provides a means of counselling patients to avoid or reduce these factors, thereby diminishing frequency and severity of attacks; (2) a comprehensive migraine pathogenetic theory must incorporate how and where precipitants act. It is concluded that analysis of triggering mechanisms lends support to the concept that migraine is a primary neurological disturbance with secondary vascular manifestations.

Contraceptives, Oral↗
PubMed1991

The clinical diagnosis of migraine: the beginning of therapy.

Clear symptoms and signs are found in patients during severe migraine attacks. Diagnostic difficulties are encountered in eliciting this episodic clinical picture. A label of migraine, however, is only the beginning: factors that precipitate attacks, fears aroused in the migraineur and the failure, or partial efficacy, of acute and prophylactic therapy need also to be determined. If migraine is complicated by an additional headache, the analysis becomes more difficult, but the diagnosis still has to be accurate. This, however, is not always possible at the initial interview. A successful consultation should be more than just diagnostic; it is the beginning of treatment.

Attitude of Health Personnel↗
PubMed1991

Migraine postdromes: symptoms after attacks.

To determine the nature and duration of symptoms after the headache phase of migraine, 40 migraineurs (11 with and 29 without an aura) were given a questionnaire to complete on the day after a migraine attack. The most common symptoms that remained were physical and mental tiredness, subdued or depressed mood, impaired concentration, reduced physical activities and yawning; weak or clumsy limbs, head tenderness, neck ache or stiffness, impaired sight and altered fluid balance were less frequent. The number of symptoms ranged from 2 to 11 (average 6) per patient lasting for a mean of 18 h, usually the whole of the next day. Symptoms after the main migraine attack can help to diagnose migraine particularly when there is no aura before the onset of headache. Eliciting postdromes aids patient-doctor rapport and confidence. The range of symptoms lends support to the notion that the whole of the brain is involved in the aftermath of migraine attacks.

Adult↗
PubMed1990

Sleep deprivation headache.

Headaches due to insufficient or interrupted sleep are generally labelled "tension headaches" of psychogenic origin. In 25 healthy subjects, variable amounts of sleep loss (1-3 h for 1-3 nights) caused headaches lasting from 1 h to all day. The headache was most frequently a dull ache, a heaviness or a pressure sensation felt in the forehead and/or at the vertex. Simple analgesics, purchaseable without a doctor's prescription, completely or markedly reduced the head pain in 20-60 min. Headaches due to insufficient sleep differ from tension headaches in their site, duration and response to analgesics. Assuming that pain implies a regional dysfunction, headaches caused by sleep loss provide support for the notion that sleep has a restorative function in the brain.

Adult↗
PubMed1990

Common headaches: type, duration, frequency and implications.

Questionnaires completed by 327 preclinical medical and dental students showed that 97.9% had experienced headaches, most frequently attributed to insufficient sleep (38.8%), mental stress (38.8%), alcohol (38.5%), excess heat (36.7%), reading (31.5%), excess noise (29.9%) or light (27.7%), and sleeping too long (23.5%). The frequency and duration of these and other headaches are listed. 8% of the headache group had consulted a doctor. Only 2.1% of all students had never experienced a headache. Two hypotheses are examined: (1) can headaches be normal?--delineated by their disappearing soon after the noxious stimulus has ceased; (2) can pain in the head, as elsewhere in the body, act as a warning and therefore have protective, even survival value?

Adolescent↗
PubMed1990

Episodic paroxysmal hemicrania: a further case and review of the literature.

Episodic paroxysmal hemicrania was delineated as a clinical entity only two years ago, separating patients whose attacks remained grouped in bouts lasting weeks, from those who started irregularly and lapsed into chronicity or began and continued in the chronic state. A further case of the episodic variety and a review of the nine previously recorded cases is reported. The division into episodic and chronic variants of paroxysmal hemicrania conforms with the classification of cluster headache. The similarity of the two conditions is emphasised although the response to indomethacin in paroxysmal hemicrania is a special feature.

Adult↗
PubMed1989

Headaches in insulin-dependent diabetic patients.

Headaches affecting 117 insulin-dependent diabetic patients were studied. 50 developed 3 varieties of headaches associated with clinical hypoglycaemic episodes: (1) Brief headaches, contemporaneous with cerebral and autonomic symptoms, were relieved within minutes of ingesting carbohydrates (8 patients). (2) Prolonged headaches outlasting hypoglycaemic symptoms by 1-48 (average 4.3) hours, not relieved by food, occurred in 36 patients; 12 of these also had nausea, vomiting or photophobia. (3) Migraine headache. 11 of the 117 patients were migraineurs: in 6 of the 11 their typical migraines (2 classical and 4 common) were induced by hypoglycaemic episodes. 9 of the 50 had 2 types of headaches, easily distinguished by each subject. In the whole series of 117 patients, 9 had never had a headache in their life. The remainder had headaches associated with premenstrual tension, anxiety, alcohol or other causes.

Adolescent↗