Biomedical subjects

O Sjaastad

Publications and source records attributed to O Sjaastad.

At least 19 recordsLinked to original sources

PubMed1992

The Chiari type I malformation in two monozygotic twins and first-degree relatives.

The presence of the Chiari type I malformation in 2 adult monozygotic female twins, their mother, and possibly in 2 of their 4 daughters is reported. The diagnosis was made by magnetic resonance imaging and confirmed at the time of surgery in 1 twin. Monozygosity of the twins was proved by DNA typing. The disorder in the present family should probably be classified together with the autosomal dominant craniocervical malformations. Nongenetic factors also seem to be important because the twins were discordant for the extent of herniation of the cerebellar tonsils and the presence of syringomyelia.

Adolescent↗

PubMed1992

Mutual modification of vasoactivity by calcitonin gene-related peptide and endothelin-1 in isolated porcine ophthalmic artery.

Vasodilation has been implicated in the pathophysiology of some headaches, but the mechanisms behind such abnormalities remain unknown. Calcitonin gene related peptide (CGRP), a peptide present in sensory trigeminal fibres, induces strong and long lasting vasodilation in cranial vessels, and has been found to be increased in jugular blood during migraine attacks. Endothelin (ET) is a recently identified potent vasoconstrictor peptide, which also induces long-lasting responses. ET-CGRP interactions may be of importance in vascular beds putatively involved in pain development in the head, and were therefore studied in isolated porcine ophthalmic arteries. Both peptides were found to induce strong and long-lasting reactions in this artery. CGRP decreased ET-induced contractions and ET decreased CGRP-induced relaxations. These effects were additive rather than synergistic.

Animals↗

PubMed1992

Substance P augments the rate of vasodilation induced by calcitonin gene-related peptide in porcine ophthalmic artery in vitro.

Peptides may function as neurotransmitters liberated antidromically by sensory nerve fibres, provoking vascular responses having potential importance in some neurological disorders. Dose-response relaxation curves induced by substance P (SP) and calcitonin gene related peptide (CGRP) have been studied in porcine ophthalmic arteries in vitro. Both peptides induced vasodilation when tested separately (CGRP much greater than SP). Because of the putative interactions between such peptides in this vascular territory, a computerised system was also used for analysing over time the response to a single addition of either 10(-8) M CGRP, 10(-8) M SP or a combination of 10(-8) M SP + 10(-8) M CGRP. SP did not augment the maximum relaxation induced by CGRP alone, but increased significantly the rate of relaxation during the initial phase of the response. The effect induced by the SP+CGRP combination was stronger than the sum of the individual SP and CGRP-induced relaxations during the first 4 min of the response, which suggests a SP-CGRP synergism in this artery.

Animals↗

PubMed1992

Cervicogenic headache: the controversial headache.

Cervicogenic headache is characterized by unilaterality without sideshift, and the pain attack starts in the neck, in contradistinction to what is the case in common migraine. Signs of neck involvement (e.g. reduction of the range of motion; mechanical precipitation of attacks; ipsilateral, diffuse arm/shoulder pain) are typical in cervicogenic headache but not in common migraine. These and many other features aid in distinguishing these two headaches.

Cervical Vertebrae↗

PubMed1992

Cluster headache: phospholipid metabolism in polymorphonuclear cells.

Our group has previously reported significant changes in the incorporation of precursors into glycerophospholipids, particularly phosphatidylserine, in polymorphonuclear cells obtained from the peripheral blood of cluster headache patients, when compared with controls. The potential of these results led to further work using both the previous methodology and a modified isolation technique to obtain polymorphonuclear cells in as pure a state as possible. Neither the new results obtained using the original technique, nor the results with high purity polymorphonuclear cells from controls and cluster headache patients, confirm the marked changes in precursor uptake into glycerophospholipids originally reported.

Adult↗

PubMed1992

Cluster headache: alterations in heart rate, blood pressure and orthostatic responses during spontaneous attacks.

Changes in heart rate and blood pressure (BP) have been monitored beat-to-beat in a cluster headache patient with and without attacks using a non-invasive Doppler servo method. Two attacks were monitored and during one of them a tilt test was carried out. The variability of heart rate and BP was greater during the attack than during the interparoxysmal period. A marked bradycardia occurred during attacks. Systolic BP increased slightly. There was no heart rate increase after tilting during the attack, whereas this was present invariably during tests carried out interparoxysmally. BP changes during "attack tilt" were difficult to evaluate because of large variation. This may be the first observation of a baroreflex arc dysfunction during a cluster headache attack.

Blood Pressure↗

PubMed1992

Reduction of calcitonin gene-related peptide in jugular blood following electrical stimulation of rat greater occipital nerve.

Although it is known that pain in the forehead may be induced by neck abnormalities, the actual neck-head connections responsible for development of pain in trigeminal areas are poorly understood. Vasoactive neuropeptides released from sensory fibres, such as substance P (SP) and calcitonin gene-related peptide (CGRP), have been considered as important elements in headache pathophysiology. The levels of CGRP-like immunoreactivity (LI) were measured bilaterally in the jugular blood (52 rats) and intraocular aspirates (66 rats) following electrical stimulation of the left greater occipital nerve, and in the jugular blood of 13 control animals. One-third of the stimulated rats had varying combinations of conjunctival injection, tearing, diminished eye aperture and miosis or mydriasis on the stimulated side. The other two-thirds exhibited no ocular signs. Significantly lower levels of CGRP-LI were present in the jugular blood on the stimulated side in comparison with control rats. There was comparatively lower CGRP-LI on the non-stimulated side as well, but to a lesser extent. Significant differences between the stimulated and the non-stimulated side were present, particularly in the tearing/diminished eye cleft group. It is proposed that stimulation of the rat GON inhibits the trigeminal system (reduction of CGRP-LI) and possibly activates parasympathetic fibres (ocular changes).

Animals↗

PubMed1992

Cluster headache: oxygen saturation and end-tidal CO2 during and without attack.

Twenty-eight cluster headache patients were examined either in remission (n = 10), in the interparoxysmal period ("cluster phase") (n = 12), or during spontaneously occurring (n = 7), or nitroglycerin provoked (n = 7) attacks. Fourteen healthy controls participated in the study. Oxygen saturation (SaO2), end-tidal CO2 (PCO2), and respiratory rate (R.R.) were recorded for the controls and the patients during the different phases of cluster headache. Both PCO2 and SaO2 tended to be lower during the interparoxysmal period of the cluster phase when compared to the control group or to the remission. During both nitroglycerin-provoked and spontaneous attacks, PCO2 and SaO2 tended to respectively decrease and increase, both when compared with the "cluster phase" and with the period immediately prior to attack ("pre-attack"). Hence the "pre-attack" state may, on an average, be characterized by a slight hypoxia and a slight hyperventilation. Marked, clinically observable hyperventilation was present only in the occasional cluster headache patient. There was no SaO2 decrease from the "cluster phase" (interparoxysmal period) to the period immediately preceding the attack ("pre-attack"), and SaO2 "dips" preceding an attack were only observed in one cluster headache patient. As demonstrated previously by our group, a considerable lowering of SaO2 (i.e. partly to less than or equal to 83%) does only exceptionally lead to attack (Zhao et al, 1990). This observation combined with the evidence presented herein may seem to indicate that the slight pre-attack oxygen desaturation probably is too small to be a symptom-producing factor in cluster headache--be it in the spontaneously occurring or in the induced attack.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Neurolysis of the greater occipital nerve in cervicogenic headache. A follow up study.

Entrapment of the greater occipital nerve (GON) in its peripheral course has been thought to be of possible pathogenic significance in cervicogenic headache. We have performed a "liberation" operation ("neurolysis") of the nerve in the nuchal musculature, with special attention to the trapezius insertion, and the follow-up results in 50 patients are presented. The immediate effect of the operation was quite good, but the pain gradually recurred in the majority (46/50) of the patients. Eventually, all operated patients will probably have recurrence of pain episodes. Nevertheless, most patients claim that the overall disability is less after the operation, and 40% actually want to undergo a new, identical procedure. The justification for doing a second "liberation" operation is clearly less than for a first operation. In our opinion, this operation should not be performed in patients with cervicogenic headache in general. The present study shows that other therapeutic approaches should be searched for in cervicogenic headache.

Adult↗

PubMed1992

Short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome): IV. Respiratory sinus arrhythmia during and outside paroxysms.

SUNCT is a headache syndrome characterized by short-lasting (usually 15-120 sec), unilateral head pain paroxysms localized in the peri-ocular area, accompanied by conjunctival injection, lacrimation, nasal stuffiness, rhinorrhea, and subclinical forehead sweating, all on the symptomatic side. A relative bradycardia seems to be an integral part of the paroxysm; a parasympathetic stimulation could theoretically be the causative factor for the bradycardia. In 3 SUNCT patients, vagal nerve function (E:I ratio) has been monitored outside and during pain paroxysms, while 3 other patients could be studied in the attack-free period only. E:I ratio is obtainable in the course of a maximally deep breath and represents the ratio of the longest R-R interval during a 5 sec long expiration to the shortest R-R interval during a 5 sec long expiration. The mean E:I ratio of SUNCT patients outside paroxysms was significantly higher than the mean E:I ratio in an aged-matched control group. The E:I ratio was, however, significantly decreased during paroxysms in comparison with ratios obtained outside the pain paroxysms. After 0.6 mg atropine administration s.c. to one of the patients in the symptomatic phase, the heart rate increased, and the relative bradycardia during headache paroxysm was diminished (but not completely abolished). The E:I ratio was lowered but it was still slightly larger outside than during attacks. The reason for the abrupt and seemingly clear attack-related decrement in E:I ratio together with the previously described relative bradycardia remains enigmatic, however the possibility of increased parasympathetic tone cannot be excluded.

Aged↗

PubMed1992

Low concentrations of lithium and cyclooxygenase inhibitors enhance endothelin-1 (ET-1)-induced contractions in human temporal artery, but not in porcine ophthalmic artery.

Endothelins are a recently discovered group of potent vasoconstrictor peptides synthesized by endothelial cells and other tissues in various species, which seem to participate in the regulation of vascular tonus. Abnormalities in vasoactivity in the head may be an important event in headache pathophysiology, although the mechanisms responsible for such constrictions and/or dilations are not known. The endothelium and its constrictor peptide, endothelin, may play a key role in such mechanisms. Of the various drugs used in the treatment of headache, lithium is an accepted treatment for cluster headache, and indomethacin is the drug of choice for the associated condition chronic paroxysmal hemicrania. The mechanism of action of these drugs in these headaches is not known. Due to the possible involvement of endothelin in headache disorders, the objective of this study was to verify the effects of lithium and cyclooxygenase inhibitors (indomethacin, acetylsalicylic acid and naproxen) on endothelin-1 (ET-1)-induced contractions in isolated human temporal arteries and porcine ophthalmic arteries. It was found that all drugs increased the (ET-1)-induced contractions in human temporal arteries. Conversely, there were no significant changes induced by the drugs in porcine ophthalmic arteries. These results are consistent with the variation of activity often seen in different vascular beds and between species. The potential importance of such reactions for the understanding of vascular changes putatively involved in headache development and treatment is discussed.

Animals↗

PubMed1992

SUNCT syndrome: VII. Ocular and related variables.

SUNCT is a unilateral headache syndrome with shortlasting attacks, accompanied by e.g. conjunctival injection and lacrimation on the painful side. Intraocular pressure (IOP), corneal indentation pulse (CIP) amplitudes, episcleral venous pressure, and corneal, tympanic, and facial temperature have been studied in 6 SUNCT patients. IOP and CIP amplitudes increased on the painful side during headache paroxysms, while episcleral venous pressure remained unchanged. Corneal temperature seemed to increase during attack on both sides. However, the number of observations during attacks is scanty. Outside of attacks, the corneal temperature on the symptomatic side seemed to be higher when compared with the non-symptomatic side (generally > or = 0.5 degrees C), provided that the attack frequency was high. The facial temperature seemed to be even on both sides or slightly higher on the symptomatic than on the non-symptomatic side in the periocular area. This pattern seems to be different from the one in trigeminal neuralgia, in which the temperature has been reported to be lowest on the painful side of the face. During attacks, there seemed to be a tendency for the temperature to increase in the periocular area, but not over the mandible or in the neck. The results obtained could be caused by increased blood supply to the eye (and the surrounding skin) on the symptomatic side because of vasodilatation during repeated pain attacks. As far as the ocular changes are concerned, probably the arteriolar side of the vascular bed is involved.

Aged↗

PubMed1992

A new hereditary syndrome with a bleeding tendency, extreme miosis, spasms, dyslexia, thrombocytopathia etc. Pupillometric, evaporimetric, and ophthalmological observations.

A recently described familiar syndrome consists of the following components: A bleeding tendency with thrombocytopathia, miosis, muscular weakness and spasms, ichthyosis, asplenia, dyslexia, and headache. Four definite and 2 probable patients have been identified in 4 generations. In the present study, the pupillary behaviour was scrutinized in two 'definite' cases with the infrared, binocular pupillometer. The forehead sweating pattern was also investigated with an Evaporimeter. The basal pupillary widths were: 1.25-1.75 mm. Only minor responses were noted upon topical stimulation with an indirectly acting pupillodilating agent (OH-amphetamine). A directly acting sympathicomimetic drug (phenylephrine) exerted a more marked influence on the pupil, indicating a relative supersensitivity. The evaporimetric pattern in the forehead seemed to be within reference limits, at variance with what is the case in Horner's syndrome. Further findings were: the orbit seemed to be smaller than normal; a bilateral VI. cranial nerve palsy was identified, and a marked upward gaze palsy coexisted with pupils with Argyll Robertson's traits. There is no readily acceptable explanation for the ocular abnormalities. The disorder underlying the pupillary abnormality may possibly be located in the upper mesencephalon.

Adult↗

PubMed1991

Hereditary essential myoclonus in a large Norwegian family.

We examined 56 members of a large Norwegian family with hereditary essential myoclonus, affecting mainly the neck and upper parts of the body, and inherited in an autosomal-dominant pattern. We observed definite myoclonus in nine individuals, probable myoclonus in one, and possible myoclonus in one. There were two other living members who had a history compatible with myoclonus but who had developed a permanent remission, so we did not observe the movements, and two who had involuntary movements only with stress. Writing usually increased the myoclonus in the neck and trunk, but did not produce myoclonus in the arm used for writing. Having a conversation with an individual who was aware of being watched would also usually increase the myoclonus. Alcohol ameliorated the myoclonus in many, but not all, affected members. Activities such as walking and concentrating during reading would usually reduce the myoclonus. Three living members with definite myoclonus also had features of mild focal dystonia, either spasmodic torticollis or blepharospasm, indicating that focal dystonia may exist as part of the clinical spectrum in hereditary essential myoclonus. In addition to examining the members of the family, we videotaped them and obtained blood samples for molecular genetic analysis.

Adolescent↗

PubMed1991

Topographic variations in the peripheral course of the greater occipital nerve. Autopsy study with clinical correlations.

The description of the peripheral course of the greater occipital nerve (GON) varies in the literature. An autopsy study was done on 20 cases without known headache problems. These findings showed a marked variation in the relation between the GON and nuchal muscles. The trapezius muscle was penetrated by the GON in 45% of cases, the semispinal muscle of the head was penetrated in 90% of cases, and the inferior oblique muscle of head was penetrated in 7.5% of cases. Macroscopic findings of possible compression were made in 11 cases (27.5%), indicating that nerve compression per se may be of minor importance since it seems to exist in the absence of headache.

Aged↗

PubMed1991

Hormonal and biochemical disturbances in Down's syndrome.

Clinical and laboratory endocrine variables in 29 adult institutionalized patients with Down's syndrome were compared with those of matched controls consisting of other mentally retarded patients from the same institution. Of the clinical variables, testes volume and body height were significantly lower in patients with Down's syndrome than in control patients. The thyroid function tests documented a higher average TSH level in Down's syndrome than in other mentally retarded patients. However, there was no clear-cut correlation between TSH and thyroid hormone levels. The data indicate that there is a tendency towards primary thyroid dysfunction in Down's syndrome. In addition, there is some evidence indicating a relative failure of TSH secretion. In male patients, estradiol was elevated compared to controls. FSH and LH also seemed slightly higher in the study group, but the differences only reached statistical significance when patients on chronic medication were omitted. Prolactin was significantly greater in the Down's syndrome patients than in the controls, both over the entire sample and in the subgroup of men with Down's syndrome, with P-values of around 0.001. The elevation of prolactin was not due to medication and did not correlate to thyroid function or difficulties during blood sampling. In females, the difference was not statistically significant. Laboratory tests that may be associated with endocrine disease or might indicate disease which could influence the endocrine status, were also included in this study. Compared with the controls, ESR, creatinine and uric acid levels were higher in Down's syndrome patients, while albumin was lower, all with P-values lower than 0.001. Vitamin B12 was moderately lower in Down's syndrome patients than in controls (P less than 0.05).

Adult↗

PubMed1991

Somatomedin C (insulin-like growth factor 1) in adults with Down's syndrome.

In a Norwegian institution for the mentally retarded, 29 adults with chromosomally verified Down's syndrome were compared to other mentally retarded patients with respect to serum somatomedin C (SmC) (insulin-like growth factor 1 [IGF-1]). Contrary to what has been observed in children, no shortage of SmC could be demonstrated in the adults with Down's syndrome. The results were within the normal range, and there was no difference between those with Down's syndrome and the other mentally retarded patients. Human growth hormone (HGH) and body height were studied in a previous work. Some correlations with these data are, nevertheless, included herein because they are of relevance. SmC correlated with body height in Down's syndrome, while there was no correlation between SmC and HGH or between HGH and body height.

Adult↗

PubMed1991

"Hemicrania continua": a clinical review.

Hemicrania continua (HC) is a headache entity completely responsive to indomethacin. Since 1984, 18 cases have been described, 15 females and 3 males, i.e. a F:M ratio of 5.0. The finding of a female preponderance, like that in chronic paroxysmal hemicrania, is a new observation. HC is, in general, a unilateral headache in the sense that it sets in on one side and subsequently sticks to this side. In two cases, both sides might possibly be involved, when the pain was at its maximum. In another (somewhat dubious) case the headache was bilateral. The pain was continuous from the beginning in 8 of 18 cases (early stage ratio continuous: non-continuous = 0.8). Over time, the headache developed a continuous character in 16 of the 18 cases, producing a "continuous: non-continuous ratio" of 8:1. The intensity of pain generally was moderate and was not reported as excruciatingly severe by any patient. The autonomic involvement from a clinical point of view, was clearly less pronounced than that of other unilateral headaches, such as cluster headache and chronic paroxysmal hemicrania.

Adult↗