Biomedical subjects

P H Monzillo

Publications and source records attributed to P H Monzillo.

7 recordsLinked to original sources

PubMed2000

Chronic paroxysmal hemicrania-tic syndrome.

The association of chronic paroxysmal hemicrania and ticlike pain-chronic paroxysmal hemicrania-tic (CPH-tic)-is a recently described syndrome. The authors found only two previously reported cases. They report three new cases of this rare syndrome with both chronic paroxysmal hemicrania and ticlike pain concurrently and ipsilaterally. The trigeminal-autonomic cephalalgias (TAC) are considered as differential diagnoses. CPH-tic syndrome could be a different clinical entity.

Aged↗

PubMed2000

Cluster-tic syndrome: report of five new cases.

The so-called short lasting primary headaches include heterogenic entities that can be divided between those without pronounced autonomic activation and those where this activation is evident, which includes the cluster-tic syndrome. We report five new cases with age closer to the trigeminal neuralgia's one, and concomitance of cluster headache and trigeminal neuralgia, which is less frequent in the literature. We also discuss briefly the pathophysiology of these clinical entities, suggesting that the trigeminus nerve is a common pathway of pain manifestation.

Aged↗

PubMed1998

[Use of chlorpromazine in the treatment of headache at an emergency service].

Therapeutic measures, with intravenous chlorpromazine, taken during acute headache are evaluated in fourteen patients at the emergency room in Santa Casa de São Paulo. Four patients had the diagnosis of migraine with aura and five patients migraine without aura. Four patients had diagnosis of chronic daily headache with intermittent and superimposed migrainous events. Finally one patient had the diagnosis of chronic paroxysmal hemicrania. All patients were diagnosed according to International Headache Society criteria. The intravenous chlorpromazine dose used was 0.7 mg/Kg diluted in 5% glucose solution and the dose never exceeded 50 mg. The time of drug administration was never less than 60 minutes. The results were considered excellent in all cases. Some patients presented side effects, particularly orthostatic hypotension, always moderate and transitory. This study has clearly demonstrated that intravenous chlorpromazine (0.7 mg/Kg) was highly effective in terminating episodes of primary headache.

Acute Disease↗

PubMed1997

[Use of tissue plasminogen activator factor for acute ischemic stroke].

PURPOSE: To evaluate thrombolytic therapy with rt-PA for acute stroke within 6h of symptom onset, and assessment of neurologic outcome. METHODS: We studied 6 patients, four women, mean age 63 +/- 18 years, with severe neurologic deficit within 6h of stroke onset, and with no spontaneous improvement. The stroke was embolic in 3, and thrombotic in the others. All patients were submitted to a head CT scan followed by either a cerebral angiography in 3 patients, or a transcranial Doppler, in the other 3 for assessment of arterial obstruction, and patency after thrombolytic therapy. We used 0.9 mg/kg of rt-PA, IV, over 60 min in 5 patients, and 0.5 mg/kg by intra-arterial infusion, over 60 min, in one. At the beginning a bolus of 10% of the total dose was delivered during 1 to 2 min. Head scan was repeated 24h and 7 days after treatment to detect ischemic areas and hemorrhagic complications. RESULTS: Middle cerebral artery occlusion was observed in 5 patients and posterior cerebral artery occlusion in one. The obstruction was cleared in 4 patients with persistence of the patency after 24h. A complete neurologic recovery was found in one patient, and a partial recovery in three. In two patients there was failure of arterial recanalization with no neurologic recovery. Only one patient had hemorrhagic transformation of ischemic tissue, without neurologic worsening. Death occurred in one patient due to pulmonary infection. CONCLUSION: Arterial patency with thrombolytic therapy was effective in 4 of our 6 patients. All 4 patients also disclosed a certain degree of neurologic improvement, rt-PA can be successfully used in selected patients up to 3h of the event onset, as shown in randomized studies.

Acute Disease↗

PubMed1996

The epidemiology of migraine in medical students.

The purpose of this study was to investigate the prevalence of migraine in medical students, as well as its clinical aspects and impact. All 595 medical students of Santa Casa School of Medicine of São Paulo, Brazil were asked if they had experienced any kind of headache in the past year. Those who responded positively were further investigated by an appropriate questionnaire. Diagnosis of migraine was based on the International Headache Society criteria of 1988. Forty percent of students suffered from some kind of headache; 40.2% of these headaches were migraine. The prevalence of migraine was 54.4% in women and 28.3% in men. Migraine headaches were unilateral in 24.2%, had a gradual onset in 69%, and were of a throbbing type in 88.3%. Migraine was considered incapacitating by 53.9% of students. Migraine with aura caused more disability than migraine without aura. Women experienced more intense migraine than men, and migraine with aura was especially more severe than migraine without aura. Photophobia, phonophobia, and nausea were more commonly encountered in migraine with aura. Despite the high prevalence, the high rate of disability, and the need for analgesic medication, only 7.1% of students with migraine had sought medical treatment.

Adolescent↗

PubMed1996

[Cluster-tic syndrome: two case reports].

Two patients with cluster-tic syndrome are reported. The first, a 43-years-old man, complaining of trigeminal pain in the right side of the face, accompanied by homolateral autonomic signs, such as ocular injection, sweating and drooped eyelid. The cluster attack was triggered by chewing, shaving and washing the face. The periodicity of bouts was six months. The pain was relieved by carbamazepine (800 mg/day). The second patient, a 43-year-old man, with an excruciant, neuralgic pain in the left side of the face, accompanied by tearing, conjuntival injection, drooped eyelid, rhinorrhea, photophobia and phonophobia. The neurologic examination showed triggered points in the first and second division of the trigeminal nerve. The patient was treated with verapamil (160 mg/day) and prednisone (60 mg/day), with relief of his symptoms. The periodicity of bouts was once a year. The literature was reviewed and 37 cases previosly reported are considered. We conclude that there are two different groups of patients. In the first group, the patients had cluster and trigeminal bouts in different time. In the second group, with only nine cases, the patients presented both cluster and trigeminal type of pain at the same time, as in the two cases reported here.

Adult↗

PubMed1986

[Complicated migraine: apropos of 3 cases].

After brief considerations about complicated migraine, three cases are reported. The diagnosis was made by the clinical features and by computed tomography. The term complicated migraine must be reserved for those cases in which the neurological symptoms and signs outlast migraine attack for more than 24 hours or in which permanent deficit develops because of cerebral or brainstem infarction. Other criteria for diagnosis is the presence of infarction in CT scanning, although prolonged or permanent deficit are absent. The possible role of platelet aggregation, vascular spasm and increased coagulability of the blood, as the cause of infarction, is discussed. All the patients in this report showed prolonged neurological deficit and infarction in CT scanning.

Adult↗