[Propranolol in the treatment of migraine and similar headaches].
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Biomedical subjects
Publications and source records attributed to A Klimek.
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The authors report a case in which the last cranial nerves were damaged with development of the Collet-Sicard-Villaret syndrome. The cause was metastasis of clear cell renal carcinoma. The syndrome is extremely rare. The fairly long, intermittent course in this case deserves attention.
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In a 19-year-old man sudden Bell's palsy developed and after 2 days vertigo and peripheral-type nystagmus supervened. ENG demonstrated presence of spontaneous nystagmus on right gaze and lack of excitability of the left horizontal canal. The cerebrospinal fluid was normal, virological examination failed to demonstrate presence of antibodies to zoster virus or a rise of antibodies to enteroviruses. Vertigo and nystagmus disappeared within several days. Bell's palsy regressed later. The results of virological investigations cast doubt on the views of these authors who regard Frankl-Hochwart syndrome as a variety of Ramsay Hung Syndrome. In the presently reported case the possibility of zoster virus being the cause of the disease has been ruled out.
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The authors present the results of own investigations about the use of both pizotifen (SandomigranR) and cyproheptadine (PeritolR). 32 sufferers were treated with pizotifen and showed positive improvement in 68% of the cases. In this group no serious side effects were found. 20 patients before administration of the drug had placebo and this helped to establish the results statistically. 25 sufferers were treated with cyproheptadine and equally positive results in 64% of the cases. In this group were noted infrequent side effects. The results of the two tests were compared with the results of other tests done with other drug. From this it has been established that the antiserotonin drugs are the most effective at present in the treatment of migraine.
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The author presents a case of a 52-year old woman who suffered from dermatitis seborrhoica. She was treated with chloroquine. During the third month of treatment with chloroquine the symptoms of myasthenia appeared and led to hospitalization. The neurological and additional examinations confirmed the diagnosis. Four days after withdrawal of chloroquine treatment the myasthenic symptoms began to disappear and they finally ceased after two weeks. At this all other drugs were also withdrawn. The control examination after two months showed normal neurological status.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tears (SUNCT) syndrome is a very rare disorder, first described by Sjaastad et al. in 1989. The authors report a case of that type of headache in an 80 years old woman. They also discuss the pathophysiology and treatment.
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