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Biomedical subjects

D Soyka

Publications and source records attributed to D Soyka.

At least 37 records · Page 2Linked to original sources
PubMed1992

Pain sensitivity and pain reactivity of pericranial muscles in migraine and tension-type headache.

We investigated whether experimentally determined, suprathreshold pain sensitivity of pericranial musculature in patients with tension-type headache differs from that of migraine patients or from that of healthy subjects. Furthermore, we looked to see whether differences could be found in the effects of experimental pain induction on EMG activity of pericranial musculature and whether subgroups could be discovered with higher and lower pericranial pain sensitivity within the three diagnostic groups in terms of neurophysiological, psychological and clinical variables. In 20 patients with tension-type headache, 23 patients with migraine without aura, and 29 healthy individuals experimental pain was induced in the temporal muscle by mechanical pressure; pain sensitivity in the entire metrically subdivided suprathreshold pain sensitivity range was measured. Surface EMG activity of pericranial muscles was determined before, during and after experimental pain induction. In addition, headache characteristics as well as personality and mood states were determined and recorded in a standardized fashion. There were no significant differences in pain sensitivity of pericranial musculature between the three groups. Patients with tension-type headache showed significantly higher EMG scores during suprathreshold pain stimulation than did migraine patients. EMG scores of healthy subjects fell between these two groups. With respect to pericranial tenderness significant differences in clinical, neurophysiological and psychological variables were found only between subgroups within the group of patients with tension-type headache. The results indicate that significant differences in the examined groups are found not in pain perception but in the processing or reaction to experimental headache stimuli. In patients with tension-type headache subgroups evolve based on pericranial pain sensitivity with quantitatively and/or qualitatively impaired reactions; for this reason diagnostic grouping according to the IHS classification seems to be pathophysiologically relevant. The intraindividual phasic comparison of pain reactions appears to be more important than the absolute interindividual tonic comparison.

Adult↗
PubMed1992

[Recommendation for an expanded classification with operational diagnostic criteria for craniocerebral trauma].

Neither nationally nor internationally is there today agreement on a classification of head injuries. The traditional system using the terms commotio/concussion, contusion and compression, as well as more functionally oriented classifications are in-adequate for present-day purposes. Furthermore, there is no conformity in evaluating the severity and duration of the posttraumatic disturbances of consciousness. None of the classifications in use today includes information on important details such as the type of head injury (closed or open), possible complications or the findings of modern neurophysiological investigation and neuroimaging procedures. The requirements which a modern classification system must meet are specified and a classification of head injuries with operational diagnostic criteria is proposed, which is intended to satisfy both clinical and scientific requirements.

Brain Concussion↗
PubMed1990

[Etiology and therapy of trigeminal neuralgia].

Trigeminal neuralgia is an exactly defined syndrome with a non-uniform aetiology but an obviously uniform pathogenesis. A subdivision in an idiopathic and a symptomatic type is non-essential. In a part of the cases microvascular compression of the sensory root may be the cause of trigeminal neuralgia but there are some good arguments against this concept. Other causes such as multiple sclerosis, acoustic neuroma or carotid aneurysm are well known. The principle of neurosurgical procedures is either an interruption of the pain-conducting fibres or a non-specific manipulation at the Gasserian ganglion or the sensory root with the result of an interruption of abnormal ephapses and short-circuits which may recur later on. So microvascular decompression should not be considered to be a specific and causal therapeutic approach as well as the therapy of first choice for all cases.

Humans↗
PubMed1989

[Lisuride for the prevention of migraine. Results of a multicenter study].

In an open multicenter study involving 420 patients lisuride proved to be an effective and well-tolerated migraine prophylactic. In 61.4% of the patients the frequency of migraine attacks was reduced by more than 50% during the 3 month treatment period; the severity and duration of remaining attacks were markedly reduced. In the overall assessment, the effect was regarded as good to excellent in 69.7% of the patients and tolerance was good to excellent in 94.2%. The most common side effects were nausea (4.0%), vertigo (3.1%), drowsiness (1.4%). Prognostic criteria for the response to lisuride could not be identified.

Adult↗
PubMed1989

Flunarizine i.v. in the acute treatment of common or classical migraine attacks--a placebo-controlled double blind trial.

The efficacy and tolerance of 20 mg flunarizine i.v. were tested in comparison with placebo in a multicentre randomised double-blind trial in the acute treatment of migraine attacks. Sixty case reports were included in the evaluation; 31 patients were treated with flunarizine and 29 with placebo. Flunarizine proved to be significantly superior in its effect on the intensity of pain and the typical concomitant symptoms of the attacks. Patients were classed as responders who displayed a reduction in pain intensity by at least 50% within 60 minutes after the administration of flunarizine. 23 patients (= 74.2%) were responders, including 11 patients being without pain after 60 minutes. In the placebo group the responder rate was 27.6% The fact that both groups were comparable in all respects should be emphasized. The tolerance of intravenously administered flunarizine was excellent and corresponded to that of placebo. Apart from a sedative effect reported by 9 patients there were no side-effects. The circulatory conditions remained largely stable. The result of this study seems to indicate that an intravenous injection of 20 mg flunarizine might represent a genuine alternative, and as regards tolerance even a superior one, to the parenteral administration of ergotamine in migraine attacks.

Adult↗
PubMed1988

Flunarizine vs. propranolol in the prophylaxis of migraine: two double-blind comparative studies in more than 400 patients.

In the course of a 16 weeks' interval treatment of migraine in connection with two multicenter double-blind studies, flunarizine was compared with propranolol in patients suffering predominantly from "classical migraine". Eighty-seven patients from 12 outpatient departments were admitted to the first study, while 434 patients from 99 medical practices participated in the second study. After each month of treatment, the patients were clinically evaluated, and the number, duration, and severity of attacks were documented. Concerning the frequency and intensity of attacks, additional analgesics consumption and overall evaluation, both drugs proved to be highly effective in the practice as well as in the hospital study. The percentage and severity of side-effects were comparable in the two treatment groups. Summarizing, it may be stated that the studies proved the efficacy of flunarizine to be rather similar to that of propranolol in the prophylactic treatment of migraine.

Adult↗
PubMed1988

Flunarizine i.v. in the acute treatment of the migraine attack. A double-blind placebo-controlled study.

Flunarizine, 20 mg by slow intravenous injection, was studied in the acute treatment of migraine attacks in a multicentre, double-blind, placebo-controlled study. At the end of the 60 min observation period, 23 of the 31 (74.2%) patients treated with flunarizine reported complete relief, or a pain reduction of more than 50%, vs. 8 of 29 (27.6%) placebo patients (p less than 0.017). Accompanying symptoms also improved significantly better in the flunarizine than in the placebo group. The investigators evaluated the therapy as good or excellent in 77.4% of the flunarizine and in 27.6% of the placebo patients, respectively. Tolerance of the therapy was good and comparable in the two groups. Somnolence was the only flunarizine-related adverse reaction. Blood pressure and heart rate were not affected. Flunarizine i.v. deserves further study in the acute treatment of a migraine attack.

Adult↗
PubMed1984

[Classification and symptomatology of migraine].

The different variants of migraine can be classified in common migraine, classical migraine and complicated migraine. Since objective methods of diagnostic proof are not available, diagnosis and categorisation have to be based on the patient's history and clinical criteria including hard and soft symptoms. Fundamental conditions are the evidence of recurrent headache attacks and the exclusion of other causes of headache.

Autonomic Nervous System↗
PubMed1982

Visual and somatosensory evoked potentials and F-wave latency measurements in hereditary neuropathy with liability to pressure palsies.

Pattern shift visual evoked potentials (VEPs), cervical and cortical somatosensory evoked responses (SEPs) and motor conduction velocities studied by F-wave latency measurements were investigated in two family members with hereditary neuropathy with liability to pressure palsies (HN-PP). In both cases in VEPs and SEP conduction times N13-N20 were normal. A bilateral pathological increase of latencies of early SEP components, N9-N13 transit times and F-wave latencies revealed a lesion in the proximal parts of the median nerves close to the spinal cord in the older patient. These abnormalities emphasize the close relationship of HN-PP with hereditary polyradiculopathy (Mayer 1975).

Adult↗