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Biomedical subjects

K Ekbom

Publications and source records attributed to K Ekbom.

At least 55 records · Page 3Linked to original sources
PubMed1985

Concentration and uptake of 5-hydroxytryptamine in platelets from cluster headache and migraine patients.

Concentrations of 5-hydroxytryptamine (5-HT) in platelets were determined in 33 cluster headache patients (17 males) and in 34 migraine patients (16 males) outside attacks. The 5-HT uptake into platelets was measured and the kinetic constants Vmax and Km determined in 26 cluster patients (14 males) and in 30 migraine patients (13 males). Significantly lower 5-HT concentrations in whole blood were found in cluster headache and migraine patients than in 50 healthy controls (19 males). The Vmax and Km values of the 5-HT uptake were significantly lower in cluster headache and migraine patients compared with 22 healthy controls (9 males). The 5-HT concentrations and the kinetics of the 5-HT uptake did not differ between cluster headache and migraine. In healthy controls a significant positive correlation was found between the 5-HT uptake rate at 0.25 microM and Km but not in cluster headache and migraine patients. The 5-HT concentrations in whole blood correlated positively with Vmax and Km, respectively, in cluster headache and with Km in healthy controls but not with Vmax nor with Km in migraine. There was no obvious relation between the kinetics of platelet monoamine oxidase (MAO) and the 5-HT uptake except for an increased incidence of low Vmax of MAO and low Km of the 5-HT uptake in cluster headache. The kinetics of the 5-HT uptake was apparently not related to the state of migraine. The results indicate a possible constitutional trait in cluster headache and migraine expressed as low 5-HT concentrations in whole blood and low Vmax and Km of the 5-HT uptake into platelets.

Adolescent↗
PubMed1984

Headache and mood: a time-series analysis of self-ratings.

Self-ratings with respect to headache and five mood dimensions were obtained twice daily from five patients suffering from migraine and six patients suffering from muscle-contraction headache during a mean period of 47.9 days (range: 38-61). The data were analysed by multiple regression, with the rated headache as dependent variable. Different time intervals between measurement of the independent variables and measurement of the dependent variable were used. A significant time-dependent relation was found between the migraine ratings and the alertness ratings. Significant time-dependent relations were also found between rated muscle-contraction headache and rated anger and alertness, respectively, but the trends were not very pronounced. In the case of no time lag, rated muscle-contraction headache tended to be negatively related to rated alertness, happiness and concentration. Significant periodic trends were found for both the migraine and the muscle-contraction headache. The major findings are discussed in terms of stress and biological rhythms.

Adolescent↗
PubMed1984

Kinetics and thermolability of platelet monoamine oxidase in cluster headache and migraine.

Platelet monoamine oxidase activity (MAO) from 33 cluster headache patients (17 males, 16 females) and 34 migraine patients (16 males, 18 females) was assayed. The kinetic constants (apparent Vmax and apparent Km) and the thermolability, measured as the ratio of the platelet MAO activity after and before heat treatment (+52 degrees C, 30 min), were determined. The MAO activity and Vmax values were significantly lower in cluster headache than in migraine and in both headache disorders compared to a control group (62 males, 66 females). When comparing all groups, Km was not significantly different except for migraine females, who had lower Km values compared to control females. Thermolability was significantly higher in cluster headache than in migraine and in both headache disorders compared to the control group. Smokers of five cigarettes or more per day had significantly lower Vmax values but similar Km and thermolability values compared to those smoking less or nothing. The findings of low maximal velocities and high thermolability of platelet MAO in cluster headache and migraine are suggested to represent constitutionally different enzyme properties.

Adolescent↗
PubMed1983

Optimal routes of administration of ergotamine tartrate in cluster headache patients. A pharmacokinetic study.

Bioavailability and rate of absorption of ergotamine were studied in eight cluster headache patients outside attacks. In a cross-over design, approximately 2 mg ergotamine tartrate was administered as effervescent tablets, suppositories, and from an inhalation device, with 0.25 mg intravenously as the reference. Ergotamine in plasma was measured by high performance liquid chromatography with fluorescence detection from 5 to 420 min. For all three routes of administration, a similar low (0.5-4.2%) bioavailability of ergotamine was estimated. Only inhalation of ergotamine resulted in early (at 5 min) peak concentrations of ergotamine in plasma and is therefore most likely to relieve the short-lived attacks of cluster headache. The inhalation route for ergotamine poses problems, however, and we suggest ways of improving the inhalation device.

Administration, Oral↗
PubMed1981

Cluster headache in women: evidence of hypofertility(?) Headaches in relation to menstruation and pregnancy.

Two hundred and forty-nine patients with cluster headache have been studied, 215 male and 34 female (ratio 6.3:1). Twenty-five of the 26 fertile female cluster patients stated that their headaches had no relation to menstrual periods. Eight had had 13 pregnancies since the onset of cluster headache. Six of them experienced remission of their headache during pregnancy. Four women with cluster headache had a history of infertility or premature menopause. Parity rate was low in patients who contracted cluster headache as nulliparae; it was lower than in those who contracted the disease after earlier pregnancy or post menopause, and also significantly lower than in 99 consecutive women with migraine. Significant differences were also found when the numbers of childbirths in the cluster patients were compared with total fertility rates up to successive ages for birth cohorts in the general population of Swedish women.

Adult↗
PubMed1981

Low biological availability of ergotamine tartrate after oral dosing in cluster headache.

An attempt was made to determine the plasma ergotamine concentrations in nine male patients with cluster headache 15-600 min after oral therapeutic doses of ergotamine tartrate (Cafergot). Some of the patients were studied twice. Five patients received a constant dose of 2-4 mg daily for at least seven days. Four patients were given 1 mg five times on one day and three patients a single oral dose of 2 mg. Ergotamine was determined by means of high performance liquid chromatography with fluorescence detection--a new highly sensitive, specific method, the detection limit of which is less than 100 pg/ml for ergotamine. Ergotamine tartrate was not discovered in any of the plasma samples. In one patient ergotamine could not be detected in the cerebrospinal fluid one hour after a single oral dose of 2 mg. The oral biological availability is less than 1%, which is the maximal available fraction of unchanged ergotamine after oral administration. A clinical benefit was observed in several of our patients. These effects of the drug may be because of active metabolites being formed and/or to high affinity of ergotamine to cranial vessels.

Administration, Oral↗
PubMed1981

Trigeminal neuralgia: time course of pain in relation to carbamazepine dosing.

Eight in-patients with idiopathic trigeminal neuralgia (TN) were studied while receiving carbamazepine (CBZ) treatment. The aim was to study diurnal pain distribution, its relation to CBZ dosing and plasma concentration and the effect of decreasing the dose. All pain attacks were registered by the patients at three-hour intervals. CBZ was given b.i.d. in a single blind manner with the patient unaware of dose and dose changes. Plasma concentrations of CBZ were followed every fourth hour during a period of altogether sixteen dosage intervals. The diurnal pain distribution revealed marked intra-individual similarities with pain-free nights and a significant drop in pain during mid-day hours. The latter coincided in time with the peak plasma concentration of CBZ, thus indicating an effect of plasma concentration fluctuations on pain relief. Shorter dosage intervals might therefore be beneficial in problem cases. A significant increase in pain was detected within six to nine hours after a dose reduction, whereas the full effect of the dose change seemed to be established only after one day.

Aged↗
PubMed1980

Carbamazepine therapy in trigeminal neuralgia: clinical effects in relation to plasma concentration.

Seven patients with trigeminal neuralgia were treated with carbamazepine at three dose levels, each period lasting for six days. A single-blind technique was used, the patients being unaware of the dose changes. During the last three days of each dose treatment, the pain score was determined by the patients and the plasma concentrations of carbamazepine and its epoxide metabolite were measured. There was a correlation between the dose and plasma level of carbamazepine (r = .56; P < .01). At the carbamazepine doses studied (200 to 1,400 mg/day), no indication of saturation kinetics was seen. As the ratio between the plasma levels of the epoxide and carbamazepine was relatively low and constant, it was not possible to evaluate the potency of the epoxide. In six of the patients studied a plasma level-effect relationship was found. The best effect was seen at carbamazepine levels between 24 and 43 mu mole/L (5.7 and 10.1 microgram/mL). In one patient who was studied twice, the plasma level-response curve was different on the two occasions. Side effects were recorded in two patients, both with carbamazepine plasma levels above 33 mu mole/L (7.9 microgram/mL).

Carbamazepine↗
PubMed1980

Carbamazepine in trigeminal neuralgia: clinical effects in relation to plasma-concentration.

Seven patients (mean age 60 years) with idiopathic trigeminal neuralgia previously treated with Carbamazepine(CBZ) were studied as in patients. One patient was examined twice. CBZ (Tegretol) was given twice daily in three different dose-levels to each patient, six days on each level. A single-blind technique was used. The doses were individually chosen with previous dose requirements as a basis. Plasma samples were taken immediately before the morning dose the three last days on each dose-level. CBZ and CBZ-10, 11-epoxide were analysed using liquid chromatography. All pain paroxysms were graded and registered by the patient and pain scores were calculated. The CBZ-doses given ranged from 200 to 1 400 mg/day, the mean being 733 mg/day. In six courses of treatment, patients experienced complete or almost complete pain relief, achieved at CBZ-plasma-concentrations of 24-43 mumol/l. Patients with high pain-scores at plasma-concentrations of 30 mumol/l did not benefit from further dose increase. Small adjustments of plasma-concentration otherwise resulted in pronounced changes in pain-score. Side-effects were not reported below 34 mumol/l. No conclusions could be drawn as to the possible clinical effect of CBZ-10,11-epoxide.

Carbamazepine↗