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Biomedical subjects

L J Stovner

Publications and source records attributed to L J Stovner.

68 records · Page 4Linked to original sources
PubMed1990

Side effects after lumbar iohexol myelography. Relation to radiological diagnosis, sex and age.

Side effects of iohexol lumbar myelography have been analyzed with respect to the influence of the type of radiological abnormality, sex and age in a group of 200 patients. Headache, postural headache, nausea and back/leg pain were significantly more frequent in patients without definite radiological abnormalities. Postural headache, nausea, dizziness and mental symptoms were more frequent in women, while headache, postural headache, nausea, dizziness, minor mental symptoms (i.e. anxiety or depression) and pain became less frequent with age. This pattern is similar to that reported after lumbar puncture. Young women without definite clinical signs of nerve root lesions probably have the greatest risk of experiencing side effects after iohexol lumbar myelography.

Adult↗
PubMed1990

Lumbar iohexol myelography and diagnostic lumbar puncture. Headache and associated side effects in relation to neurological signs and diagnosis, previous mental symptoms and pain history.

Various possible risk factors for postlumbar puncture (and postiohexol-myelographic) headache and associated side effects were analysed. Headache and nausea occurred significantly more often in patients without clinical findings than in those with findings. We found significantly different incidences of severe headache and nausea between diagnostic subgroups after a lumbar puncture. The greatest headache incidence was found in patients without a definite neurological diagnosis, while nausea occurred most frequently in patients with various painful disorders. Following iohexol myelography, nausea occurred most often in patients who had a history of previous mental symptoms and in patients with a history of previous headache disorders. Mental symptoms were more frequently reported in patients who also had experienced mental symptoms previously. The relationship between side effects and negative clinical findings was stronger than the relationship between side effects and previous mental symptoms.

Adult↗
PubMed1989

Side effects after ambulatory lumbar iohexol myelography.

Side effect incidences after ambulatory (22G needle and two h bed rest) and after non-ambulatory (22 and 20G needles and 20 h bed rest) lumbar iohexol myelography have been estimated and compared. Headache incidence was significantly greater in ambulatory (50%, n = 107) as compared to non-ambulatory myelography (26%, n = 58). Headaches in the ambulatory group tended to be of shorter duration and the difference between severe headaches in ambulatory and non-ambulatory groups was not significant. Serious adverse reactions did not occur and none of the ambulatory patients required readmission because of side effects. The headache was predominantly postural and occurred significantly earlier in the ambulatory group. Headache incidence was significantly greater after 20G needle myelography (44%, n = 97) as compared to 22G needle iohexol myelography (26%, n = 58). The results supports the hypothesis that CSF leakage is a major cause of headache after lumbar iohexol myelography.

Adult↗
PubMed1989

Cluster headache: incorporation of (1-14C)oleic acid into phosphatidylserine in polymorphonuclear cells.

As recently demonstrated by our group, polymorphonuclear cells (PMNs) from cluster headache patients have an increased ability to incorporate arachidonic acid (AA) and L-serine into phosphatidylserine (PS). To evaluate whether there is an increased incorporation into PS also from fatty acids not involved in eicosanoid metabolism, PMNs from controls (n = 14) and cluster headache patients (n = 12) were incubated with (1-14C)oleic acid. After 1 h 2.7% +/- 1.1 (mean value +/- SD) of the glycerophospholipid radioactivity was found in PS in controls, whereas 4.2% +/- 1.2 was found in cluster headache patients (p less than 0.005). For phosphatidylcholine (PC) the corresponding figures were 74.2 +/- 5.4 in controls and 66.7 +/- 7.6 in cluster headache patients (p less than 0.01). The results suggest that the de novo biosynthesis of PS is increased and the biosynthesis of PC is decreased in cluster headache. The results may have an effect on the role of PS as an obligate protein kinase C activator.

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PubMed1989

Cluster headache: increased incorporation of (1-14C)arachidonic acid into phosphatidylserine in polymorphonuclear cells.

Vasoactive metabolites deriving from arachidonic acid (AA) have been considered as putative mediators in the pathogenesis of various types of headache. In the present study we therefore compare the ability to synthesize AA containing precursor phospholipids in polymorphonuclear cells (PMNs) from healthy controls and cluster headache patients. 3.7% +/- 1.4 (mean +/- SD) of the (1-14C)AA incorporated into total PMN glycerophospholipids (GPLs) was recovered in the phosphatidylserine (PS) in a group of cluster headache patients (n = 12). This was almost twice the value of 1.9% +/- 0.8% found in a corresponding group of 24 healthy controls (p less than 0.001). A significant decrease in the incorporation of (1-14C)AA into phosphatidylcholine (PC) (p less than 0.01) and an increase in the incorporation of (1-14C)AA into phosphatidyletanolamine (PE) (p less than 0.05) were also found in cluster headache patients when compared to the control group. The increased incorporation of (1-14C)AA into PS in PMNs from this group of patients is interesting because PS plays an important role in the activation of protein kinase C, an enzyme involved in transmembrane signalling. The clinical implications of the present findings in cluster headache, if any, cannot yet be defined.

Adult↗
PubMed1989

Increased incorporation of L-(U-14C)serine into phosphatidylserine in polymorphonuclear cells from cluster headache patients.

It has recently been demonstrated by our group that polymorphonuclear cells (PMNs) from cluster headache patients incorporate more arachidonic acid (AA) into phosphatidylserine (PS) than PMNs from controls. In the present report, the incorporation of L-(U-14C)serine into PS in PMNs from 14 healthy volunteers and 12 cluster headache patients was studied. PMNs from controls incorporated 1194 +/- 578 (mean +/- SD) cpm of L-(U-14C)serine into PS, 268 +/- 292 cpm into phosphatidylethanolamine, and 57 +/- 71 cpm into sphingomyeline. The corresponding figures in cluster headache patients were 2365 +/- 841 cpm, 291 +/- 207 cpm, and 88 +/- 66 cpm, respectively. Incorporation of L-(U-14C)serine into PS was significantly increased (p less than 0.0004) in PMNs from cluster headache patients, whereas no significant difference was seen in other lipids. The results confirm that patients with cluster headache have an increased incorporation of precursors into PS in isolated PMNs, and they indicate that this is due to an increased de novo synthesis of PS.

Adult↗
PubMed1988

Arachidonic acid metabolism in polymorphonuclear cells in headaches. A methodologic study.

Prostaglandins and leukotrienes have been implicated in the pathogenesis of various types of headache, mainly because some, but not all, cyclo-oxygenase inhibitors are effective in their treatment. We have therefore investigated whether a pathologically changed turnover of arachidonic acid (AA)-containing phospholipids can be seen in headache patients, using isolated polymorphonuclear cells (PMNs) from healthy controls and patients with chronic paroxysmal hemicrania (CPH) and cluster headache. PMNs from healthy controls incorporated 55% of the added (1-14C)AA into total lipids, and 0.5% +/- 0.14% of this radioactivity was found in the phosphatidylserine (PS) fraction. PMNs from a cluster headache and a CPH patient showed 300% and 900% increase in PS labeling from AA, respectively. No other phospholipids showed any difference between controls and patients. The results are discussed in connection with membrane signal transduction via the PS-dependent protein kinase C.

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PubMed1987

Side effects after diagnostic lumbar puncture and lumbar iohexol myelography.

A prospective, controlled study was performed to compare side effect incidences after lumbar iohexol myelography (n = 97) and diagnostic lumbar puncture (n = 85). No significant side effect incidence differences (iohexol vs. controls) were found regarding number of patients with any side effect (63 vs. 73%), headache (44 vs. 54%), nausea, dizziness, visual, auditory, or psychic symptoms. Early-onset headache occurred significantly more often in the iohexol group (17 vs 5%), while postural headache occurred most frequently after lumbar puncture (25 vs. 41%). These results suggest that apart from the slight early-onset headache, most side effects after lumbar iohexol myelography are related to the puncture per se, not to the contrast agent.

Adult↗
PubMedDate not supplied

Photophobia and phonophobia in tension-type and cervicogenic headache.

Light and sound-induced discomfort and pain thresholds were measured in 26 patients with cervicogenic headache, in 40 patients with tension-type headache, and in 100 headache-free controls. Neither headache group was significantly different as to photophobia and phonophobia, but both were significantly more sensitive to light and sound than controls (p<0.0001), even when patients were tested in the headache-free period (p<0.05). Episodic and chronic tension-type headache had similar photo- and phonophobia thresholds (p> or =0.7). Tension-type headache patients were more photo- and phonophobic during headache than outside attack (p<0.05), but this was not true for cervicogenic headache (p> or =0.56). In cervicogenic headache patients, photophobia (p<0.05) but not phonophobia (p=0.28) was greater on the symptomatic side than on the non-symptomatic side.

Adult↗
PubMedDate not supplied

Dental caries and periodontitis in persons with Down syndrome.

In a central institution for persons with mental retardation, the dental status in 30 adult patients with Down syndrome was compared with that in a carefully selected group of gender- and age-matched mentally retarded patients. This investigation showed an increased frequency of periodontitis in the population with Down syndrome. The caries rate, however, did not differ demonstrably between the groups. Edentulism was more frequent in patients with Down syndrome than in controls, and this fact may substantiate the observation of increased frequency of periodontitis. Caries seems to be less prevalent in institutionalized patients with mental retardation than in the population at large.

Adult↗
PubMedDate not supplied

Laterality of pain and other migraine criteria in common migraine. A comparison with cervicogenic headache.

Patients diagnosed as suffering from common migraine according to the "Ad hoc committee" criteria of 1962 have been studied as for type of unilaterality of headache. Patients, with trauma to the face, head, and neck were excluded, together with patients with the faintest suspicion of aura and those with chronification of the headache. Common migraine criteria, as stipulated by the IHS and Vahlquist, were counted in every patient (n = 32), except the laterality which was a free variable (a total of 8 variables remaining). For comparison, as far as the number of migraine criteria is concerned, a group of cervicogenic headache patients was also studied (n = 30). Unilaterality with side shift of pain was present in 75% in the common migraine group; in 34% of the patients, a combined pattern, i.e. bilateral headache + unilaterality with sideshift was present. Common migraine, therefore, just as classic migraine, seems to be a headache characterized by unilaterality with side alternation of pain. Common migraine criteria were present to a high degree in common migraine patients selected in this way, i.e. ca. 6.8 of a maximum of 7. In cervicogenic headache, the corresponding figure was ca. 3.8 (of a maximum of 7). These figures are statistically significantly different (p < 1.3 10(-11), Mann-Whitney test). Still, the level of criteria is relatively high in cervicogenic headache, and 6 of 30 patients would fulfil the IHS common migraine criteria.

Adult↗
PubMedDate not supplied

Sinus arrhythmia and pupil size in Chiari I malformation: evidence of autonomic dysfunction.

In a prospective study on latent autonomic dysfunction in the Chiari type I malformation, 15 patients were examined for degree of sinus arrhythmia in the supine and the sitting positions with a deep breathing test, and for pupil size and function with electronic pupillometry after sympathicomimetic eyedrop stimulation. The 5 patients with brainstem signs had a marked disturbance of sinus arrhythmia, which was more pronounced in the supine than in the sitting position. The clinical signs suggested a dysfunction of the reflex centers in the medulla rather than of the lower cranial nerves. The patients also tended to have more anisocoria than healthy controls, but no clear-cut pattern existed as to pupil dysfunction. Of the 4 patients with syringomyelia, however, the two with the most extensive cord cavitations had a Horner-like pupil reaction ipsilaterally to a marked hand wasting, indicating a sympathetic lesion at the T1 level of the cord.

Adult↗
PubMedDate not supplied

Common migraine ("migraine without aura"): localization of the initial pain of attack.

In classical migraine ("migraine with aura"), the attack pain is usually initially felt in the oculo-fronto-temporal area (around 90% of the cases). A fronto-temporal onset of pain is in other words a typical trait of classic migraine. The initial location of pain in common migraine ("migraine without aura") is not so well known. In the present study, 32 migraine patients and 29 cervicogenic headache patients were compared as for localization of pain onset. Twenty-four of 32 migraine patients (75%) felt the initial pain in the oculo-fronto-temporal area; in 28 of 32 cases the onset was in the "anterior" parts (88%). The corresponding figures in the cervicogenic group were: 5 of 29 (17%) and 6 of 29 (21%) respectively. There is thus a clear-cut difference between the two groups in this respect. The initial localization of pain can probably also be used for diagnostic purposes. The similarity between classic and common migraine in this respect is striking.

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