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PubMed2006

Headache prevalence related to smoking and alcohol use. The Head-HUNT Study.

The aim of this study was to examine a possible association between smoking, alcohol and headache in a large population-based cross-sectional study. A total of 51,383 subjects completed a headache questionnaire and constituted the 'Head-HUNT' Study. Questionnaire-based information on smoking was available in 95% and on alcohol in 89% of the individuals. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). Prevalence rates for headache were higher amongst smokers compared with never smokers, most evident for those under 40 years smoking more than 10 cigarettes per day (OR 1.5, 95% CI 1.3-1.6). Passive smoking was also associated with higher headache prevalence. For alcohol use, there was a tendency of decreasing prevalence of migraine with increasing amounts of alcohol consumption compared with alcohol abstinence. Only with regard to symptoms indicating alcohol overuse, a positive association with frequent headache was found. The association between headache and smoking found in the present study raises questions about a causal relationship, e.g. that smoking causes headache or that it allays stress induced by headache. The observed negative association between migraine and alcohol consumption is probably explained by the headache precipitating properties of alcohol.

Adult↗
PubMed2004

The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-HUNT-Youth), a large population-based epidemiological study.

The aim of this study was to examine the prevalence of headache and primary headache disorders like migraine and tension-type headaches among adolescents, and to explore the differences in headache prevalence and frequency by gender and age. This cross-sectional study was conducted in Nord-Trøndelag county, Norway, during the years 1995-97. In total, 8984 (88%) out of 10 202 invited adolescents aged 12-19 years participated in the youth part of the Nord-Trøndelag Health Study [Helseundersøkelsen i Nord-Trøndelag (HUNT)]. The total study population in this study consisted of 8255 individuals after exclusion of invalid questionnaires and students outside the target range of 13-18 years of age. The students completed a comprehensive questionnaire, and one of the questions was whether the students had experienced any headaches during the last 12 months. In addition, 5847 of these students were also subject to an interview in which they were asked whether they had experienced recurring headaches during the last year and, if so, were they classified as migraine (MI), tension-type headache (TTH) or non-classifiable headache. In the total questionnaire-based population, 76.8% reported having had headaches during the last 12 months (69.4% boys and 84.2% girls). Among those who also were interviewed, 29.1% reported having recurrent headaches (21.0% boys and 36.5% girls). The overall 1-year prevalence of migraine was 7%, of tension-type headache 18%, and of non-classifiable headache 4.8%. Higher prevalence rates were found for girls in all age groups and for all headache categories. The overall frequency of recurrent headaches did not vary significantly with age, but girls had significantly more frequent headaches than boys. We concluded that headache in general, and recurrent primary headache disorders like migraine and tension-type headaches, are common somatic complaints among Norwegian adolescents, especially among girls.

Adolescent↗
PubMed2004

Headache prevalence related to haemoglobin and ferritin. The HUNT Study.

As clinic-based studies show an association between headache and both high and low levels of haemoglobin, we analysed this relationship in a population-based cross-sectional study (the HUNT Study). A total of 2385 women aged 20-55 years responded to a headache questionnaire and gave blood samples for measuring haemoglobin and ferritin. In the multivariate analyses, adjusting for age and education, there was a linear trend of decreasing prevalence of headache (P = 0.02) and migraine (P = 0.01) with decreasing haemoglobin. In particular, migraine was less likely among women with low haemoglobin (values < 11.5 g/dl) (odds ratio 0.4, confidence interval 0.2, 0.9). There was no correlation between headache prevalence and ferritin. The present findings may be relevant for the headache reported in polycythaemia and chronic altitude sickness.

Adult↗
PubMed1993

Sensorimotor development in cerebral-palsied infants assessed with the Uzgiris-Hunt scales.

The cognitive development of a group of 89 cerebral-palsied infants, aged six to 24 months, was investigated using the Uzgiris-Hunt scales. The results were compared with normative data for the Italian population and with data obtained in a group of low-risk term and preterm infants, 11 to 13 months old. The test was easy to carry out, even on infants with a severe motor impairment. The majority of the infants showed cognitive delay on most of the scales. Tetraplegic patients performed significantly worse than those with diplegia or hemiplegia. There were no differences between preterm and term infants, for either normal or cerebral palsy groups, if age was corrected for preterm birth. Sensorimotor development appeared to be organized similarly for cerebral-palsied infants and normal controls; however, these data raise the question of the role of action in early cognitive development.

Cerebral Palsy↗
PubMed1993

A contrast enhanced lesion of the III nerve on MR of a patient with ophthalmoplegic migraine as evidence for a Tolosa-Hunt syndrome.

A 23-year-old female with a six year history of migraine without aura twice developed a nearly complete internal and external III nerve paresis ipsilateral to her headache, two days after the onset of migraineous headache. An MR scan performed one week after the second episode showed a contrast enhanced lesion of the prepontine III nerve, where it enters the cavernous sinus on the left side. The headache, as well as the paresis ameliorated spontaneously. We suggest this is a further well documented case of "ophthalmoplegic migraine" which might reflect Tolosa-Hunt syndrome.

Adult↗
PubMed1990

The Ramsay Hunt syndrome revisited: Mediterranean myoclonus versus mitochondrial encephalomyopathy with ragged-red fibers and Baltic myoclonus.

Among progressive myoclonus epilepsies (PME), the nosography of the Ramsay Hunt syndrome (RHS) has been much debated. The authors report on a homogeneous group of 43 patients originating from around the western Mediterranean, with a large number of northern African subjects, who were followed up for a mean period of 11.6 years. Onset is between 6 and 17 years (mean: 11.2) and the transmission appears to be recessive. The clinical features include: action myoclonus, generalized epileptic seizures, mild cerebellar signs and lack of dementia. EEG features include normal background activity, spontaneous fast generalized spike-wave discharges, photosensitivity, lack of activation during nREM sleep and vertex/rolandic spikes during REM sleep. The prognosis is variable, even within families, but the progression seems to be slow in a majority of patients. This condition can be distinguished from mitochondrial encephalomyopathy and is less severe than Baltic myoclonus. The authors propose that this form of PME, formerly reported as RHS, be more properly described as Mediterranean myoclonus.

Adolescent↗
PubMed1992

Progressive myoclonic ataxia without ragged red fibres: Unverricht-Lundborg disease vs Ramsay Hunt syndrome.

We describe eight patients from three families presenting with myoclonus, ataxia, infrequent seizures and minimal intellectual impairment. All were Arabs from different parts of the Arabian peninsula. The new consensus on terminology, genetic and clinical definition of Baltic myoclonus, Ramsay Hunt syndrome and Unverricht-Lundborg disease suggests that our group are best categorised under the term of progressive myoclonic ataxia of the Unverricht-Lundborg type. Moreover, this report reinforces the existence of this syndrome outside Scandinavia.

Adolescent↗
PubMed2006

Outcomes in adulthood for children with foetal growth retardation. A linkage study from the Nord-Trøndelag Health Study (HUNT) and the Medical Birth Registry of Norway.

OBJECTIVE: The aims were to examine the long-term functional outcome and risk of mood disorders in adulthood in individuals with foetal growth retardation. METHOD: In a prospective cohort study of 7806 individuals aged 20-30 years, using linked data from the Health Survey of Nord-Trøndelag (HUNT-2) and the Medical Birth Registry of Norway, we studied the long-term effects of being born with a birth weight below the 10th percentile for gestational age (SGA). RESULTS: SGA individuals had lower educational level (OR: 1.33), lower socioeconomic functioning level (OR: 1.77) and more frequent reported mood disorder in adulthood (OR: 1.26). Analyses of a substratum of infants born at term showed almost identical results. CONCLUSION: Foetal growth retardation measured as SGA shows a moderate risk for lower education and socioeconomic level and for anxiety and/or depression in young adulthood. Issues concerning interventions for children at risk should be considered.

Adult↗
PubMed2006

Prognostic value of electroneurography in Bell's palsy and Ramsay-Hunt's syndrome.

OBJECTIVES: This study evaluated the accuracy of electroneurography to predict the prognosis of Bell's palsy and Ramsay-Hunt's syndrome. DESIGN: A retrospective, institutional review board-approved study. SETTING: A secondary referral and a university-based centre. PARTICIPANTS: The patients had been treated for a sudden onset unilateral facial paralysis over the past 10 years (1994-2004). This retrospective study included only those patients who had been followed up for at least 3 months or if they had reached a complete recovery before then. MAIN OUTCOMES MEASURES: House-Backmann grade versus electroneurography value. RESULTS: The recovery rates to House-Brackmann grade II or better were 95% in those with Bell's palsy and 84% in those with herpes zoster oticus. The electroneurography value of the recovery and non-recovery groups from those with either Bell's palsy or herpes zoster oticus was similar. The logistic regression model between the electroneurography values and the probability of recovery showed no correlation in those with Bell's palsy or with herpes zoster oticus. This study did not identify the proper electroneurography value that had enough appropriate sensitivity and specificity to predict the prognosis of paralysis accurately in Bell's palsy or in herpes zoster oticus patients. CONCLUSION: Electroneurography performed between day 7 and 10 for Bell's palsy or day 10 and 14 for herpes zoster oticus does not provide accurate information on the prognosis or recovery rate of the facial paralysis.

Adult↗
PubMed2004

Bushmeat hunting, wildlife declines, and fish supply in West Africa.

The multibillion-dollar trade in bushmeat is among the most immediate threats to the persistence of tropical vertebrates, but our understanding of its underlying drivers and effects on human welfare is limited by a lack of empirical data. We used 30 years of data from Ghana to link mammal declines to the bushmeat trade and to spatial and temporal changes in the availability of fish. We show that years of poor fish supply coincided with increased hunting in nature reserves and sharp declines in biomass of 41 wildlife species. Local market data provide evidence of a direct link between fish supply and subsequent bushmeat demand in villages and show bushmeat's role as a dietary staple in the region. Our results emphasize the urgent need to develop cheap protein alternatives to bushmeat and to improve fisheries management by foreign and domestic fleets to avert extinctions of tropical wildlife.

Agriculture↗
PubMed1985

Peptide neurotoxins from fish-hunting cone snails.

To paralyze their more agile prey, the venomous fish-hunting cone snails (Conus) have developed a potent biochemical strategy. They produce several classes of toxic peptides (conotoxins) that attack a series of successive physiological targets in the neuromuscular system of the fish. The peptides include presynaptic omega-conotoxins that prevent the voltage-activated entry of calcium into the nerve terminal and release of acetylcholine, postsynaptic alpha-conotoxins that inhibit the acetylcholine receptor, and muscle sodium channel inhibitors, the mu-conotoxins, which directly abolish muscle action potentials. These distinct peptide toxins share several common features: they are relatively small (13 to 29 amino acids), are highly cross-linked by disulfide bonds, and strongly basic. The fact that they inhibit sequential steps in neuromuscular transmission suggests that their action is synergistic rather than additive. Five new omega-conotoxins that block presynaptic calcium channels are described. They vary in their activity against different vertebrate classes, and also in their actions against different synapses from the same animal. There are susceptible forms of the target molecule in peripheral synapses of fish and amphibians, but those of mice are resistant. However, the mammalian central nervous system is clearly affected, and these toxins are thus of potential significance for investigating the presynaptic calcium channels.

Amino Acid Sequence↗
PubMed2001

Quantitation of varicella-zoster virus DNA in patients with Ramsay Hunt syndrome and zoster sine herpete.

Varicella-zoster virus (VZV) reactivation causes facial nerve palsy in Ramsay Hunt syndrome (RHS) and zoster sine herpete (ZSH) with and without zoster rash, respectively. In the present study, we analyzed the VZV DNA copy number in saliva samples from 25 patients with RHS and 31 patients with ZSH using a TaqMan PCR assay to determine differences in the viral load between the two diseases. VZV copy number in saliva peaked near the day of the appearance of zoster in patients with RHS. Consequently, VZV DNA was less frequently detected in patients with RHS who exhibited facial palsy several days after the appearance of zoster. These findings suggest that the VZV load in saliva samples reflects the kinetics of viral reactivation in patients with RHS. In addition, VZV DNA was equally detected in saliva from patients with RHS and ZSH, and there was no significant difference in the highest viral copy number between patients with RHS and those with ZSH. The VZV load does not appear to reflect a major difference between RHS and ZSH.

DNA, Viral↗
PubMed1975

Tolosa-Hunt syndrome. The dangers of an eponym.

Two cases of painful ophthalmoplegia are described which were initially thought to be examples of the Tolosa-Hunt syndrome. Both were partially responsive to steroid treatment. Subsequent investigations showed that in one case the condition was due to an aneurysm and in the other to a malignant lymphoma.

Aneurysm↗
PubMed2005

Estimating the high risk group for cardiovascular disease in the Norwegian HUNT 2 population according to the 2003 European guidelines: modelling study.

OBJECTIVE: To estimate the high risk group for cardiovascular disease in a well defined Norwegian population according to European guidelines and the systematic coronary risk evaluation system. DESIGN: Modelling study. SETTING: Nord-Tröndelag health study 1995-7 (HUNT 2), Norway. PARTICIPANTS: 5548 participants of the Nord-Tröndelag health study 1995-7, aged 40, 50, 55, 60, and 65. MAIN OUTCOME MEASURES: Distribution of risk categories for cardiovascular disease, with emphasis on the high risk group. MAIN RESULTS: At age 40, 22.5% (95% confidence interval 19.3% to 25.7%) of women and 85.9% (83.2% to 88.6%) of men were at high risk of cardiovascular disease. Corresponding numbers at age 50 were 39.5% (35.9% to 43.1%) and 88.7% (86.3% to 91.0%) and at age 65 were 84.0% (80.6% to 87.4%) and 91.6% (88.6% to 94.1%). At age 40, one out of 10 women and no men would be classified at low risk for cardiovascular disease. CONCLUSION: Implementation of the 2003 European guidelines on prevention of cardiovascular disease in clinical practice would classify most adult Norwegians at high risk for fatal cardiovascular disease.

Adult↗
PubMed1993

Response to Roger W. Hunt.

A response to a critique by Roger W. Hunt of my views on the eventual likely need to use age as a standard for the allocation of expensive, high-technology, life-extending medical care for the elderly. The response encompasses three elements: 1. that while the elderly have a substantial claim to publicly-provided health care, it cannot be an unlimited claim; 2. that a health care system which provided a decent, coherent set of medical and social services for the elderly would be sufficient, even if some limits had to be set; and 3. allocation and rationing decisions should not be made by individual doctors at the bedside but by regional or national policy.

Age Factors↗
PubMed1978

Progressive myoclonus and epilepsy with dentatorubral degeneration: a clinicopathological study of the Ramsay Hunt syndrome.

Ramsay Hunt's progressive myoclonus and epilepsy associated with dentatorubral degeneration is a rare disorder. We report a 19 year old woman with this clinical syndrome who also has a more mildly affected brother. Neuropathological in addition to dentatorubal involvement. The evidence suggests that this is a distinctive hereditary disorder producing neuromal degeneration at several levels in the central nervous system.

Adult↗
PubMed1983

Psychophysical assessment of a patient with Tolosa-Hunt syndrome.

Patients may complain of impaired vision and yet exhibit no abnormalities when tested with conventional tests of visual acuity. Some sensitive psychophysical tests used by psychologists and neurophysiologists to examine the function of the normal visual system are beginning to gain recognition as useful tools in clinical situations. They are particularly sensitive indicators of damage to the visual pathways. The results are presented of one such application which characterises the visual defects of a patient with a suspected diagnosis of Tolosa-Hunt Syndrome.

Discrimination Learning↗
PubMed1989

Clinicopathological correlation in a case of painful ophthalmoplegia: Tolosa-Hunt syndrome.

A case of painful ophthalmoplegia due to idiopathic granulomatous involvement of the superior orbital fissure (Tolosa-Hunt syndrome) is described. The clinical features of recurrent pain, ocular motor nerve palsies and proptosis correlated well with the eventual demonstration of an enhancing mass in the region of the cavernous sinus. Removal of the lesion led to a resolution of the clinical picture and demonstration of a non-caseating granuloma with no other detectable cause. The original observation of Tolosa was thus re-affirmed.

Cavernous Sinus↗