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At least 919 records · Page 51Linked to original sources
PubMed1995

[Distribution of headache by diagnosis as the reason for neurologic consultation].

BACKGROUND: The aim of this study was to analyze the diagnostic distribution of patients consulting because of headache in a neurology department. METHODS: The clinical records of 3,498 patients who had consulted specifically due to headache between 1978 to 1993 were retrospectively studied. Diagnosis was reclassified according to the criteria of the new headache classification with data concerning the age of onset and sex distribution also being collected. RESULTS: The most frequent diagnoses were migraine (1,802 patients; 52%) tension-type headache (113; 32%), followed in decreasing order by trigeminal neuralgia, post injury headache, cluster headache, subarachnoid hemorrhage, analgesic-ergotamine abuse headache, tumoral headache, cervical disease headache, benign exertional headache, due to paranasal sinusal disorders and benign intracranial hypertension. Female predominance was observed in the whole series (68%) as in the groups with migraine, tension-type headache, neuralgia headache by analgesic-ergotamine drugs and benign intracranial hypertension. Cluster, post injury, tumor and provoked headaches (cough, exertional and sexual) were found to be more frequent in men. The age of onset was very specific for each kind of headache. The percentage of symptomatic headaches increased in direct relation to age, being 10 fold higher in patients over the age of 65. CONCLUSIONS: The diagnostic distribution of headache as a cause of medical consultation is very different to the prevalence of different headaches. This distribution by diagnosis largely depends on the age of the patient at the time of headaches onset [corrected].

Adolescent↗
PubMed1976

Treatment of migraine attacks with an analgesic combination (Mersyndol).

The relief of acute migraine attacks with an analgesic/antihistamine combination containing paracetamol, codeine phosphate, doxylamine succinate and caffeine (Mersyndol) compared with that achieved with a placebo has been studied in a double-blind, crossover trial. Mersyndol emerged as significantly better than placebo in the complete relief of migraine pain, and was clearly superior to placebo in partially relieving the pain of migraine. These results suggest that it could be a useful alternative to ergotamine, and a comparative trial with ergotamine is suggested. Side effects with this combination were fairly common but mild, and consisted mainly of drowsiness caused by the antihistamine component.

Acetaminophen↗
PubMed1993

Human S31 serotonin receptor clone encodes a 5-hydroxytryptamine1E-like serotonin receptor.

We reported recently the molecular cloning of a genomic fragment, designated S31, that has an open reading frame of 1095 nucleotides, encoding a protein of 365 amino acids. Amino acid similarity analysis suggested that the S31 protein could be a guanine nucleotide-binding protein-coupled receptor pertaining to the serotonin receptor subfamily. Expression of the S31 open reading frame in murine L cells confirmed this, because it led to the appearance of serotonin-mediated inhibition of adenylyl cyclase activity, which was absent in the recipient L cells. We now report some aspects of the pharmacological profile of this receptor. We found that the relative potencies with which 5-hydroxytryptamine, 5-carboxamidotryptamine, methysergide, ergotamine, 8-hydroxydipropylaminotetralin, and trifluoromethylphenylpiperazine promote inhibition of adenylyl cyclase are as follows: 5-hydroxytryptamine >> methysergide >> ergotamine >> trifluoromethylphenylpiperazine > or = 8-hydroxydipropylaminotetralin > 5-carboxyamidotryptamine. This corresponds to the rank order of potencies assigned for these drugs for the 1E subtype of serotonin receptors discovered by Leonhardt and collaborators in human brain [J. Neurochem. 53:465-471 (1989)].

Adenylyl Cyclase Inhibitors↗
PubMed1984

Prostaglandin E1 for alleviating symptoms of ergot intoxication: a case report.

A woman was admitted after ergotamine tartrate overuse for migraine headaches and her symptoms of arterial vasospasm were treated with PGE1, the first reported use of the vasodilator for ergot intoxication. The advantages of producing local vasodilatation without systemic effect, as well as inhibiting the formation of arterial microthrombi, suggest PGE1 as the agent of choice for relief of symptoms due to peripheral vasoconstriction caused by ergot. Treatment with PGE1 may allow sufficient collateral to preserve limb function and integrity, while awaiting remission of anatomic changes after withdrawal of ergot.

Adult↗
PubMed1984

Ergot poisoning in paraplegia.

Ergot derivatives are widely used for migraine headaches. However, ergotamine tartrate may cause intoxication which may even become fatal. A case of ergot poisoning in a paraplegic patient is reported, where deep vein thrombosis and ischaemia of the lower limbs were the presenting signs.

Ergotamine↗
PubMed1981

Variability in the content and composition of alkaloids found in Canadian ergot. II. Wheat.

The total alkaloid content and individual alkaloid composition were determined by colorimetry and high performance liquid chromatography, respectively, for Canadian wheat ergot sclerotia. The total alkaloid content was highly variable between individual sclerotia from the same or different sources and ranged from 0.013 to 0.307%; the overall average for bulked samples from 75 sites was 0.163%. Ergocristine and its isomer ergocristinine were the major constituents (approximately 46%). Other alkaloid pairs observed were ergotamine (approximately 17%), ergocryptine (approximately 12%), ergocornine (approximately 11%), ergometrine (approximately 7%), and ergosine (approximately 5%), plus about 2% unidentified alkaloids.

Canada↗
PubMed2003

Crossover comparison of efficacy and preference for rizatriptan 10 mg versus ergotamine/caffeine in migraine.

Rizatriptan is a selective 5-HT(1B/1D) receptor agonist with rapid oral absorption and early onset of action in the acute treatment of migraine. This randomized double- blind crossover outpatient study assessed the preference for 1 rizatriptan 10 mg tablet to 2 ergotamine 1 mg/caffeine 100 mg tablets in 439 patients treating a single migraine attack with each therapy. Of patients expressing a preference (89.1%), more than twice as many preferred rizatriptan to ergotamine/caffeine (69.9 vs. 30.1%, p < or = 0.001). Faster relief of headache was the most important reason for preference, cited by 67.3% of patients preferring rizatriptan and 54.2% of patients who preferred ergotamine/caffeine. The co-primary endpoint of being pain free at 2 h was also in favor of rizatriptan. Forty-nine percent of patients were pain free 2 h after rizatriptan, compared with 24.3% treated with ergotamine/caffeine (p < or = 0.001), rizatriptan being superior within 1 h of treatment. Headache relief at 2 h was 75.9% for rizatriptan and 47.3% for ergotamine/caffeine (p < or = 0.001), with rizatriptan being superior to ergotamine/caffeine within 30 min of dosing. Almost 36% of patients taking rizatriptan were pain free at 2 h and had no recurrence or need for additional medication within 24 h, compared to 20% of patients on ergotamine/caffeine (p < or = 0.001). Rizatriptan was also superior to ergotamine/caffeine in the proportions of patients with no nausea, vomiting, phonophobia or photophobia and for patients with normal function 2 h after drug intake (p < or = 0.001). More patients were (completely, very or somewhat) satisfied 2 h after treatment with rizatriptan (69.8%) than at 2 h after treatment with ergotamine/caffeine (38.6%, p < or = 0.001). Recurrence rates were 31.4% with rizatriptan and 15.3% with ergotamine/caffeine. Both active treatments were well tolerated. The most common adverse events (incidence > or = 5% in one group) after rizatriptan and ergotamine/caffeine, respectively, were dizziness (6.7 and 5.3%), nausea (4.2 and 8.5%) and somnolence (5.5 and 2.3%).

Adolescent↗
PubMedDate not supplied

Antagonistic effects of simultaneous exposure of ergot alkaloids on kidney adenosine triphosphatase system.

Much of the research on fescue toxicosis has concentrated on evaluating animal response to grazing endophyte-infected (E+) versus endophyte-free tall fescue or the effects of single toxins such as ergonovine (EN), ergovaline (EV), or ergotamine (ET) on animal performance. Such approaches have eliminated the opportunity to test the possible additive, synergistic, or antagonistic interactions of one or more ergot alkaloids with the other ergot alkaloids found in E+ tall fescue. This study was conducted to determine the effects of simultaneous exposure of pairs of EN, EV, and ET on the kidney adenosine triphosphatase (ATPase) system in vitro. Tests were performed using three separate rat kidney homogenates and were repeated four times at concentrations of 0, 75, and 200 microM. Individually, EN, EV, and ET induced dose-dependent inhibitions of kidney Na(+)/K(+) ATPase, with EN being most potent, followed by purified EV, and then by ET. The ergot alkaloids inhibited Mg(2+) ATPase to a lesser degree than Na(+)/K(+) ATPase, with EN again being the most potent toxin. Simultaneous exposure to any combination of the ergot alkaloid pairs tested (EV + ET, EV + EN, and ET + EN) resulted in significant interactions (P < 0.05), indicating antagonistic effects on the inhibition of Na(+)/K(+) ATPase and Mg(2+) ATPase for most concentration combinations. These interactions suggest that in studies of the effects of any ergot alkaloid on animal performance, effects of other ergot alkaloids may also be present. Effects may not be additive, as was the case in this study, and the presence of one toxin may enhance or hinder the effectiveness of others.

Animals↗
PubMed1990

Effects of increasing dietary levels of endophyte-infected tall fescue seed on diet digestibility and ruminal kinetics in sheep.

Three experiments were conducted with sheep to determine the effects of 1) increasing the dietary concentration of ergovaline and 2) environmental temperature on site of nutrient digestion and ruminal passage rates. Dietary ergovaline concentration, a measure of endophyte-alkaloid concentration, was modified by substituting ergovaline-infected for noninfected tall fescue seed. Ruminal and total tract OM, NDF and cellulose digestibilities were less (P less than .10) and ruminal fluid dilution rate (%/h) and fluid outflow (liters/h) were greater (P less than .05) when diets contained 3 ppm ergovaline than when diets contained 0 ppm ergovaline. An interaction (P less than .05) between dietary ergovaline concentration (0 vs 1.5 ppm) and environmental temperature (27 vs 34 degrees C) was found for OM intake and NDF and cellulose digestion. Ruminal fluid dilution and outflow rates decreased (P less than .01) even though water consumption increased (P less than .01) with increasing temperature. Rectal temperature increased (P less than .01) when ergovaline and ergotamine tartrate were fed and when sheep were exposed to increased environmental temperature. Under the dietary (and environmental) conditions described, our results suggest that alkaloid(s) present in infected tall fescue seed inhibit ruminal fiber digestion and increase the sensitivity of sheep to heat stress.

Acremonium↗
PubMedDate not supplied

Tongue necrosis in temporal arteritis.

Temporal arteritis, or cranial arteritis, is a granulomatous arteritis with the common presenting manifestations of headache and visual loss. The disease is generally limited to elderly individuals; its pathogenesis is unknown, but may be of an immunological nature. Although otolaryngologic manifestations of the disease are common, few reports have been published. Visual loss is one of the most serious complications. Tongue necrosis has been reported in only 23 cases. We report a case of tongue necrosis and partial visual field loss in a patient with temporal arteritis. These complications were probably released by ergotamine tartrate administered because of migrainoid headache. This particular complication has been described only once previously.

Aged↗
PubMed1991

Saint Anthony's fire revisited. Vascular problems associated with migraine medication.

Ergotamine and related compounds have been used for many years in the management of migraine. This review highlights the potential for toxic effects upon the arterial system which may arise from the use of ergot medications. Data on four female patients aged from 30 to 49 years were collected retrospectively from in-patient records and out-patient follow-up between 1978 and 1990. All four patients presented with the symptoms and signs of arterial obstruction and all had been prescribed ergot preparations as treatment and prophylaxis of migraine, for periods ranging from three to 12 years. Two patients had an acute arterial obstruction that resolved completely when the migraine medication was withdrawn. Two had chronic obstructions and radiological and surgical examination gave evidence of arterial stenosis. These two patients were treated with bypass surgery. Review of the literature indicated that other authors had described similar cases but without specifying the methods of data collection. This report supports the findings of others regarding the toxic effects of ergot preparations upon the arterial system, which may take the form of chronic or acute obstruction. General practitioners and physicians should be aware of the possible complications arising from prolonged or excessive use of ergot medications.

Adult↗
PubMed1991

Severe iatrogenic ergotism: incidence and clinical importance.

Ergot's derivatives are widely used to treat and prevent migraine and, associated with heparin, for the prevention of deep vein thrombosis. During a five-year period, 7 patients have been admitted in our hospital for severe vasospasm of one or several extremities due to ergot's derivatives. All patients presented with acute severe ischemia of the lower limb requiring iv infusion of vasodilator drugs. Ergotamine tartrate was the responsible drug in four patients and dihydroergotamine(DHE)-heparin in three patients. Intravenous administration of sodium nitroprusside (n = 6) relieved vasospasm in all but one of the patients within hours to days and no amputation was required. Ankle or great toe to arm systolic pressure index was normalized in the majority of the patients after treatment. A sympathectomy was performed in two patients which did not improve the clinical course. Distal necrosis developed in two patients (DHE-heparin). It is concluded that incidence of severe ergotism is less than 0.5/100,000/year in Geneva. This contrasts with the high prevalence (15%) of subclinical ergotism reported by others. No amputation was required in this series in spite of severe and prolonged vasospasms. Subclinical ergotism most probably precedes for weeks the onset of severe vasospasm, which calls for close monitoring of patients taking ergot's derivatives.

Adolescent↗
PubMed1990

[Ergotism: an occasional unrecognized cause of acute ischemia of the extremities].

Vasospasm related to ergot intoxication has been recognised since the Middle Ages when it occurred due to ingestion of rye contaminated with Claviceps purpurea. Today ergotism is a rare cause of peripheral ischaemia, most often associated with ergotamine tartrate therapy for migraine headaches. Recognition of the typical angiographic pattern is important, as the classic drug history may not be obtained, and the cause of the ischaemia can be overlooked. Early diagnosis is important as the outcome may be serious if left untreated. Arterial vasospasm, collateralisation, and secondary thrombus formation are the major angiographic findings. Ergotism responds to conservative therapy which includes drug withdrawal, intravenous nitroprusside, fluid therapy and heparinisation. We describe the angiographic findings of four cases and report on the results of therapy.

Adult↗
PubMed1989

Reactivity of dorsal pedal vein of cattle to selected alkaloids associated with Acremonium coenophialum-infected fescue grass.

We determined the vasoconstrictive effects of selected ergot alkaloids, and a sample containing loline and its derivative alkaloids, on the isolated dorsal pedal vein of cattle, as a model system to study one of the toxic effects that result from cattle ingesting fescue forage infected with the endophytic fungus Acremonium coenophilalum. The ergot compounds ergotamine, ergosine, and agroclavine constricted this peripheral vein of cattle, but much less so than did the alpha-adrenergic agonist norepinephrine, which supports the ergots acting as partial agonists for these receptors. However, the sample of loline and loline-derivative alkaloids did not affect the dorsal pedal vein when given at concentrations similar to those of the ergot compounds. Loline and loline-derivative alkaloid sample at high concentrations partially inhibited norepinephrine-elicited vascular contraction, an effect that appeared to be unrelated to alpha-adrenoceptor activity. Thus, in the dorsal pedal vein model in cattle, the ergopeptide alkaloids were more venoconstrictive than were loline and its derivative alkaloids.

Acremonium↗
PubMed1985

[Effect of various adenine derivatives on gastric acid secretion in the isolated rat stomach].

The adenine derivatives adenosine 5'-triphosphate (ATP), adenosine 5'-diphosphate (ADP), adenosine 5'-monophosphate (AMP) and adenosine (AD), in concentrations of 10(-3)M and 10(-4)M caused significant and dose-related modifications in the basal acid secretion from isolated whole rat stomach. The first three purine derivatives, ATP, ADP and AMP significantly increased the spontaneous acid secretion. On the other hand, AD caused a significant reduction in the basal acid secretion. When ATP, ADP, AMP and AD were assayed in the presence of the adrenergic and cholinergic blocking agents, ergotamine, 10(-6)M, propranolol, 5 X 10(-7)M and atropine, 10(-6)M, all these purine derivatives, including AD, caused a significant increase in the basal acid secretion.

Adenine Nucleotides↗
PubMed1980

[Ano-cutaneous gangrenous ergotism].

A case of ergotism by abuse of ergotamine tartrate suppositories is reported. The patient developed the clinical picture of ergotism with multiple perianal ulcers. After ergot had been withdrawn there was a spontaneous healing of these ulcers after a few weeks. It is well known that ergot abuse can develop severe vascular spasm in the arteries, but it is unknown that cutaneous ulcers may occur by topical application.

Adult↗
PubMed1981

[Distal mesenteric arteritis: a rare complication of D. methylsergide treatment (author's transl)].

A patient developed typical abdominal angina due to mesenteric arteritis secondary to D. methylsergide (Desernil) treatment. Multiple regular distal stenoses were revealed by arteriography, but these had completely disappeared 5 months after discontinuing treatment. Histology demonstrated fibrosis of the three tunicae with hyperelastosis. Six analogous cases due to D. methylsergide or ergotamine tartrate have been reported in the published literature, rapid regression occurring in all of them after interruption of treatment.

Arteritis↗
PubMed1980

Cerebroarthrodigital syndrome: a newly recognized formal genesis syndrome in three patients with apparent arthromyodysplasia and sacral agenesis, brain malformation and digital hypoplasia.

We describe three patients with a complex syndrome of apparent arthromyodysplasia, dyscephaly, sacral agenesis, and hypoplastic digitis. Cause is unknown, but an environmental cause is suspected on the basis of ergotamine exposure in one case and diazoxide intake in another, together with suggestive similarities to anomalies seen in animals treated with these drugs and to calves with the Australian hydranencephaly/arthrogryposis syndrome caused by Akebane or Aino virus. Pathogenetically the primary defect may be a neural tube-neural crest dysplasia with multiple secondary and tertiary manifestations and deformities.

Arthrogryposis↗