The platelet levels of serotonin and the amino acids aspartic acid, glutamine, glutamic acid and gamma-aminobutyric acid were measured in 18 drug-free autistic (DSM-III criteria) and 14 age-matched healthy children. Serotonin was significantly increased while the amino acids aspartic acid, glutamine, glutamic acid and gamma-aminobutyric acid were significantly decreased in comparison with the controls. It is suggested that the decline of the amino acids in platelets from autistic children represents a biochemical marker related to infantile autism.
Drug-induced headache is a well-known complication of the treatment of primary headache disorders, and its successful management is only possible by withdrawal therapy. However, it is unknown whether ambulatory or stationary withdrawal is the therapy preferred. We conducted a prospective study on the outcome of stationary versus ambulatory withdrawal therapy in patients with drug-induced headache according to the International Headache Society criteria. Out of 257 patients with the diagnosis of drug-induced headache during the study period, 101 patients (41 after ambulatory and 60 after stationary withdrawal therapy) could be followed up for 5.9 +/- 4.0 years. The total relapse rate after successful withdrawal therapy was 20.8% (14.6% after ambulatory and 25.0% after stationary withdrawal therapy, p < 0.2). The main risk factors for a relapse were male sex (OR = 3.9, CI = 1.3-11.6), intake of combined analgesic drugs (OR = 3.8, CI = 1.4-10.3), administration of naturopathy (OR = 6.0, CI = 1.2-29.3), and a trend to tension-type headache as the primary headache disorder (OR = 1.9, CI = 0.6-53.0). Our data suggest that neither the method of withdrawal therapy nor the kind of analgesic and other antimigraine drugs has a major impact on the long-term result after successful withdrawal therapy. Patients with risk factors according to our findings should be informed and monitored regularly, and combined drugs should be avoided. Furthermore, our data suggest that there is a need for research on individual psychological and behavioral risk factors for relapse after successful withdrawal therapy in drug-induced headache.
Brainstem auditory evoked potentials (BAEPs) were recorded in 38 unselected patients (6 m./32 f.; age 18-54 yrs.) with various forms of migraine, during the pain-free interval. The values were compared to those of 50 control persons (18 m./32 f.; age 17-75 yrs.). Peak latencies (PL I-VI), interpeak latencies (IPL I-III, III-V, I-V) and side differences of all peaks (delta I-VI) were calculated. In contrast to PL's of migraine patients, all PL's of control persons were normally distributed. In 6 migraine patients (2 with basilar migraine) PL's were pathologically delayed. Statistical analysis did not show any significant difference in regard to PL's and IPL's between migraine patients and controls. However, side differences of all peaks (except peak IV,VI) were significantly increased in migraine patients as compared to controls. Our results indicate a slight but permanent impairment of brainstem function in migraine.
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