Muscle Relaxation in the Treatment of Headache

Blumenthal, Lester S.; Fuchs, M

doi:10.1111/j.1526-4610.1961.hed0102008.x

Cited by 8 publications

(6 citation statements)

References 10 publications

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“…Because the practical difficulties associated with ergotamine injections and suppositories limit their use, alternative routes of administration have been sought and a formulation of ergotamine tartrate suitable for oral inhalation (" medihaler-ergotamine ") has recently been devised. Although a number of workers from other countries have reported favourably on its use (Finch, 1960;Graham et al, 1960;Blumenthal and Fuchs, 1961 ;Sutherland and Eadie, 1961 ;Dalsgaard-Nielsen, 1961) their opinions were, in the main, based on uncontrolled observations. The present paper gives the results of a clinical trial of inhaled ergotamine tartrate in the treatment of migraine in which the therapeutic effectiveness of inhalation has been compared with that of the drug given sublingually.…”

Section: Discussionmentioning

confidence: 99%

Clinical Trial of Inhaled Ergotamine Tartrate in Migraine

Crooks¹,

Stephen²,

Brass³

1964

BMJ

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MEBITALJOSHRNAL (921 Ekbom (1947) using " gynergen "1 reported results similar to our own. It has been our impression that gastro-intestinal side-effects were less marked with migril than with other preparations, but we have no statistically valid evidence to support this view.We are unable to throw any light on the aetiology of this condition. We see no reason why it should be attributed to histamine allergy and it is also difficult to relate it to migraine. In our cases a family history of migraine was rarely obtained, and this would be unexpected if this condition was indeed a variant of the migraine syndrome in which a positive family history is the rule rather than the exception. The age and sex distribution is also somewhat different from that of migraine, many of our patients having had their first symptoms in their forties. Though these are only two facets of the clinical picture, they may be of possible significance in distinguishing this syndrome from migraine. Summary Twenty-eight cases of periodic migrainous neuralgia are reviewed. The cermical picture is described. The average time which elapsed between the onset of symptoms and accurate I Known in Great Britain as " femergen." diagnosis was 6.5 years. Our experiences of treatment using prophylactic migril in 20 patients are discussed. In 14 the response was satisfactory and in six relief was only slight. Two of these patients showed further improvement on prophylactic ergotamine injections. Three patients who failed to respond to oral ergotamine or relapsed responded to methysergide. A plea is made for early diagnosis in this eminently treatable condition.We are grateful to Dr. Henry Miller for allowing us to review a number of patients who were under his care.

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Section: Discussionmentioning

confidence: 99%

Clinical Trial of Inhaled Ergotamine Tartrate in Migraine

Crooks¹,

Stephen²,

Brass³

1964

BMJ

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“…The utilization of behavioral techniques for the treatment of headaches is widely accepted (Adams, Feuerstein, & Fowler, 1979;Bakal, 1975;Blumenthal & Fuchs, 1961;Fahrion, 1978;Fowler, 1975). Studies demonstrating the efficacy of these treatments typically rely on three types of data: physiological measures, medication intake, and self-reported headache characteristics (e.g., pain intensity, accompanying symptoms).…”

Section: Introductionmentioning

confidence: 99%

Reliability and standardization in the assessment of self-reported headache pain

CollinsJr.

Thompson

1979

Journal of Behavioral Assessment

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“…1a A previous report on the use of muscle relaxants in the treatment of headache, published in July, 1961, indicated extremely promising results with orphenadrine citrate (Norflex (R) ) in a variety of headache problems. 2 Results were satisfactory in approximately 80 per cent of patients with tension headaches, arthritic involvement of the cervical spine, as well as post traumatic headaches, whereas treatment was singularly ineffective in patients with vascular headaches of the migraine and histaminic cephalalgia variety. The very satisfactory results achieved in the treatment of backache were analogous to those achieved in tension and traumatic headache, since many of the dynamic factors applicable in the genesis of neck pain were present likewise in patients with backache.…”

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confidence: 96%

Analgesic Combination in Headache

Fuchs

Blumenthal

1965

Headache

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A RECENT double-blind study demonstrated that the combination of orphenadrine citrate and APC had analgesic properties significantly superior to either of its component parts, which were each superior to a placebo. 1 A second double-blind study reported orphenadrine-APC to be superior to A previous report on the use of muscle relaxants in the treatment of headache, published in July, 1961, indicated extremely promising results with orphenadrine citrate (Norflex (R) ) in a variety of headache problems. 2 Results were satisfactory in approximately 80 per cent of patients with tension headaches, arthritic involvement of the cervical spine, as well as post traumatic headaches, whereas treatment was singularly ineffective in patients with vascular headaches of the migraine and histaminic cephalalgia variety. The very satisfactory results achieved in the treatment of backache were analogous to those achieved in tension and traumatic headache, since many of the dynamic factors applicable in the genesis of neck pain were present likewise in patients with backache.Some little inflexibility in dosage utilization of orphenadrine citrate was encountered since the average dose was 100 mg. twice a day and smaller amounts were required at times in order to minimize occasional side effects. Most patients were also using analgesics of the salicylate variety and it seemed most logical to incorporate standard doses of APC compound with 25 mg. of orphenadrine, then a flexible dosage schedule of 1 or 2 tablets at intervals of 2 to 4 times a day would be available to render satisfactory analgesia. There is ample evidence of the value of this type of combination in the literature.Our experience likewise indicated that certain classes of disorders would he most responsive to this combination of drugs. Accordingly, patients with severe pain, associated with vascular headache, were excluded, as were those patients in whom the mechanism of pain was not clearly understood, such as cases of trigeminal neuralgia and headache associated with severe depression or hysteria. The pharmacological considerations of the action of orphenadrine have been reported in our previous publication.Each patient in this study was evaluated, as previously described, including thorough history and physical examination, as well as appropriate laboratory and x-ray studies. The groups of patients selected for this study included patients with tension headache, cervical strain, cervical dic, cervical arthritis and acute torti-

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Muscle Relaxation in the Treatment of Headache

Cited by 8 publications

References 10 publications

Clinical Trial of Inhaled Ergotamine Tartrate in Migraine

Clinical Trial of Inhaled Ergotamine Tartrate in Migraine

Reliability and standardization in the assessment of self-reported headache pain

Analgesic Combination in Headache

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