OBSERVATIONS ON 500 CASES OF MIGRAINE AND ALLIED VASCULAR HEADACHE

Abstract

Extracranial vascular headaches including migraine were studied in 300 females and 200 males. Headaches began during the first 4 decades of life in 92% of the patients and during the first decade in 21%. A family history of headache, epilepsy and allergic disorders existed in 55% of 464, 15% of 439 and 38% of 330 patients, respectively. Convulsions or epilepsy during childhood occurred in 11% of 348 patients while 35% of 311 had a past history of allergies. Cyclical vomiting, bilious attacks and severe motion sickness were recognized during early years. The headaches occurred 1-4 times each month with emotional factors increasing the frequency of attacks. The duration was less than a day in 2/3 of the cases. Precipitating factors included alterations in hormonal and/or fluid balance, diet and nervous tension. Nausea, vomiting, vertigo and scalp tenderness were among the accompanying symptoms and a few physical signs such as alterations in muscle tone, reflexes and blood pressure appeared. Ecg abnormalities were seen in 30% of 459 patients. Ergotamine compounds were effective in 80% of the cases and histamines were of value in 63%. Migraine syndrome is basically related to an autonomic disturbance affecting intra-and extracranial arteries and should not be considered separate from other forms of extracranial vascular headaches.