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Jes Olesen - One of the best experts on this subject based on the ideXlab platform.
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part i pituitary adenylate cyclase activating polypeptide 38 induced Migraine like attacks in patients with and without familial aggregation of Migraine
Cephalalgia, 2017Co-Authors: Song Guo, Jes Olesen, Anne Luise Haulund Vollesen, Rikke Dyhr Hansen, Annlouise Esserlind, Faisal Mohammed Amin, Anne Francke Christensen, Messoud AshinaAbstract:Background Intravenous infusion of adenylate cyclase-activating polypeptide-38 (PACAP38) provokes Migraine-like attacks in 65-70% of Migraine sufferers. Whether aggregation of Migraine in first-degree relatives contributes to this discrepancy in PACAP38-induced response is unknown. We hypothesized that genetic enrichment plays a role in triggering of Migraine and that Migraine without Aura patients with a high family load ( ≥ 2 first-degree relatives with Migraine) would report more Migraine-like attacks after intravenous infusion of human PACAP38. Methods In this study, we allocated 32 previously genotyped Migraine without Aura patients to receive intravenous infusion of 10 pmol/kg/min PACAP38 and recorded Migraine-like attacks including headache characteristics and associated symptoms. Information of familial aggregation was obtained by telephone interview of first-degree relatives using a validated semi-structured questionnaire. Results PACAP38 infusion induced a Migraine-like attack in 75% (nine out of 12) of patients with high family load compared to 70% (14 out of 20) with low family load ( P = 0.761). In an explorative investigation, we found that the Migraine response after PACAP38 was not associated with the risk allele of rs2274316 ( MEF2D), which confers increased risk of Migraine without Aura and may regulate PACAP38 expression. Conclusion Migraine response to PACAP38 infusion in Migraine without Aura patients is not associated with high family load or the risk allele of rs2274316 ( MEF2D).
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ehmti 0203 increased prevalence of Migraine without Aura in patients with saccular intracranial aneurysms sia and remission after clipping of the aneurysm
Journal of Headache and Pain, 2014Co-Authors: Elena R Lebedeva, A V Busygina, E Y Guzhina, V S Kolotvinov, V P Sakovich, Jes OlesenAbstract:During the year before rupture, 124(62.3%) had one or more types of headache: Migraine without Aura (MO) -78 (39.2%), Migraine with Aura - 2(1%), probable Migraine: 4 (2%), TTH: 39(19.6%), cluster headache: 2(1%).Only the prevalence of MO was significantly higher in patients with SIA compare to controls (39.2% VS 8.8%, OR 6.7, 95% CI 3.8-11.9, p < 0.0001).One year after clipping, the prevalence of MO was significantly more reduced in patients with SIA than in controls (74.5% VS 12.8%, p < 0.0001). No factors except clipping of the aneurysm could explain the remission of Migraine. The prevalence of TTH did not change significantly after clipping of SIA but decreased significantly after treatment in controls. Conclusions Unruptured SIA is associated with a marked increase in the prevalence of Migraine without Aura which decreases significantly after clipping. No conflict of interest.
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the relative role of genetic and environmental factors in Migraine without Aura
Neurology, 1999Co-Authors: Morten Gervil, Jes Olesen, V Ulrich, Jaakko Kaprio, M B RussellAbstract:Objective: To clarify the relative role of genetic and environmental factors in the etiology of Migraine without Aura (MO). Methods: The study population consisted of 5,360 twins, 1,013 monozygotic (MZ) and 1,667 same-gender dizygotic (DZ) twin pairs, from the population-based Danish Twin Registry. A total of 87% completed a simple validated questionnaire screening for Migraine. All twin pairs, in whom at least one twin had self-reported Migraine or severe headache with accompanying symptoms, were interviewed via telephone by a physician. Ninety percent of the eligible twins were interviewed. Probandwise concordance rates and correlations in liability were calculated, and structural equation model-fitting analyses were applied to quantitate the relative role of genetic and environmental factors in the etiology of MO. Results: The probandwise concordance rate was higher in MZ than DZ twin pairs (0.43 versus 0.31; 95% CI, 0.36 to 0.49 versus 0.26 to 0.36). The correlation in liability was higher in MZ than in DZ twin pairs (0.62 versus 0.41; 95% CI, 0.50 to 0.74 versus 0.29 to 0.53). Structural equation model fitting indicated a highly significant genetic component, because a model with both genetic and environmental components fitted significantly better than a model with only environmental components. The best fitting model implied that the liability to MO resulted from additive genetic effects (61%; 95% CI, 49 to 71%)) and individual-specific environmental effects (39%; 95% CI, 29 to 51%). Conclusion: This study indicates that genetic factors play a role in the etiology of Migraine without Aura. The genetic variability is additive, with a negligible contribution of nonadditive genetic effects. The genetic contributions were similar in men and women despite a higher prevalence in women. Environmental factors are equally important and these factors are individual to the Migraineurs.
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Glyceryl trinitrate induces attacks of Migraine without Aura in sufferers of Migraine with Aura.
Cephalalgia : an international journal of headache, 1999Co-Authors: I Christiansen, Ll Thomsen, Daren DAUGAARD, Vibeke Ulrich, Jes OlesenAbstract:Migraine with Aura and Migraine without Aura have the same pain phase, thus indicating that Migraine with Aura and Migraine without Aura share a common pathway of nociception. In recent years, incr...
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Migraine without Aura and Migraine with Aura are distinct clinical entities a study of four hundred and eighty four male and female Migraineurs from the general population
Cephalalgia, 1996Co-Authors: M B Russell, Birthe Krogh Rasmussen, Kirsten Fenger, Jes OlesenAbstract:The clinical characteristics of Migraine without Aura (MO) and Migraine with Aura (MA) were compared in 484 Migraineurs from the general population. We used the criteria of the International Headache Society. The lifetime prevalence of MO was 14.7% with a M:F ratio of 1:2.2; that of MA was 7.9% with a M:F ratio of 1:1.5. The female preponderance was significant in both MO and MA. The female preponderance was present in all age groups in MA, but was first apparent after menarche in MO, suggesting that female hormones are an initiating factor in MO, but not likely so in MA. The age at onset of MO followed a normal distribution, whereas the age at onset of MA was bimodally distributed, which could be explained by a composition of two normal distributions. The estimated separation between the two groups of MA was at age 26 years among the females and age 31 years among the males. The observed number of persons with co-occurrence of MO and MA was not significantly different from the expected number. The specificity and importance of premonitory symptoms are questioned, but prospective studies are needed. Bright light was a precipitating factor in MA, but not in MO. Menstruation was a precipitating factor in MO, but not likely in MA. Both MO and MA improved during pregnancy. The clinical differences indicate that MO and MA are distinct entities.
Michael Bjorn Russell - One of the best experts on this subject based on the ideXlab platform.
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a clinical interview versus prospective headache diaries in the diagnosis of menstrual Migraine without Aura
Cephalalgia, 2015Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn RussellAbstract:ObjectivesThe objective of this article is to compare the diagnosis of menstrual Migraine without Aura (MM) from a clinical interview with prospective headache diaries in a population-based study.Material and methodsA total of 237 women with self-reported Migraine in at least half of menstruations were interviewed by a neurologist about headache and diagnosed according to the International Classification of Headache Disorders II (ICHD II). Additionally, the MM criteria were expanded to include other types of Migraine related to menstruation. Subsequently, all women were asked to complete three month prospective headache diaries.ResultsA total of 123 (52%) women completed both clinical interview and diaries. Thirty-eight women were excluded from the analyses: Two had incomplete diaries and 36 women recorded ≤1 menstruation, leaving 85 diaries eligible for analysis. Sensitivity, specificity, positive and negative predictive value and Kappa for the diagnosis of MM in clinical interview vs. headache diary wer...
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menstrual versus non menstrual attacks of Migraine without Aura in women with and without menstrual Migraine
Cephalalgia, 2015Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn Russell, Jūratė Saltytė BenthAbstract:ObjectiveThe objective of this article is to compare clinical characteristics of menstrual and non-menstrual attacks of Migraine without Aura (MO), prospectively recorded in a headache diary, by women with and without a diagnosis of menstrual Migraine without Aura (MM) according to the International Classification of Headache Disorders (ICHD).Material and methodsA total of 237 women from the general population with self-reported Migraine in ≥50% of their menstrual periods were interviewed and classified by a physician according to the criteria of the ICHD II. Subsequently, all participants were instructed to complete a prospective headache diary for at least three menstrual cycles. Clinical characteristics of menstrual and non-menstrual attacks of MO were compared by a regression model for repeated measurements.ResultsIn total, 123 (52%) women completed the diary. In the 56 women who were prospectively diagnosed with MM by diary, the menstrual MO-attacks were longer (on average 10.65 hours, 99% CI 3.17–18...
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ehmti 0188 contraceptive induced amenorrhoea leads to reduced Migraine frequency in women with menstrual Migraine
Journal of Headache and Pain, 2014Co-Authors: E A Macgregor, Kjersti Grotta Vetvik, Christofer Lundqvist, Michael Bjorn RussellAbstract:Menstrual Migraine without Aura (MM) is defined as attacks of Migraine without Aura (MO) occurring on day 1±2 of the menstrual cycle in at least 2/3 menstruations. Population-based studies shows that MM affects approximately 20% of female Migraineurs in their 30s. Many women in this age group need contraception.
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contraceptive induced amenorrhoea leads to reduced Migraine frequency in women with menstrual Migraine without Aura
Journal of Headache and Pain, 2014Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn RussellAbstract:Background: Menstrual Migraine without Aura (MM) affects approximately 20% of female Migraineurs in the general population. The aim of the present study was to investigate the influence of contraception on the attacks of Migraine without Aura (MO) in women with MM. Findings: 141 women from the general population with a history of MM according to the International Classification of Headache Disorders II (ICHD II) were interviewed by a headache specialist. Of 49 women with a history of MM currently using hormonal contraception, 23 reported amenorrhoea. Significantly more women with amenorrhoea reported no MO- days during the preceding month compared to women without amenorrhoea (OR 16.1; 95% confidence interval (CI) 1.8-140.4; P = 0.003). A reduction of MO-frequency was more often reported in women with than without amenorrhoea (OR 3.5; 95% CI 1.1-11.4; P = 0.04). Conclusion: Amenorrhoea leads to a reduction of MO-frequency in women with MM using hormonal contraceptives. Future prospective studies on MM should focus on contraceptive methods that achieve amenorrhoea.
Kjersti Grotta Vetvik - One of the best experts on this subject based on the ideXlab platform.
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a clinical interview versus prospective headache diaries in the diagnosis of menstrual Migraine without Aura
Cephalalgia, 2015Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn RussellAbstract:ObjectivesThe objective of this article is to compare the diagnosis of menstrual Migraine without Aura (MM) from a clinical interview with prospective headache diaries in a population-based study.Material and methodsA total of 237 women with self-reported Migraine in at least half of menstruations were interviewed by a neurologist about headache and diagnosed according to the International Classification of Headache Disorders II (ICHD II). Additionally, the MM criteria were expanded to include other types of Migraine related to menstruation. Subsequently, all women were asked to complete three month prospective headache diaries.ResultsA total of 123 (52%) women completed both clinical interview and diaries. Thirty-eight women were excluded from the analyses: Two had incomplete diaries and 36 women recorded ≤1 menstruation, leaving 85 diaries eligible for analysis. Sensitivity, specificity, positive and negative predictive value and Kappa for the diagnosis of MM in clinical interview vs. headache diary wer...
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menstrual versus non menstrual attacks of Migraine without Aura in women with and without menstrual Migraine
Cephalalgia, 2015Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn Russell, Jūratė Saltytė BenthAbstract:ObjectiveThe objective of this article is to compare clinical characteristics of menstrual and non-menstrual attacks of Migraine without Aura (MO), prospectively recorded in a headache diary, by women with and without a diagnosis of menstrual Migraine without Aura (MM) according to the International Classification of Headache Disorders (ICHD).Material and methodsA total of 237 women from the general population with self-reported Migraine in ≥50% of their menstrual periods were interviewed and classified by a physician according to the criteria of the ICHD II. Subsequently, all participants were instructed to complete a prospective headache diary for at least three menstrual cycles. Clinical characteristics of menstrual and non-menstrual attacks of MO were compared by a regression model for repeated measurements.ResultsIn total, 123 (52%) women completed the diary. In the 56 women who were prospectively diagnosed with MM by diary, the menstrual MO-attacks were longer (on average 10.65 hours, 99% CI 3.17–18...
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ehmti 0188 contraceptive induced amenorrhoea leads to reduced Migraine frequency in women with menstrual Migraine
Journal of Headache and Pain, 2014Co-Authors: E A Macgregor, Kjersti Grotta Vetvik, Christofer Lundqvist, Michael Bjorn RussellAbstract:Menstrual Migraine without Aura (MM) is defined as attacks of Migraine without Aura (MO) occurring on day 1±2 of the menstrual cycle in at least 2/3 menstruations. Population-based studies shows that MM affects approximately 20% of female Migraineurs in their 30s. Many women in this age group need contraception.
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contraceptive induced amenorrhoea leads to reduced Migraine frequency in women with menstrual Migraine without Aura
Journal of Headache and Pain, 2014Co-Authors: Kjersti Grotta Vetvik, Anne E Macgregor, Christofer Lundqvist, Michael Bjorn RussellAbstract:Background: Menstrual Migraine without Aura (MM) affects approximately 20% of female Migraineurs in the general population. The aim of the present study was to investigate the influence of contraception on the attacks of Migraine without Aura (MO) in women with MM. Findings: 141 women from the general population with a history of MM according to the International Classification of Headache Disorders II (ICHD II) were interviewed by a headache specialist. Of 49 women with a history of MM currently using hormonal contraception, 23 reported amenorrhoea. Significantly more women with amenorrhoea reported no MO- days during the preceding month compared to women without amenorrhoea (OR 16.1; 95% confidence interval (CI) 1.8-140.4; P = 0.003). A reduction of MO-frequency was more often reported in women with than without amenorrhoea (OR 3.5; 95% CI 1.1-11.4; P = 0.04). Conclusion: Amenorrhoea leads to a reduction of MO-frequency in women with MM using hormonal contraceptives. Future prospective studies on MM should focus on contraceptive methods that achieve amenorrhoea.
Messoud Ashina - One of the best experts on this subject based on the ideXlab platform.
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Investigation of cortical thickness and volume during spontaneous attacks of Migraine without Aura: a 3-Tesla MRI study
'Springer Science and Business Media LLC', 2021Co-Authors: Faisal Mohammad Amin, Frauke Wolfram, Roberto De Icco, Mohammad Al-mahdi Al-karagholi, Jayachandra Raghava, Henrik B. W. Larsson, Messoud AshinaAbstract:Abstract Background Structural imaging has revealed changes in cortical thickness in Migraine patients compared to healthy controls is reported, but presence of dynamic cortical and subcortical changes during Migraine attack versus inter-ictal phase is unknown. The aim of the present study was to investigate possible changes in cortical thickness during spontaneous Migraine attacks. We hypothesized that pain-related cortical area would be affected during the attack compared to an inter-ictal phase. Methods Twenty-five patients with Migraine without Aura underwent three-dimensional T1-weighted imaging on a 3-Tesla MRI scanner during spontaneous and untreated Migraine attacks. Subsequently, 20 patients were scanned in the inter-ictal phase, while 5 patients did not show up for the inter-ictal scan. Four patients were excluded from the analysis because of bilateral Migraine pain and another one patient was excluded due to technical error in the imaging. Longitudinal image processing was done using FreeSurfer. Repeated measures ANOVA was used for statistical analysis and to control for multiple comparison the level of significance was set at p = 0.025. Results In a total of 15 patients, we found reduced cortical thickness of the precentral (p = 0.023), pericalcarine (p = 0.024), and temporal pole (p = 0.017) cortices during the attack compared to the inter-ictal phase. Cortical volume was reduced in prefrontal (p = 0.018) and pericalcarine (p = 0.017) cortices. Hippocampus volume was increased during attack (p = 0.007). We found no correlations between the pain side or any other clinical parameters and the reduced cortical size. Conclusion Spontaneous Migraine attacks are accompanied by transient reduced cortical thickness and volume in pain-related areas. The findings constitute a fingerprint of acute pain in Migraine patients, which can be used as a possible biomarker to predict antiMigraine treatment effect in future studies. Trial registration The study was registered at ClinicalTrials.gov ( NCT02202486 )
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altered thalamic connectivity during spontaneous attacks of Migraine without Aura a resting state fmri study
Cephalalgia, 2018Co-Authors: Faisal Mohammad Amin, Anders Hougaard, Stefano Magon, Till Sprenger, Frauke Wolfram, Egill Rostrup, Messoud AshinaAbstract:BackgroundFunctional connectivity of brain networks may be altered in Migraine without Aura patients. Functional magnetic resonance imaging (fMRI) studies have demonstrated changed activity in the thalamus, pons and cerebellum in Migraineurs. Here, we investigated the thalamic, pontine and cerebellar network connectivity during spontaneous Migraine attacks.MethodsSeventeen patients with episodic Migraine without Aura underwent resting-state fMRI scan during and outside of a spontaneous Migraine attack. Primary endpoint was a difference in functional connectivity between the attack and the headache-free days. Functional connectivity was assessed in four different networks using seed-based analysis. The chosen seeds were in the thalamus (MNI coordinates x,y,z: right, 22,–24,0 and left, –22,–28,6), pons (right, 8,–24,–32 and left, –8,–24,–32), cerebellum crus I (right, 46,–58,–30 and left, –46,–58,–30) and cerebellum lobule VI (right, 34,–42,–36 and left, –32,–42,–36).ResultsWe found increased functional con...
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part i pituitary adenylate cyclase activating polypeptide 38 induced Migraine like attacks in patients with and without familial aggregation of Migraine
Cephalalgia, 2017Co-Authors: Song Guo, Jes Olesen, Anne Luise Haulund Vollesen, Rikke Dyhr Hansen, Annlouise Esserlind, Faisal Mohammed Amin, Anne Francke Christensen, Messoud AshinaAbstract:Background Intravenous infusion of adenylate cyclase-activating polypeptide-38 (PACAP38) provokes Migraine-like attacks in 65-70% of Migraine sufferers. Whether aggregation of Migraine in first-degree relatives contributes to this discrepancy in PACAP38-induced response is unknown. We hypothesized that genetic enrichment plays a role in triggering of Migraine and that Migraine without Aura patients with a high family load ( ≥ 2 first-degree relatives with Migraine) would report more Migraine-like attacks after intravenous infusion of human PACAP38. Methods In this study, we allocated 32 previously genotyped Migraine without Aura patients to receive intravenous infusion of 10 pmol/kg/min PACAP38 and recorded Migraine-like attacks including headache characteristics and associated symptoms. Information of familial aggregation was obtained by telephone interview of first-degree relatives using a validated semi-structured questionnaire. Results PACAP38 infusion induced a Migraine-like attack in 75% (nine out of 12) of patients with high family load compared to 70% (14 out of 20) with low family load ( P = 0.761). In an explorative investigation, we found that the Migraine response after PACAP38 was not associated with the risk allele of rs2274316 ( MEF2D), which confers increased risk of Migraine without Aura and may regulate PACAP38 expression. Conclusion Migraine response to PACAP38 infusion in Migraine without Aura patients is not associated with high family load or the risk allele of rs2274316 ( MEF2D).
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magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous Migraine without Aura a cross sectional study
Lancet Neurology, 2013Co-Authors: Faisal Mohammad Ami, Mohammad Sohail Asgha, Anders Hougaard, Adam E Hanse, Vibeke Andree Larse, Patrick J H De Koning, Jes Olese, Henrik Larsso, Messoud AshinaAbstract:Summary Background Extracranial arterial dilatation has been hypothesised to be the cause of pain in patients who have Migraine without Aura. To test that hypothesis, we aimed to measure extracranial and intracranial arteries during attacks of Migraine without Aura. Methods In this cross-sectional study, we recruited patients aged 18–60 years from the Danish Headache Centre and via announcements on a Danish website. We did magnetic resonance angiography during spontaneous unilateral Migraine attacks. Primary endpoints were difference in circumference of extracranial and intracranial arterial segments comparing attack and attack-free days and the pain and the non-pain side. The extracranial arterial segments measured were the external carotid (ECA), the superficial temporal (STA), the middle meningeal (MMA), and the cervical part of the internal carotid (ICA cervical ) arteries. The intracranial arterial segments were the cavernous (ICA cavernous ) and cerebral (ICA cerebral ) parts of the internal carotid, the middle cerebral (MCA), and the basilar (BA) arteries. This study is registered at Clinicaltrials.gov, number NCT01471314. Findings Between Oct 12, 2010, and Feb 8, 2012, we recruited 78 patients, of whom 19 women had a scan during Migraine and were included in the final analysis. On Migraine compared with non-Migraine days, we detected no statistically significant dilatation of the extracranial arteries on the pain side (ECA, mean difference 1·2% [95% CI −5·7 to 8·2] p=0·985, STA 3·6% [–3·7 to 11·0] p=0·532, MMA 1·7% [–1·7 to 5·2] p=0·341, and ICA cervical 2·3% [–0·3 to 4·9] p=0·093); the intracranial arteries were more dilated during attacks (MCA, 13·0% [6·4 to 19·6] p=0·001, ICA cerebral 11·5% [5·6 to 17·3] p=0·0004, and ICA cavernous 11·4% [5·3 to 17·5] p=0·001), except for the BA (1·6% [–2·7 to 5·9] p=0·621). Compared with the non-pain side, during attacks we detected dilatation on the pain side of the intracranial arteries (MCA, mean difference 10·5% [0·7–20·3] p=0·044, ICA cerebral (14·4% [4·6–24·1] p=0·013), and ICA cavernous (9·1% [3·9–14·4] p=0·003) but not of the extracranial arteries (ECA, 2·1% [–3·8 to 9·2] p=0·238, STA, 3·6% [–3·7 to 10·8] p=0·525, MMA, 2·7% [–1·3 to 5·6] p=0·531, and ICA cervical , 5·0% [–0·5 to 10·4] p=0·119). Interpretation Migraine pain was not accompanied by extracranial arterial dilatation, and by only slight intracranial dilatation. Future Migraine research should focus on the peripheral and central pain pathways rather than simple arterial dilatation. Funding University of Copenhagen, the Lundbeck Foundation, the Research Foundation of the Capital Region of Denmark, Danish Council for Independent Research-Medical Sciences, and the Novo Nordisk Foundation.
José Geraldo Speciali - One of the best experts on this subject based on the ideXlab platform.
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Intravenous magnesium sulphate in the acute treatment of Migraine without Aura and Migraine with Aura. A randomized, double-blind, placebo-controlled study.
Cephalalgia : an international journal of headache, 2002Co-Authors: Marcelo E. Bigal, Carlos A Bordini, Stewart J Tepper, José Geraldo SpecialiAbstract:Magnesium sulphate has been used in the acute treatment of Migraines; some studies found it to be a highly effective medication in the acute control of Migraine pain and associated symptoms. This randomized, double-blind, placebo-controlled study assesses the effect of magnesium sulphate on the pain and associated symptoms in patients with Migraine without Aura and Migraine with Aura. Sixty patients in each group were assigned at random to receive magnesium sulphate, 1000 mg intravenously, or 0.9% physiological saline, 10 ml. We used seven parameters of analgesic evaluation and an analogue scale to assess nausea, photophobia and phonophobia. In the Migraine without Aura group there was no statistically significant difference in the patients who received magnesium sulphate vs. placebo in pain relief. The analgesic therapeutic gain was 17% and number needed to treat was 5.98 at 1 h. There was also no statistical difference in relief of nausea. We did observe a significant lower intensity of photophobia and phonophobia in patients who received magnesium sulphate. In the Migraine with Aura group patients receiving magnesium sulphate presented a statistically significant improvement of pain and of all associated symptoms compared with controls. The analgesic therapeutic gain was 36.7% at 1 h. A smaller number of patients continued to have Aura in the magnesium sulphate group compared with placebo 1 h after the administration of medication. Our data support the idea that magnesium sulphate can be used for the treatment of all symptoms in Migraine with Aura, or as an adjuvant therapy for associated symptoms in patients with Migraine without Aura.
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intravenous metamizol dipyrone in acute Migraine treatment and in episodic tension type headache a placebo controlled study
Cephalalgia, 2001Co-Authors: Marcelo E. Bigal, Carlos A Bordini, José Geraldo SpecialiAbstract:: Acute headache is a very frequent symptom, responsible for significant demand at primary care units and emergency rooms. In such sets in Brazil, metamizol is easily found but, on the other hand, neither ergotics nor triptans are available. The aim of this study is to compare intravenous metamizol with placebo in the acute treatment of Migraine with Aura, Migraine without Aura and episodic tension-type headache. Fifty-four Migraine with Aura patients, 95 Migraine without Aura patients and 30 tension-type headache patients were treated with metamizol. Ninety patients (30 Migraine with Aura, 30 Migraine without Aura and 30 tension-type headache patients) received placebo. Pain intensity, nausea, Aura, photo- and phonophobia were investigated at 30 min and 60 min after the administration of the drug. Significant improvement of pain after 30 min and 60 min post-dosage was achieved from metamizol groups compared with placebo groups. Significant improvement of all other symptoms was achieved after 60 min post-dosage. Side-effects were mild and with small incidence. Metamizol is an effective, safe and low price drug. It may be regarded as a good alternative drug for the treatment of common acute primary headaches.