THE NATURE OF MIGRAINE
It was, therefore, also with some hesitation that I accepted the invitation, humbly realizing that I can bring my audience nothing new, and when now, I nevertheless venture to try to speak about the nature of migraine seen from my point of view after a long life of work with migraineological problems, I do it to a very limited extent only on the basis of my own experience, but first and foremost because I base my opinion on the facts with which friends and colleagues have enriched our knowledge through their research, not only through numerous literary publications and lectures, but also and not least through the answers to personal inquiries which I have received with thanks in the course of time.
Femoxetine ‐ a new 5‐HT uptake inhibitor ‐ and propranolol in the prophylactic treatment of migraine
ABSTRACT The prophylactic effect of a 5‐HT uptake inhibitor, femoxetine, was compared with that of propranolol in a double‐blind crossover study of 6‐months duration. 29 patients commenced the experiment. 3 subjects withdrew because of side effects and 2 because the program was inconvenient for them. In the 24 patients who continued the study to the end, the periods of propranolol (administered 160 mg daily) and of femoxetine (given 400 mg daily) differed significantly from each other with respect to the attack frequency and headache index. A significant reduction in the use of medication relieving attacks was observed during the propranolol treatment as compared with the pre‐treatment period. The study showed that partial depletion of thrombocyte 5‐HT by a 5‐HT uptake inhibitor did not lead to a marked improvement in headache, contrary to what might be expected on the grounds of the 5‐HT hypothesis of migraine.
BILATERAL TEMPORAL ARTERITIS WITH COMPLETE LOSS OF VISION
Since the original paper of Horton, Magath and Brown1many cases of temporal arteritis have been reported, and this syndrome is now recognized as a definite clinical entity. Temporal arteritis is a self-limited, nonfatal disease characterized by headaches more or less constant and frequently worse at night, general malaise, lassitude, weakness, night sweats and low grade fever, and frequently there is pain in the jaws which makes chewing difficult. The temperature ranges from 98 to 103 F., and the blood may show a mild leukocytosis and an anemia. Mental symptoms are not common, but in a case reported by Sprague2there was definite dulling of the intellect. Most of these patients have rather severe constitutional symptoms and appear much sicker than the objective signs would indicate. In the typical case, a few weeks after the onset of the headache, the temporal arteries become tortuous, enlarged and