CERVICOGENIC HEADACHE - RESPONSES TO NITROGLYCERIN, OXYGEN, ERGOTAMINE AND MORPHINE

The responses in cervicogenic headache to four different agents have b een studied. Nitroglycerin was given sublingually to 27 patients. Eigh teen patients got more than 20% increase of their headache. Of those w ith any headache increase at all, 12 got bilateral and 12 unilateral p ain. The typical late cluster headache response to nitroglycerin was n ot seen in cervicogenic headache. The provocative effect of nitroglyce rin seemed less marked in cervicogenic than in cluster headache. Oxyge n inhalation, a frequently used treatment for cluster headache, was gi ven to 14 patients with cervicogenic headache. In general, the effect seemed uncertain and probably clearly inferior to the effect in cluste r headache. Ergotamine treatment (given to 13 patients) also seemed to be of little avail in cervicogenic headache. Morphine injections give n to 11 cervicogenic headache patients resulted in ''marked'' improvem ent in 4, but complete pain freedom was only seen in 2 cases. In our o pinion, the present results add further evidence to the view that diff erent etiologic and pathogenetic factors underlie cervicogenic headach e and cluster headache.