A report of three patients in whom the surgical closure of terminal branches of the external carotid arteries for treatment of migraine resulted in significantly reduced frequency of epileptic attacks.

Three patients under treatment for grand mal epilepsy, and who were also suffering from chronic migraine, underwent vascular surgery for their migraine. A serendipitous benefit from the successful vascular surgery for migraine was a significant reduction in the frequency of their grand mal seizures.

Intra-oral condylotomy for the treatment of temporomandibular joint derangement.

Open condylotomy using Moose's intra-oral approach was performed on 46 patients suffering from anterior disc displacement. The results show that condylotomy is useful in the treatment of this disorder, but the technique used is not recommended due to the risk of dislocation of the condylar fragment.

A subjective assessment of pain and swelling following the surgical removal of impacted third molar teeth using different surgical techniques.

Pain and swelling are two of the most common problems experienced by patients who have undergone surgical removal of impacted third molars. The purpose of this research project was to ascertain which of two surgical techniques was judged by patients to cause the least pain and swelling. The survey comprised 20 patients with bilaterally symmetrical impacted third molar teeth. In each patient, the third molars on one side were removed using a standard mucoperiosteal flap, while on the opposite side, a smaller access incision was used. The results of this survey show conclusively that when a small incision was used, with minimal reflection of the mucoperiosteum, the subjective evaluation of patients is that there is significantly less postoperative pain and swelling than when the larger standard incision is used.

Effects of amitriptyline and intra-oral device appliance on clinical and laser-evoked potentials features in chronic tension-type headache.

In the present study, we examined clinical and laser-evoked potentials (LEP) features in two groups of chronic tension-type headache (CTTH) patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline. Eighteen patients suffering from CTTH (IHS, 2004) participated in the study. We performed a basal evaluation of clinical features and LEPs in all patients (T0) vs. 12 age- and sex-matched controls; successively, patients were randomly assigned to a two-month treatment by amitriptyline or intra-oral device appliance. The later LEPs, especially the P2 component, were significantly increased in amplitude in the CTTH group. Both the intra-oral prosthesis and amitriptyline significantly reduced headache frequency. Total Tenderness Score was significantly reduced in the group treated by the prosthesis. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment. The results of this study may confirm that pericranial tenderness is primarily a phenomenon initiating a self-perpetuating circuit, favoured by central sensitisation at the level of the cortical nociceptive areas devoted to the attentive and emotive compounds of pain. Both the interventions at the peripheral and central levels may interrupt this reverberating circuit, improving the outcome of headache.