Boes, CJ

William Gowers and William Osler first met in 1878, and Osler visited Gowers often when in London. Osler dedicated his book On Chorea and Choreiform Affections to Gowers in 1894, addressing himself as Gowers’ sincere friend. Two warm letters between Osler and Gowers exist in the Osler Library Archives, highlighting their strong friendship, and Gowers’ son Ernest wrote Osler a letter after the death of his father. Referring to the relationship between William Osler and William Gowers, he noted that Osler had indeed been a good friend to him all through. Osler wrote and edited the first edition of his textbook from 1890 through early 1892, and was influenced by Gowers’ Manual of Diseases of the Nervous System. In 1913, Osler commented that Gowers had ataxic paraplegia. Macdonald Critchley disagreed, and felt that Gowers had generalised cerebrovascular degeneration. Osler and Gowers were close friends, and this friendship was mutually beneficial.

Background and purposeTrochlear headaches are a recently recognized cause of headache, of which both primary and inflammatory subtypes are recognized. The clinical features, long‐term prognosis and optimal treatment strategy have not been well defined.MethodsA cohort of 25 patients with trochlear headache seen at the Mayo Clinic between 10 July 2007 and 28 June 2012 were identified.ResultsThe diagnosis of trochlear headache was not recognized by the referring neurologist or ophthalmologist in any case. Patients most often presented with a new daily from onset headache (n = 22, 88%). The most characteristic headache syndrome was reported as continuous, achy, periorbital pain associated with photophobia and aggravation by eye movement, especially reading. Individuals with a prior history of migraine were likely to have associated nausea and experience trochlear migraine. Amongst individuals with trochleitis, 5/12 (41.6%) had an identified secondary mechanism. Treatment responses were generally, but not invariably, favorable to dexamethasone/lidocaine injections near the trochlea. At a median follow‐up of 34 months (range 0–68), 10/25 (40%) of the cohort had experienced complete remission.ConclusionsTrochlear headaches are poorly recognized, have characteristic clinical features, and often require serial injections to optimize the treatment outcome. The identification of trochleitis should prompt neuroimaging to look for a secondary cause.

The aim of this study was to review the life of Mary E. O'Sullivan and to summarize her important contributions to the study of migraine. Mary E. O'Sullivan underwent extensive training to become a neurologist at a time when only 5% of women in America were physicians. She published five papers on migraine. In a 1936 Journal of the American Medical Association article, she described a patient with ergotamine overuse headache and recommended that daily doses of oral ergotamine should be avoided. Three years later she described migraine as a ‘complex’ syndrome with multiple causes and multiple cures. Mary E. O'Sullivan, an ambitious female headache specialist of the 1930s, was an early advocate of the use of ergotamine to treat migraine, yet she was one of the first to report ergotamine overuse headache. Although her life was short, her research, knowledge and ambition at a time when women had limited opportunities in medicine have left a mark.

Ipsilateral headache associated with hypoglossal nerve palsy is uncommon and is usually reported to be secondary to internal carotid artery dissection. Herein, we report three idiopathic cases of berign ipsilateral headache with hypoglossal nerve palsy.

The author set out to review the thought processes of Bayard Horton as he was clinicopathologically describing the first cases of temporal arteritis. The Mayo Clinic records of the original temporal arteritis patients were examined. Horton obtained the first biopsies of the temporal arteries in temporal arteritis and was the first to describe the histopathology. Horton initially thought his first two patients had actinomycosis of the temporal arteries, but later abandoned this diagnosis. He reported these two patients in 1932 as ‘an undescribed form of arteritis of the temporal vessels’. He was the first to describe jaw claudication. He saw a patient with blindness and symptoms suggestive of temporal arteritis before this complication was described in the literature, but initially felt the patient had some other disease. The sedimentation rate was elevated in his first patient. He cared for the first temporal arteritis patient ever treated with cortisone.

We set out to review early descriptions of chronic migraine and medication-overuse headache. The International Headache Society (IHS) recently gave criteria for chronic migraine and medication-overuse headache. Chronic migraine was absent from the 1988 IHS criteria. Peters and Horton described ergotamine-overuse headache in 1951. In the 1980s it was more fully appreciated that overuse of other acute headache medications could increase headache frequency. We reviewed published English-language papers and book chapters. Willis (1672), Oppenheim (1900), Collier (1922), Balyeat (1933), and von Storch (1937) all described chronic migraine. Lennox (1934), O'Sullivan (1936), Silfverskiöld (1947), Graham (1955), Friedman (1955), and Lippman (1955) wrote about ergotamine-overuse headache. Graham (1955), Friedman (1955), Lippman (1955), and Horton and Peters (1963) outlined withdrawal protocols. Chronic migraine has been mentioned in the literature for centuries, while medication-overuse headache has been written about for decades. Graham, Friedman, and Lippman deserve credit for separately reporting the first ergotamine withdrawal programmes.

We analysed the adverse events of placebo in acute and preventive randomized, double-blind, placebo-controlled studies for migraine treatment. Fifty-seven trials (oral triptans, non-steroidal anti-inflammatory drugs, nasal ergot alkaloids and preventive agents) were included. From 10 to 30% of subjects reported adverse events after placebo. Most common were features associated with a migraine attack, such as nausea, phono- and photophobia. Other frequent complaints resembled those of the active drug (e.g. chest pressure in triptan trials). A third group of adverse events appeared to be coincidental (e.g. sleep disturbance). Adverse events following placebo are probably related to the drug under study and the symptomatology of migraine; some have no obvious explanation.

Wilfred Harris was a London neurologist with a significant interest in the treatment of neuralgia. Harris' descriptions of what he called migrainous neuralgia were the first recorded of cluster headache in the English medical literature. He was probably one of the first to describe the cluster phenomenon itself and the effectiveness of ergotamine in treating acute attacks of cluster headache. His seminal contributions to the clinical and therapeutic spectrum of cluster headache are reviewed.