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Psychosomatic Medicine 15:337-348 (1953)
© 1953 American Psychosomatic Society

Electroencephalographic and Psychological Studies of a Case of Migraine with Severe Preheadache Phenomena

With Comments on Cerebral Vasospasm and Focal Hypertensive Encephalopathy

GEORGE L. ENGEL M.D.1, WALTER W. HAMBURGER M.D.1, MORTON REISER M.D.2, and JOHN PLUNKETT M.D.1

1 Departments of Psychiatry and Medicine, University of Rochester, School of Medicine and Dentistry, and Strong Memorial and Municipal Hospitals, Rochester, N. Y. (G. E. L. and W. W. H.); and the Department of Psychiatry, University of Cincinnati, College of Medicine, and Cincinnati General Hospital, Cincinnati, Ohio (M. R. and J. P.)
2 Departments of Psychiatry and Medicine, University of Rochester, School of Medicine and Dentistry, and Strong Memorial and Municipal Hospitals, Rochester, N. Y. (G. E. L. and W. W. H.); and the Department of Psychiatry, University of Cincinnati, College of Medicine, and Cincinnati General Hospital, Cincinnati, Ohio (M. R. and J. P.); Present address: Neuropsychiatry Division, Army Medical Service, Graduate School, Walter Reed Army Medical Center, Washington 12, D. C.

The clinical and electroencephalographic findings in a case of migraine with severe and repeated preheadache focal neurological phenomena are presented. Psychological data on the patient revealed many of the attacks to have occurred in a setting of unexpressed anger.

Evidence is presented to support the vasospatic nature of these attacks in migraine, and the relationship of the preheadache phenomena in migraine and the focal hypertensive encephalopathy is commented on. The case of the man who had first migraine and then focal and hypertensive encephalopathy is presented and the similarity in the psychological events preceding the attacks in both patients is noted.




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