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June 1982

Cyclical Migraine Headache

Author Affiliations

Department of Neurology The General Infirmary at Leeds Great George Street Leeds LS1 3EX England

Arch Neurol. 1982;39(6):386. doi:10.1001/archneur.1982.00510180064024

To the Editor.—  The contention of Drs Medina and Diamond (Archives 1981;38:343-344) that "cyclical migraine" can be distinguished from atypical cluster headache would be more convincing if they provided details of the duration of the headaches in each of their subjects rather than just the group mean. The figure of 25.5 hours is scarcely compatible with the statement that some of their subjects had seven attacks weekly. It would also be of interest to hear whether the response to lithium carbonate was better in subjects with the briefer headaches. The patient with cyclical attacks of unequivocal migraine in our series1 was having only one attack weekly, but his condition was worsened by lithium carbonate as much as were those of the other patients with migraine.