Purpose: To determine if relief from various pain conditions with sympathomimetic amines may be a direct effect on pain fibers or related to improvement of edema. Methods: A woman with severe migraine headaches resistant to standard therapy was treated with dextroamphetamine sulfate. Results: The headaches markedly improved shortly after treatment as did her vasomotor symptoms. However, in this case the inability to lose weight despite dieting related to edema did not improve. Conclusions: The improvement of pain and vasomotor symptoms in this disorder of the sympathetic nervous system does not seem to necessarily be related to edema causing pain. Sympathomimetic amines may have a direct effect on sympathetic nervous system fibers. Thus, a more appropriate term for this condition instead of idiopathic orthostatic cyclic edema would be sympathetic hyperalgesia-edema syndrome.;">