Presentation
(five male and two female) found in association with other pathologies published from 1980 up to the present. [ncbi.nlm.nih.gov]
Entire Body System
- Hunting
Orbital phlebography showed changes similar to those previously observed in patients with Tolosa-Hunt syndrome and cluster headache. Venous vasculitis thus seems to be associated with all three disorders and may be a factor of etiologic significance. [ncbi.nlm.nih.gov]
Gastrointestinal
- Epigastric Pain
Due to appearance of epigastric pains indomethacin treatment was replaced with lamotrigine which successfully resolved the symptoms. Full Text: PDF Refbacks There are currently no refbacks. [pjms.com.pk]
Ears
- Ear Fullness
The history, physical examination, imaging studies, and successful treatment plan in two patients with otalgia and ear fullness and a subsequent diagnosis of chronic paroxysmal hemicrania are summarized. [ncbi.nlm.nih.gov]
Eight patients (26%) apparently had “fullness in the ear”, one of whom had no other autonomic symptom. The specificity of this symptom has not been checked. The whole “ear fullness” argument in CPH leaves much to be desired. [functionalneurology.com]
One patient in Cittadini case series had not any classical autonomic features and reported only a sense of ear fullness during the attacks. [thejournalofheadacheandpain.springeropen.com]
Musculoskeletal
- Back Pain
She also suffered from chronic fatigue, back pain, arthralgia, vertigo, chronic constipation and spontaneous ecchymoses. [ncbi.nlm.nih.gov]
Psychiatrical
- Suggestibility
Furthermore, the data suggest that cluster headache and chronic paroxysmal hemicrania are distinct entities. [ncbi.nlm.nih.gov]
Face, Head & Neck
- Severe Unilateral Headaches
The patient was admitted because of frequent episodes of severe unilateral headaches during the day and nighttime as well as agitation. During the episodes, she complained of severe pains on the left orbital and supraorbital region. [ncbi.nlm.nih.gov]
A cluster headache (according to International Headache Society criteria {Cephalgia 2004;24 (Suppl 1)} ) has to satisfy the following criteria: 1) Severe unilateral headache in the orbital, supraorbital, or temporal region lasting 15 minutes to 3 hours [bellaireneurology.com]
Affected patients usually complain of moderate to severe unilateral headache that is almost constant but has fluctuations in severity. Spikes of severe pain may last up to 60 minutes. [consultant360.com]
Workup
Since CPH is rare, a workup to exclude secondary causes may be appropriate. These would include tumors, collagen vascular disease, cerebrovascular disease, and an aneurysm. [chicagoheadacheclinic.com]
Diagnostic criteria IHS diagnostic criteria for CPH include the following (see Presentation, Workup, Treatment, and Medication) [4, 5, 6] : At least 50 attacks fulfilling the criteria mentioned in the bullet points below Attacks of severe, unilateral [emedicine.medscape.com]
Treatment
Other effective therapeutic options are intravenous steroids for acute treatment and topiramate for prolonged treatment. [ncbi.nlm.nih.gov]
Prognosis
Prognosis Many patients experience complete to near-complete relief of symptoms following physician-supervised medical treatment. [ninds.nih.gov]
(See Prognosis.) Before the development of chronic symptoms, many patients (42%) pass through a nonchronic stage, with attacks separated by intervals of complete remission. [emedicine.medscape.com]
Statistics and Prognosis of Hemicrania Continua Hemicrania continua is a rare primary headache with female predominance. Natural history and age of onset of hemicrania continua are not clear. [doctorstrizhak.com]
Prognosis Many patients experience complete relief or near-complete relief of symptoms following medical treatment for paroxysmal hemicrania. [encyclopedia.com]
[…] the PREEMPT trials than those without MOH.8 These results were similar to a previous study of topiramate for CM prophylaxis that allowed MOH.9 Both studies largely excluded patients overusing opioids and barbituates, which usually have a more guarded prognosis [practicalneurology.com]
Etiology
Venous vasculitis thus seems to be associated with all three disorders and may be a factor of etiologic significance. [ncbi.nlm.nih.gov]
(See Etiology and DDx.) [emedicine.medscape.com]
However, even people fitting all criteria for paroxysmal hemicrania, including a complete response to indomethacin, can have a secondary etiology. Tests such as an MRI may be performed to rule out other causes for the headache. [americanmigrainefoundation.org]
Diagnosis of orofacial pain is a challenge for dentists and physicians', becoming even more complicated when patient's signs and symptoms are due to rare etiologies such PH. [ijdr.in]
Epidemiology
Aspects of PH including epidemiology, genetics, pathophysiology, clinical presentation, classification and variants, diagnosis, medical management, and dental considerations are discussed. [ncbi.nlm.nih.gov]
Lipton, M.D., is Professor and Vice Chair of Neurology, and Professor of Epidemiology and Population Health at the Albert Einstein College of Medicine in New York. [books.google.com]
Epidemiological profiles, and clinical features of patients fulfilling the criteria for PH (17 patients) are noted in Table 1. Patients with atypical features (with no cranial autonomic features or headache frequency 2. [thejournalofheadacheandpain.springeropen.com]
[…] first two months, and no symptoms or side-effects were recorded after a three-month followup. [9] Use of topiramate has also been found to be an effective treatment for CPH, but cluster headache medications have been found to have little effect. [6] Epidemiology [en.wikipedia.org]
Russell MB (2004) Epidemiology and genetics of cluster headache. Lancet Neurol 3:279–283 PubMed CrossRef Google Scholar 10. Torelli P, Cologno D, Cademartiri C, Manzoni GC (2001). [link.springer.com]
Pathophysiology
The possible pathophysiological significance of this concurrence of both types of indomethacin-responsive pain is discussed. [ncbi.nlm.nih.gov]
Prevention
Both patients quickly became pain-free after taking indomethacin and required its continued use to prevent headache recurrence. Chronic paroxysmal hemicrania may be manifested by otalgia with a sensation of external ear obstruction. [ncbi.nlm.nih.gov]
[…] to the headache: – conjunctival injection and/or lacrimation – nasal congestion and/or rhinorrhoea – eyelid oedema – forehead and facial sweating – miosis and/or ptosis a sense of restlessness or agitation Occurring with a frequency of >5 per day 1 Prevented [ichd-3.org]
A cochrane study has already shown there is no evidence that occlusal adjustments treat or prevents TMD. [9] Furthermore, dental occlusal adjustment might not be recommended for TMD or even primary headache management. [ijdr.in]