Presentation
CLINICAL PRESENTATION: Case 1: A 51-year-old woman presented with severe pain in the maxillary and mandibular left molars. [ncbi.nlm.nih.gov]
Clinical Presentation: Case 1: A 51-year-old woman presented with severe pain in the maxillary and mandibular left molars. [scholarlycommons.pacific.edu]
Gastrointestinal
- Hiccup
Neuromyelitis Optica (NMO) can have atypical presentations like hiccups, vomiting, etc. which is classically described as the area postrema syndrome. [ncbi.nlm.nih.gov]
Musculoskeletal
- Muscle Tenderness
The localization of PH in the temporal, maxillary and occasionally in the ear regions, along with a certain, ipsilateral masticatory muscle tenderness, can lead to its misdiagnosis as pain associated with temporomandibular disorder (TMD) [ 37 ]. [thejournalofheadacheandpain.springeropen.com]
Psychiatrical
- Distractibility
Thus, CH attacks frequently wake patients out of sleep. 3 Finally, the clinician should not be distracted by migrainous symptoms—photophobia can occur in 91% and phonophobia in 89% of CH attacks, and nausea occurs frequently in cluster as well. 4 All [neurology.org]
Workup
HC can also be accompanied by idiopathic stabbing headache, often called “jabs and jolts,” and is frequently associated with an ipsilateral foreign body sensation in the eye, like an eyelash or grit. 13,14 MRIs of the brain are mandatory during the workup [neurology.org]
Despite the existence of clear-cut diagnostic criteria (The International Classification of Headache Disorders, 2 nd edition - ICHD-II) and several therapeutic guidelines, errors in workup and treatment of these conditions are frequent in clinical practice [thejournalofheadacheandpain.springeropen.com]
Treatment
[…] occipital nerve stimulation for the treatment of hemicrania continua; and gabapentin, lamotrigine, topiramate, and lidocaine for the treatment of unilateral neuralgiform headache attacks. © 2015 American Academy of Neurology [journals.lww.com]
CONCLUSION: Supraorbital/supratrochlear nerve stimulation appears to be a promising modality for the treatment of patients with intractable TAC. © 2012 International Neuromodulation Society. [ncbi.nlm.nih.gov]
No known effective treatment for new daily persistent headache, but standard acute and prophylactic treatments for chronic migraine and chronic tension-type headache can be tried; rarely, patients may also respond to doxycycline [cram.com]
Incidence is rare when compared to other primary headache disorders but diagnosis (and, more importantly, treatment) can prove to be a challenge even when presented with a typical clinical presentation. [neurology.org]
Pharmacogenetic studies have suggested that the GNB3 825C > T polymorphism may modify treatment response to triptans among CH patients by altering the signal transduction cascade via G protein-coupled receptors. 16 Treatment of the TACs CH is the only [acnr.co.uk]
Etiology
Arterial vasodilation and perivascular inflammation leading to neurogenic inflammation are suggested as a common etiological feature of both migraines and the TACs. [headachejournal.org]
• Reversible cerebral vasoconstriction syndrome (RCVS) should be considered as possible underlying etiology before the diagnosis of primary headache associated with sexual activity. • Cluster headache may be also responsive to indomethacin. [medlink.com]
[…] headache, often called “jabs and jolts,” and is frequently associated with an ipsilateral foreign body sensation in the eye, like an eyelash or grit. 13,14 MRIs of the brain are mandatory during the workup, as secondary HC has been reported, often with etiologies [neurology.org]
CCFs can be classified by etiology (traumatic vs. spontaneous), velocity of blood flow (high vs. low flow), and anatomy (direct vs. dural). [8] Some fistulas Direct CCFs are characterized by a direct connection between the cavernous segment of the internal [mjdrdypu.org]
SUNCT syndrome responding absolutely to steroids in two cases with different etiologies. J Headache Pain. 2009;10(1):55–7. CrossRef Google Scholar 40. Domingos J, Pereira PJ, Roriz MJ, Xavier AJ, Magalhaes M, Monteiro PJ. [link.springer.com]
Epidemiology
Epidemiology of the TACs Although rare disorders, the TACs and CH specifically may have a genetic preponderance. [acnr.co.uk]
Vågå study of headache epidemiology. J Headache Pain, 2007;8:19-27 14. Prakash S, Golwala P (2012) A proposal for revision of hemicrania continua diagnostic criteria based on critical analysis of 62 patients. Cephalalgia32:860–868 15. [pulsetoday.co.uk]
CH comes in 2 epidemiologic forms. [neurology.org]
Vaga study of headache epidemiology. Cephalalgia 2003, 23 (7):528–533. PubMed View Article Google Scholar Alonso AA, Nixdorf DR: Case series of four different headache types presenting as tooth pain. J Endod 2006, 32 (11):1110–1113. [thejournalofheadacheandpain.springeropen.com]
Pathophysiology
The existence of secondary cases may lead to a better understanding of the pathophysiology of trigeminal autonomic cephalalgias. [ncbi.nlm.nih.gov]
Pathophysiology and classification. Rev Neurol (Paris) 2005;161:692. 3. Headache classification subcommittee of the International Headache Society. The International Classification of Headache Disorders: 2nd edition. [web.archive.org]
Prevention
Otherwise, prevention is added as soon as the patient notes the cluster period has begun. Prevention might not be needed if at the end of a cycle. The mainstay of preventive therapy is verapamil. [neurology.org]
METHOD: Hemicrania continua, a continuous, unilateral, side-locked headache, absolutely responsive to preventive treatment with indomethacin, is contrasted with so-called medication-overuse headache, in which the paradoxical situation exists of tremendous [ncbi.nlm.nih.gov]
Short-term preventive therapies are useful in CH and SUNCT, in order to allow a pain-free window for titration of preventive medications. [acnr.co.uk]
Some common headache treatments are: Pain-relieving medication Preventive medication Osteopathic manipulation Acupuncture Botox Q. What are some ways to prevent headaches? A. [mayoclinichealthsystem.org]
[…] dihydroergotamine and oxygen inhalation as acute therapy for cluster headache; prednisone, dexamethasone, methylprednisolone, and occipital nerve blocks as bridge therapy for cluster headache; and verapamil, lithium carbonate, topiramate, and sodium valproate as preventive [journals.lww.com]