Migraine headache is the most common neurological complaint in adolescents 1 . It causes a significant number of missed school days 2 and is associated with several comorbidities, such as sleep disorders, anxiety and depression 3 .Sleep terrors (STs) are considered a parasomnia that are characterized by a sudden arousal from slow-wave sleep with a piercing scream or cry accompanied by autonomic and behavioral manifestations of intense fear 4 . The prevalence is approximately 3% in children and less than 1% in adults 4,5 .Typically, STs are observed in children between the ages of 4 and 12 years and, as in sleepwalking, tend to resolve spontaneously during adolescence 4 . On average, this disorder lasts 3.9 years, but it has a tendency to continue for a longer time period in children with a family history of STs 6 .The correlation between parasomnias and migraines has been described in previous studies, and a common pathophysiologic mechanism that involves the serotonergic system has been suggested 7-9 . ABSTRACTMigraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. Methods: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. Results: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs), 57 had chronic migraines (CMs) and 51 were control subjects (CG). Participants who had a history of STs had significantly more migraines than participants who did not. Conclusions: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.Key words: night terrors, migraine disorders, headache, adolescent, sleep disorders. Palavras-Chave: terrores noturnos, transtornos de enxaqueca, cefaleia, adolescentes, transtornos do sono. RESUMO

Systemic sclerosis (SSc) is a connective tissue disease manifest by fibrotic tissue changes, microvascular disease, and autoimmune abnormalities. The prevalence of different neurological manifestations in SSc has ranged from 0.8% 1 to 18.5% 2 according to the adopted criteria. Trigeminal sensory neuropathy (TSN) causes numbness in the mandibular or maxillary divisions of the nerve in about 2/3 of the cases, and in the distribution of all divisions in the remaining cases. The sensory abnormalities evolve slowly and usually spread contralaterally in an asymmetric pattern. The numbness may be accompanied by burning dysesthesia that is distinct from trigeminal neuralgia 3 . TSN is an infrequent complication of SSc. Although epidemiological studies are scarce, the prevalence of TSN associated with SSc in the largest series available was 4% 4 . A fairly diligent review of the literature revealed no previous report of TSN as a complication of SSc in Brazil. We present three cases of such association. CASES Case 1A 42-year-old male had presented progressive facial hypoesthesia and dysesthesia for the last three years and was diagnosed with the diffuse form of SSc two years ago. At his first neurological evaluation, he had sclerodermic fascies, sclerodactyly, Raynaud's phenomenon, bilateral facial and lingual hypoesthesia, left hemifacial dysesthesia, and an absent left corneal reflex. Nailfold capillaroscopy was performed and showed devascularization and ectasias. ANA was positive (1/640) and anti-RNP was also positive. Nerve conduction studies (NCS) revealed sensory myelinic polyneuropathy in all limbs and face. Blink reflex studies (BRS) demonstrated absent responses on both sides to left supraorbital nerve stimulation. Electromyography (EMG) was normal. He was on methotrexate and prednisone without improvement of the TSN. Gabapentin 800 mg daily and nortryptilin 100 mg daily were introduced with only a partial response at their maximum tolerable doses. Case 2A 47-year-old female had presented Raynaud' s phenomenon and arthritis in her hands for the last three years and was feeling progressive numbness in the inferior half of the face for the last two years, without any previous diagnosis. At her first neurological evaluation, she had sclerodermic fascies, sclerodactyly, hypoesthesia in the maxillary and mandibular divisions territory bilaterally. ANA was positive (1/80), an esophagogram showed an increased esophageal caliber and a thoracic tomography confirmed this finding and revealed signs of pulmonary fibrosis. All electrophysiological studies performed (NCS, BRS, EMG) were normal. She had never been on medication for TSN or SSc yet. Case 3A 50-year-old female had presented hypoesthesia only in the maxillary division of the right trigeminal nerve about three years before her first neurological evaluation. Six months later, she started presenting hypoesthesia in the mandibullary division, effort dyspnea, Raynaud' s phenomenon and myalgia. She was diagnosed with SSc in overlap with myositis 10 months before our firs...

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