The circadian periodicity of some endocrine (PRL, cortisol, GH) and vegetative (oral temperature, blood pressure) functions has been studied in cluster headache, common migraine, atypical facial pain, and "mixed" headache. Changes in several biological rhythms have been found not only in cluster headache (CH) but also in other kinds of headache. Although a great individual variability of rhythometric changes has been observed, particularly in CH, the dysrhythmic condition seems to be more evident in chronic than in episodic CH. The clinical and chronobiological effects of lithium administration and of a short-term sleep deprivation have been studied in CH.

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A case of Sheehan's syndrome with pancytopenia and bone marrow aplasia is presented. The diagnosis was made 6 years after an ante-partum haemorrhage. The presenting feature was an anaemia unresponsive to usual therapy. Hormonal therapy alone (cortisone and thyroid extract with triiodothyronin, oestrogen and progestogen given sequentially) produced full haematological recovery, which has continued for 2 years since the treatment was begun.

In order to study the possible relationships between melatonin secretion and pituitary-gonadal function, the circadian rhythm of plasma melatonin, the basal levels of estradiol-17beta and testosterone and the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) response to luteinizing hormone-releasing hormone (LH-RH) stimulation were evaluated in normally cycling healthy women and in two groups of women with menstrual dysfunctions related to eating disorders (19 patients with anorexia nervosa and 16 with primary obesity). The circadian rhythm of plasma melatonin reached statistical significance in anorectic patients but not in obese patients. The mean 24 h melatonin level was significantly higher in anorectic than in obese patients and in control subjects. However, both groups of patients shared some abnormalities of melatonin circadian pattern, such as increased ratio between day and night melatonin levels, abnormal secretory peaks during the light hours and great interindividual variability for timing, amplitude, and duration of melatonin nocturnal peak. A selective impairment of LH secretion was observed in both anorectic and obese patients. By considering together the two groups of patients and controls, a linear inverse correlation between the circadian mesor of plasma melatonin and the basal and LH-RH stimulated LH levels was found. The persistence of a certain melatonin secretion during the light hours in both anorectic and obese patients could play an inhibitory role on the pituitary gonadal function in these subjects.

Tolosa Hunt syndrome (THS) is a painful ophthalmoplegia due to a nonspecific inflammatory process in the cavernous sinus or to parasellar neoplasms. Although the cause of the disease is unknown, previous observations support the hypothesis that THS may be only one manifestation of a generalized vasculitis. The diagnosis is based on findings of painful ophthalmoplegia, excellent response to corticosteroids, and exclusion of other causes including aneurysm, diabetes mellitus, paranasal mucocele, and carotid cavernous fistula. We report the case of a 24-year-old woman with THS who had undergone thyroidectomy 4 years before admission for goiter with histologic diagnosis of Hashimoto's thyroiditis. This case shows the unusual association between Hashimoto's thyroiditis and THS and supports the autoimmune origin of both diseases.