A Practical Approach to Autonomic Dysfunction in Patients with Headache

Ailani, Jessica

doi:10.1007/s11910-016-0641-x

Cited by 5 publications

(2 citation statements)

References 34 publications

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“…Unilateral autonomic features might be elicited via central mechanisms such as hypothalamic activation or activation of the trigeminocervical complex leading to increased sensitivity of an otherwise normal local reflex arc 5. Hypothalamic involvement is also seen in trigeminal autonomic cephalalgias but the classification of these does not fit in with descriptions of recurrent painful ophthalmoplegic neuropathy.…”

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confidence: 99%

Recurrent painful ophthalmoplegic neuropathy

et al. 2017

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Recurrent painful ophthalmologic neuropathy (RPON), previously termed ophthalmoplegic migraine, is characterised by repeated attacks of one or more ocular cranial nerve palsies with ipsilateral headache. Its cause remains unclear; it is currently thought to be neuropathic in origin, but there is debate in the literature. In documented cases, a third cranial nerve palsy is by far the most common. Here we present a case of RPON involveing the fourth and sixth cranial nervesonly. Thorough investigation, including MR scan of brain and lumbar puncture, found no alternative explanation. This case adds to the debate over whether the cause of RPON is truly neuropathic or migrainous.

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confidence: 99%

Recurrent painful ophthalmoplegic neuropathy

et al. 2017

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“…Cranial autonomic symptoms in trigeminal autonomic cephalalgias are a result of the activation of parasympathetic trigeminal autonomic reflex (TAR), also known as trigeminal parasympathetic and trigeminal facial reflex (Ailani, 2016). The afferent limb of the reflex is identical to the sensory pathway described above up to the second order sensory neurons in the trigeminocervical complex.…”

Section: Pathophysiologymentioning

confidence: 99%

Trigeminal autonomic cephalalgias: a review

Modestowicz

Kozubski

2016

Aktualn Neurol

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Trigeminal autonomic cephalalgias are a group of primary headache disorders presenting as unilateral pain in the somatic distribution of the trigeminal nerve, associated with ipsilateral cranial autonomic symptoms. This clinicopathologic group includes cluster headache, paroxysmal hemicrania, hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features, which differ mainly as regards the duration and frequency of pain as well as response to treatment. These disorders are not as rare as they were thought to be and due to the severity of the pain can substantially affect the patients’ quality of life. Many other forms of primary headaches, such as migraine, trigeminal neuralgia and primary stabbing headache, as well as secondary headaches, particularly those caused by pituitary, posterior fossa, orbital, paranasal sinus and vascular pathology, need to be carefully considered in the diagnosis of trigeminal autonomic cephalalgias. Research in this field, particularly using functional neuroimaging, has resulted in a much better understanding of these disorders. Dysfunction in the nociceptive modulatory pathways in brain’s pain matrix is currently thought to produce a permissive state for the occurrence of a trigeminal autonomic cephalalgia attack, with posterior hypothalamus serving as a terminator rather than the generator of the attack. The current treatment strategies include medical and surgical approaches; of the latter, neuromodulation techniques, particularly deep brain stimulation of posterior hypothalamus, have proven to be particularly effective and promising.

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Botulinum Toxin Treatment of Migraine and Other Headaches

Schaefer

Jabbari

2017

Botulinum Toxin Treatment in Clinical Medicine

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A Practical Approach to Autonomic Dysfunction in Patients with Headache

Cited by 5 publications

References 34 publications

Recurrent painful ophthalmoplegic neuropathy

Recurrent painful ophthalmoplegic neuropathy

Trigeminal autonomic cephalalgias: a review

Botulinum Toxin Treatment of Migraine and Other Headaches

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