Bromocriptine‐induced trigeminal patient with a neuralgia attacks in a pituitary tumor

Ferrari, Michel D.; Haan, Joost; Seters, A. P. van

doi:10.1212/wnl.38.9.1482

Cited by 44 publications

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“…This evidence shows that a tumour mass is not correlated to the presence or intensity of the headache, thus, the cause of the headache lies in something other than the volume of the tumour. The same concept was also considered by other authors who described the presence of headache in patients with microprolactinoma [15,16]. Referring to the type of headaches related to prolactinomas, the articles published up to now have cited cases of trigeminal autonomic cephalalgias (TACs) [15], short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) [16,17] and migraine in only one case [17].…”

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confidence: 84%

High prolactin levels as a worsening factor for migraine

et al. 2006

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IntroductionMigraine is a very complex condition; in fact its physiopathology is not completely clear [1]. It is believed that many neurotransmitters are implicated in this process [2], and hormones have been shown to play a major role in women [3]. Among the neuroendocrinological alterations, disorders of the hypothalamic-hypophysial axis are believed to be implicated in the pathogenesis of primary J Headache Pain (2006) 7:83-89 DOI 10.1007 High prolactin levels as a worsening factor for migraine

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confidence: 84%

High prolactin levels as a worsening factor for migraine

et al. 2006

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“…Prolactinomas 16,19 Pituitary tumor (this case) Vasculitis 29 months to date. These facts suggest a causal re l a t i o nship between the adenoma and the headache in this patient.…”

Section: Leiomyosarcoma 14mentioning

confidence: 99%

SUNCT syndrome associated with pituitary tumor: case report

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Galvão

Teixeira

et al. 2006

Arq. Neuro-Psiquiatr.

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-For twelve years, the subject of this report, a 38-year-old man, presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. He presented a stabbing and intense daily pain located in the left pre-auricular and temporal regions. Each of these intense pain attacks lasted around one minute and presented a f requency of two to eight times per day. The pain was associated with ipsilateral lacrimation, conjunctival injection and rhinorrhea. MRI revealed a pituitary tumor with little suprasellar extent. The subject's serial assays of prolactin, GH, TSH and ACTH were within normal levels. Following transsphenoidal hypophysect o m y, with complete removal of the tumor, the subject no more presented pain. The pathological diagnosis was non-secreting adenoma. Fourteen months after the surgery, he remains symptom-free.KEY WORDS: SUNCT, pituitary tumor, surgery, ultra-shorting headaches.Síndrome SUNCT associada a tumor de hipófise: relato de caso RESUMO -O paciente relatado neste artigo apresentou uma condição clínica compatível com síndro m e SUNCT (cefaléia de curta duração, unilateral, neuralgiforme com hiperemia conjuntival e lacrimejamento). Ele referia dor diária, intensa, em facada, localizada na região pré-auricular e temporal esquerd a s . Cada ataque de dor permanecia por cerca de um minuto, com freqüência de duas a oito vezes por dia. A dor se acompanhava de lacrimejamento ipsolateral, congestão conjuntival e rinorréia. A RM mostrou um tumor de hipófise com pouca extensão suprasselar. Dosagens de prolactina, GH, TSH e ACTH estavam em níveis normais. Foi então submetido a hipofisectomia transesfenoidal com remoção completa do tumor após o que a dor cessou completamente. O diagnóstico anátomo-patológico foi adenoma não secre t o r. Quatorze meses após a cirurgia, o paciente permanecia livre de dor. PALAVRAS-CHAVE: SUNCT, tumor de hipófise, cirurgia, cefaléia de curta duração. s y n d rome is the poor response to pharm a c o l o g i c a l t re a t m e n t s 3 , 4 . There have been re p o rts of impro v ement upon the use of amitriptyline, carbamazepine, gabapentin, prednisone, topiramate 5 , lamotrigine 6 , nifedipine and sumatriptan 4 . Anesthetic blockades do not work very well, although there have been re p o rts of improvement following the local opioid blockade of the superior cervical ganglion 7 . There have also been re p o rts of surgical pro c e d u res that worked eff e c t i v e l y 5 while others re p o rts have indicated a lack of response to such procedures 8 .This syndrome has been listed in the second edition of The International Classification of Headache D i s o rders together with trigeminal autonomic cephaThe SUNCT syndrome (short-lasting unilateral neur a l g i f o rm headache attacks with conjunctival injection and tearing) is an uncommon headache characterized by moderate to severe pain. Usualy, the locations with the most severe pain are the ocular/periocular regions and the fronta...

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“…12 A variety of headache phenotypes have been associated with pituitary tumors. These include severe and intractable migraine, 13 trigeminal autonomic cephalgias, 14 such as cluster headache, 15,16 shortlasting, unilateral neuralgiform headache attacks with conjunctival injection and tearing, 17,18 and trigeminal neuralgia. 19 In such cases, conventional preventive and abortive headache treatment can often prove to be ineffective, yet medical treatment of the pituitary disease can completely resolve the symptoms.…”

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confidence: 99%