Chronic Paroxysmal Hemicranial: Mechanical Precipitation of Attacks

Sjaastad, Ottar; Egge, K.; Hørven, Ivar; Kayed, K; Lund-Roland, L; Russell, David; Conradi, I Sløordahl

doi:10.1111/j.1526-4610.1979.hed1901031.x

Cited by 65 publications

(54 citation statements)

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“…Both are indomethacin-responsive, in an absolute way [39]. In a particular subgroup of CPH, attacks can be precipitated mechanically [40]. A possible case in this category has been reported herein.…”

Section: Cph: a Comment On Its Diagnosismentioning

confidence: 99%

The rare, unilateral headaches. Vågå study of headache epidemiology

Sjaastad

Bakketeig

2007

J Headache Pain

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In the Vågå study of headache epidemiology, 1838 parishioners in the age group 18–65 years were included (88.6% of the relevant population). Each individual was questioned in a face-to-face situation. In this population, a search of rare unilateral headaches was also made, in spite of their presumed rarity. Trigeminal neuralgia was present in two cases. Two individuals with SUNCT traits were observed. Hemicrania continua may have been present in one individual. Also observed were: optic neuritis ( n =1), herpes zoster ( n =4); a case of unilateral headache upon neck rotation (chronic paroxysmal hemicrania variant? or "forme fruste" of the neck–tongue syndrome?); masseter muscle spasm ( n =1); temporo-mandibular joint dislocation ( n =1); and possible carotidynia ( n =3). A particularly intriguing form of headache was a unilateral, neuralgiform (?) pain, associated with ipsilateral, regular jabs and allodynia, a combination observed in eight females. A couple of conditions that entirely defy rubrication are also reported.

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Section: Cph: a Comment On Its Diagnosismentioning

confidence: 99%

The rare, unilateral headaches. Vågå study of headache epidemiology

Sjaastad

Bakketeig

2007

J Headache Pain

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“…In cluster headache and CPH too, the phlebographic changes were partly bilateral, but, if unilateral, they were usually on the symptomatic side. It should be emphasized that a further common pathologic feature in CPH and the Tolosa-Hunt syndrome is the presence of arterial stationary wave-like phenomena in the internal carotid artery (24,25).…”

Section: Orbital Venous Vasculitis and Cluster Headachementioning

confidence: 99%

Cluster Headache: The Possible Significance of Midline Structures

Sjaastad¹

1988

Cephalalgia

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The pathogenesis of cluster headache is unknown (see, for example, Ref. 1). With regard to the main component of cluster headache, the pain itself, little information exists both as to the origin and as to the nature of the pain. Existing theories concerning cluster headache pathogenesis have been rather unproductive. In the following, evidence from seemingly totally unrelated fields that, nevertheless, possibly has a bearing on cluster headache pathogenesis will be reviewed. On the tendency to bilaterality in cluster headacheCluster headache is in principle a unilateral headache. There is, however, a tendency for the headache to shift side, either during one single bout (circa 5%) or from one bout to another (circa 10%). All in all, approximately 15% of cluster headache cases thus shift side at some point along the time axis (2). Accordingly, there seems to be a "disposition" or "anlage" for the headache to develop on both sides in cluster headache, although the headache actually most frequently manifests itself on one side only.The prevalence of cluster headache in the form that is severe enough to lead to medical consultations may seem to be around 0.7% (3) in Western countries. The tendency to develop headache on the side opposite the pain side in a cluster headache patient may, therefore, seem to be around 200 times higher than for an individual to develop this type of headache de novo (4). Side shift is thus a conspicuous feature of this disease.On rare occasions, the headache may even be bilateral (5). Several variations of bilaterality have also been observed. Ekbom (6) has thus described a case with a most peculiar pattern, in which the headache during one bout, in addition to appearing on the original side, started appearing on the contralateral side; then "the headache shifted [side] in different attacks"; thereafter, a decrescendo occurred on the original side as opposed to a crescendo on the contralateral side, and, in the ultimate phase, attacks only appeared on the contralateral side.After operations on one side, pain attacks have a tendency to recur on the opposite, previously pain-free side. This was thus the case in 1 of 12 cases treated with the "combined procedure"-that is, sectioning of the greater superficial petrosal nerve and neurolysis of the sensory root of the trigeminal nerve (7).The attack of cluster headache as such consists of (at least) two components: the pain and the autonomic phenomena. The latter also show a tendency to bilaterality (8, 9) and, in fact, much more regularly so than does the pain. In patients with side shift there is sometimes a dichotomy between pain and autonomic phenomena, the latter persisting on the previous pain side (4). The schism may even be primary; that is, the pain has always been contralateral to the autonomic phenomena (10).This tendency to bilaterality in cluster headache is intriguing. A pathogenetic model of cluster headache must also include and explain the marked tendency to bilaterality of the pain and, above all, of the autonomic manifestati...

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“…Esses novos pacientes apresentavam cefaléia com as características acima descritas, exceto que a dor era contínua 3 . Além disso, observava-se uma tendência a uma dor mais tolerável, menos fenômenos autonômicos acompanhando a dor e ausência de mecanismos precipitantes da dor, como pode acontecer com a HPC 4 . Essa nova entidade foi denominada Hemicrania Contínua (HC) e até o período da última revisão de literatura (1991) 5 18 casos haviam sido identificados no mundo, inclusive sendo um caso no Brasil 6 .…”

Section: Introductionunclassified

Hemicrania Continua

Fragoso¹,

Machado²

1999

J Pediatr (Rio J)

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Médico, PHD. 2. Doutorando. Faculdade de Ciências Médicas de Santos. ResumoObjetivo: relatar um caso de Hemicrania Contínua em uma jovem de 17 anos que apresentava esse tipo de cefaléia há 9 anos, sem diagnóstico. Embora essa seja uma cefaléia primária relativamente rara, a imediata resposta ao tratamento com indometacina justifica que seja uma entidade melhor conhecida.Métodos: relato do caso de uma adolescente que apresentava Hemicrania Continua há anos, sem diagnóstico e sem tratamento específico. Revisão da literatura médica a respeito, através de Medline.Resultados: o tratamento clínico com baixas doses de indometacina determinou o desaparecimento completo da cefaléia.Conclusão: a Hemicrania Contínua deve ser considerada entre as hipóteses diagnósticas de pacientes que apresentam cefaléia contínua, hemicrania, sem alterações ao exame clínico, neurológi-co e exames subsidiários, independentemente da idade de aparecimento. Este é o caso da paciente mais jovem com Hemicrania Contínua e foi trazido para discussão por um acadêmico de medicina, alertado para essa possibilidade diagnóstica. AbstractObjective: to report a case of Hemicrania Continua in a female aged 17, who presented this kind of headache for 9 years without diagnosis. Although this may be a relatively rare primary headache, the immediate response to clinical treatment with indomethacin justifies this entity be better known.Methods: case report of a female adolescent who had presented Hemicrania Continua for many years, without diagnosis and adequate treatment. Review of the relevant medical literature by means of Medline.Results: treatment with low doses of indomethacin caused complete cessation of the headache.Conclusion: Hemicrania Continua must be considered as a diagnostic possibility for patients who present continuous unilateral headache, without abnormalities in the clinical, neurologic and laboratorial examination, irrespective of the age the headache starts. This is the youngest patient reported to have Hemicrania continua and it was brought to discussion by a medical student, aware of this possible diagnosis. IntroduçãoEm 1974, Sjaastad and Dale descreveram uma forma de cefaléia que era completamente abolida com o uso de Indometacina 1 . Esta cefaléia foi denominada Hemicrania Paroxística Crônica (HPC) e, desde então, centenas de casos foram identificados no mundo 2 . Trata-se de uma forma de cefaléia estritamente unilateral, com surtos de dor de duração relativamente curta (em geral 1 a 20 minutos por crise), ocorrendo diversas vezes ao dia (geralmente 5 a 20 crises ao dia), predominante em mulheres jovens, podendo se iniciar dos 11 aos 60 anos de idade. As crises de dor são em geral intensas, em aperto, predominando na porção anterior do lado afetado. Podem se associar fenômenos autônomicos tais como lacrimejamento, congestão nasal e congestão conjuntival ipsilaterais à dor. Exames clínico, neurológico, laboratoriais e de imagem eram normais e todos os pacientes obtinham efeito imediato e completo com o uso de indometacina na dose de...

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Chronic Paroxysmal Hemicranial: Mechanical Precipitation of Attacks

Cited by 65 publications

References 1 publication

The rare, unilateral headaches. Vågå study of headache epidemiology

The rare, unilateral headaches. Vågå study of headache epidemiology

Cluster Headache: The Possible Significance of Midline Structures

Hemicrania Continua

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