Dental presentations of cluster headaches

Gross, Sheldon G.

doi:10.1007/s11916-006-0023-1

Cited by 20 publications

(15 citation statements)

References 10 publications

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“…In the present study, the most common location was the region of the premolars and the periocular zone, in coincidence with the findings of most authors (15,19). This in turn led to dental extractions in 40% of the cases, in an attempt to resolve the pain, and extractions were even carried out in 37.8% of the cases after cluster headache had been diagnosed.…”

Section: Discussionsupporting

confidence: 92%

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Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: A preliminary study of 23 patients

Boronat¹,

Peñarrocha‐Oltra²,

Ata-Ali³

et al. 2012

Med Oral

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Objective: A study is made of the clinical course of patients with episodic cluster headache following the injection of corticosteroids in the proximity of the sphenopalatine ganglion of the affected side. Study Design: A retrospective observation study was made corresponding to the period between 2006 and 2010. Patients with episodic cluster headache received corticosteroid infiltrations in the vicinity of the sphenopalatine ganglion. Data were collected to assess the clinical course, quantifying pain intensity and quality of life. A total of 23 patients (11 women and 12 men) with a mean age of 50.4 years (range 25-65) were included. Forty percent of the patients had undergone dental extractions in the quadrant affected by the pain, before the development of episodic cluster headache, and 37.8% underwent extractions in the same quadrant after appearance of the headache. Results: Most of the patients suffered 1-3 attacks a day, with a duration of pain of between 31-90 minutes. The mean pain intensity score during the attacks at the time of the first visit was 8.8 (range 6-10), versus 5.4 (range 3-9) one week after the first corticosteroid injection. On the first visit, 86.9% of the patients reported unbearable pain, versus 21.7% after one week, and a single patient after one month. Conclusions: The evolution of episodic cluster headache is unpredictable and variable, though corticosteroid administration clearly reduces the attacks and their duration. Key words:Episodic cluster headache, vascular pain, sphenopalatine ganglion, corticosteroid infiltration.

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Section: Discussionsupporting

confidence: 92%

“…Many patients with cluster headache are wrongly diagnosed with symptomatic headache due to dental disease – this often leading to unnecessary and ineffective dental treatments (15). Bahra and Goadsby (16) found that 230 out of 511 patients had been examined by a dentist before being diagnosed with cluster headache.…”

Section: Discussionmentioning

confidence: 99%

Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: A preliminary study of 23 patients

Boronat¹,

Peñarrocha‐Oltra²,

Ata-Ali³

et al. 2012

Med Oral

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“…This increases the likelihood that latent medical problems will be diagnosed during evaluation and testing, a phenomenon known as “Berkson’s bias” [7]. CH patients are frequently diagnosed with sinus or dental problems, and many experience substantial delay in receiving a diagnosis [8–10]. These things may in part explain the high frequency of medical visits in this population.…”

Section: Discussionmentioning

confidence: 99%

The comorbidity burden of patients with cluster headache: a population-based study

2017

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BackgroundEvidence is limited regarding the comorbidity burden of patients with cluster headache (CH). We aimed to characterize comorbid conditions in a cohort of CH patients diagnosed by headache experts, using electronic health record information from the Partners Research Patient Data Registry (RPDR).MethodsWe identified and reviewed the charts of unique patients diagnosed by headache specialists over an 11-year period, and a set of matched controls. Patients were categorized as having Definite, Unconfirmed or no CH. We calculated the prevalence of and tested for statistically significant differences of selected comorbid conditions in these populations.ResultsAn RPDR query identified 170 patients with a free text or ICD diagnosis of cluster headache. 15 records belonging to Partners employees were excluded. 75 patients met diagnostic criteria for CH (Definite CH). 22 had headaches with some features of CH but the diagnosis was uncertain (Unconfirmed CH). In 58 the diagnosis was determined to be inaccurate due to data entry errors. Patients with Definite CH had an average age of 43.4 years; 80% were male. The average time from CH onset to diagnosis was 12.7 years (range 1–51). The average number of yearly emergency department and outpatient visits for the group of Definite CH patients was 4.5 and 25.4, respectively, compared with 1.1 and 6.9 in controls. Of the 55 examined conditions, four were statistically significantly less common in patients with definite CH compared with controls (diabetes, musculoskeletal/orthopaedic problems, “other gastrointestinal diagnoses” and skin conditions) and four were statistically significantly more common (smoking, depression, dental disorders and deviated septum).ConclusionsIn this large population-based study, we identified a surprisingly small number of patients who met strict diagnostic criteria for CH. In these patients, however, we identified a distinct pattern of selected comorbidities. The pattern is somewhat but not entirely consistent with that of the “classic” CH patient depicted in the medical literature. CH patients are frequently diagnosed with sinus or dental problems. Many experience substantial delay in receiving a diagnosis. These things may in part explain the high frequency of medical visits in this population. It is difficult to distinguish conditions that are genuinely comorbid with CH from those that reflect misdiagnoses or medical scrutiny of patients in frequent contact with the healthcare system.

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“…According to the dermatome on the face, pain from the mandibular molars is typically referred to the maxillary molars. It is therefore not surprising that orbital pain may refer to maxillary or mandibular areas, and so to the teeth in those areas (7). In this particular case, the pain appeared to radiate to the maxillary tooth on the ipsilateral side.…”

Section: Discussionmentioning

confidence: 76%

Cluster headache following dental treatment: a case report

Shoji

2011

J Oral Sci

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Dental presentations of cluster headaches

Cited by 20 publications

References 10 publications

Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: A preliminary study of 23 patients

Clinical course of patients with episodic cluster headache treated with corticosteroids inproximity to the sphenopalatine ganglion: A preliminary study of 23 patients

The comorbidity burden of patients with cluster headache: a population-based study

Cluster headache following dental treatment: a case report

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