Joint Responses From Lipton et al and Cady et al

Lipton, Richard B.; Stewart, Walter F.; Cady, Roger; Hall, Charles B.; O’Quinn, Stephen; Kuhn, Timothy A.; Gutterman, Donna

doi:10.1046/j.1526-4610.2001.01175.x

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…In addition, there were no differences between the separate headache phenotypes when pressure pain threshold, glare, light induced pain ratings, and number of blinks were considered. This supports a common pathogenesis to migraine, TTH [57][58][59] and CWAH. Indeed, the shared clinical features of patients in our study (Table 1) and primary headache is in accordance with previous studies, 2,3,7-13 and reinforces the possibility that CWAH shares a common mechanism with primary headache.…”

Section: Discussionsupporting

confidence: 79%

The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study

Watson

Drummond

2016

Headache

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Objective To investigate signs of central sensitization in a cohort of patients with chronic whiplash associated headache (CWAH). Background Central sensitization is one of the mechanisms leading to chronicity of primary headache, and thus might contribute to CWAH. However, the pathophysiological mechanism of CWAH is poorly understood and whether it is simply an expression of the primary headache or has a distinct pathogenesis remains unclear. Thus, the factors involved in the genesis of CWAH require further investigation. Methods Twenty‐two patients with CWAH (20 females, 2 males; age 25–50 years, mean age 36.3 years) and 25 asymptomatic participants (13 females, 12 males; age 18–50 years, mean age 35.6 years) rated glare and light‐induced discomfort in response to light from an ophthalmoscope. Hyperalgesia evoked by a pressure algometer was assessed bilaterally on the forehead, temples, occipital base, and the middle phalanx of the third finger. The number, latency, area under the curve, and recovery cycle of nociceptive blink reflexes elicited by a supraorbital electrical stimulus were also recorded. Results Eight and 6 CWAH patients had migrainous and tension‐type headache (TTH) profiles, respectively; the remainder had features attributable to both migraine and TTH. Patients in the whiplash group reported significantly greater light‐induced pain than controls (8.48 ± .35 vs 6.66 ± .43 on a 0–10 scale; P = .001). The CWAH patients reported significantly lower pressure pain thresholds at all sites. For stimuli delivered at 20 second intervals, whiplash patients were more responsive than controls (4.8 ± .6 blinks vs 3.0 ± .6 blinks in a block of 10 stimuli; P = .036). While R2 latencies and the area under the curve for the 20 second interval trials were comparable in both groups, there was a significant reduction of the area under the curve from the first to the second of the 2‐second interval trials only in controls (99 ± 8% of baseline in whiplash patients vs 68 ± 7% in controls; P = .009). The recovery cycle was comparable for both groups. Conclusions Our results corroborate previous findings of mechanical hypersensitivity and photophobia in CWAH patients. The neurophysiological data provide further evidence for hyperexcitability in central nociceptive pathways, and endorse the hypothesis that CWAH may be driven by central sensitization.

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Section: Discussionsupporting

confidence: 79%

The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study

Watson

Drummond

2016

Headache

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“…Raskin and Appenzeller (13) stated that 'this lack of distinguishing features between migraine and tension headaches suggests the possibility that these disorders are at two ends of a continuum'. Spierings (14), Lipton et al (15) and Cady et al (16) discussed this in a recent series of letters. Until there is a specific test to distinguish migraine from TTH, these will be separated by their clinical features.…”

Section: Discussionmentioning

confidence: 97%

Frequent Migraine and Migraine Status Without Tension-Type Headaches: an Unusual Presentation of Rebound Headaches

2003

Cephalalgia

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Rebound headaches usually present as daily or almost daily, prolonged, generalized tension-type headaches with superimposed migraine-like attacks. The latter are more frequent, more intense, and longer than any episodic migraine that the patient might have experienced prior to the development of the chronic daily headaches. Rebound presenting as migraine without tension-type pain has been mentioned in a few previous articles on chronic daily headache, but there have been no previous articles stressing that frequent migraine might relate to the analgesics that are being used. These case histories are presented to illustrate that frequent migraine and migraine status without tension-type headaches may be manifestations of rebound and improve when the offending analgesic agents are stopped. If the clinician fails to recognize this unusual presentation of rebound headache, the patient might be placed on unnecessary and often ineffective medications for prophylaxis instead of stopping the offending pain relief medications.

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“…In what probably are the most widely cited studies of this type, Lipton et al found oral sumatriptan to be effective for the acute treatment of all intensities of headache suffered by migraineurs; further investigations have demonstrated that the "tensiontype headaches" suffered by migraineurs are just as likely to respond to acute treatment with oral sumatriptan as are their typical migraine attacks, whereas the tension-type headaches experienced by subjects with "pure" tension-type headache respond to treatment with oral sumatriptan at a rate not significantly different than that observed following administration of placebo. 9 These findings and the results from the studies involving prophylactic therapy that were discussed previously seem to indicate that for the migraineur who is a positive responder to whatever treatment is administered-acute or prophylacticthe positive response will extend to all types of headache he or she experiences.…”

mentioning

confidence: 85%

Let's Put “Mixed Headache” to Rest

Rothrock¹

2007

Headache

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Joint Responses From Lipton et al and Cady et al

Cited by 4 publications

References 9 publications

The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study

The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study

Frequent Migraine and Migraine Status Without Tension-Type Headaches: an Unusual Presentation of Rebound Headaches

Let's Put “Mixed Headache” to Rest

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