Klasehodepine

Alstadhaug, Karl Bjørnar; Ofte, Hilde Karen

doi:10.4045/tidsskr.14.0824

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…The positive response to deep brain stimulation targeting the hypothalamus, the chronobiology of TAC like cluster headache, or the decrease of hormones like orexin during attacks supports a key role of the hypothalamus in TAC pathophysiology [ 17 ]. The cranial autonomic features of TACs are believed to be due to parasympathetic activation (lacrimation, rhinorrhea, conjunctival injection, and flushing) and sympathetic failure (ptosis, miosis) [ 18 ]. The latter is thought to arise from carotid artery wall swelling compressing sympathetic fibers projecting to the orbit [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pain in TACs is mainly mediated through activation of the ophthalmic branch of the trigeminal nerve and release of the signaling molecule calcitonin gene–related peptide (CGRP) [ 15 , 18 , 21 ]. CGRP was shown to cause efficient dilation of the internal carotid artery [ 22 ], which could be a possible link to a distension induced sympathetic vasomotor and sudomotor neuron dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Harlequin syndrome in a patient with probable hemicrania continua and exertional headache – is there a link? a case report

Miedl,

Baumgartner,

Disse

et al. 2024

BMC Neurol

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Background The harlequin syndrome is a rare disorder of the autonomic nervous system characterized by unilateral diminished flushing and sweating of the face following exposure to heat or physical activity. It results from sympathetic dysfunction and most commonly occurs idiopathically. A secondary development due to an underlying pathology (e.g., carotid artery dissection, tumors) must be excluded at first appearance. There is evidence that the cranial autonomic system is involved in the pathophysiology of trigeminal autonomic headaches like hemicrania continua. Therefore, an overlap in the pathophysiology of harlequin syndrome and trigeminal autonomic headache disorders seems plausible. However, the association of a harlequin syndrome with hemicrania continua was never reported. Case presentation This work describes the case of a 42‐year‐old female patient presenting to our headache unit. The patient reported persisting unilateral headache of the right side of dragging or squeezing character accompanied by trigeminal autonomic symptoms, including lacrimation, nasal congestion, conjunctival injection and Horner’s syndrome, and was responsive to treatment with 75mg/d indomethacin. Five months after the initial consultation, the patient noted that the upper right quadrant of her face was pale after jogging. A harlequin syndrome was diagnosed. Further, she developed a short-lasting, bilateral headache of pulsatile character during strenuous exercise consistent with exertional headache. Comprehensive diagnostic evaluations, encompassing cranial and cervical MRI scans, laboratory tests, and biopsies, culminated in the diagnosis of Sjögren’s syndrome. This finding suggests that the trigemino-autonomic dysfunction may either be idiopathic or a direct manifestation of Sjögren’s syndrome. Conclusions This report documents the case of a rare combination of a headache resembling probable hemicrania continua and the harlequin syndrome (and even exertional headache). It illustrates the underlying anatomy of the autonomic nervous system in a clinical context and emphasizes the hypothesis of a pathophysiological link between abnormal sympathetic activity and trigeminal autonomic headaches.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Harlequin syndrome in a patient with probable hemicrania continua and exertional headache – is there a link? a case report

Miedl,

Baumgartner,

Disse

et al. 2024

BMC Neurol

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“…It is assumed that activation of the postganglionic parasympathetic fibres occurs during the pain phase of cluster headache. 15 These fibres emerge from the sphenopalatine ganglion and supply the lacrimal gland, meningeal sheaths and cranial blood vessels. It has been proposed that stretching of the sympathetic plexus in the internal carotid sheath as a result of parasympathetic vasodilatation would lead to failure of the oculosympathetic pathway and hence induce Horner syndrome.…”

Section: Discussionmentioning

confidence: 99%

Carotid dissection presenting as a prolonged cluster-like headache in a patient with episodic cluster headache

Elhfnawy¹,

Solymosi

Sommer

2017

BMJ Case Reports

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We present a patient with known episodic cluster headache, who presented with cluster-like headache in the course of internal carotid artery dissection (ICAD) and discuss possible pathophysiological links between the two diseases. It is well known that cluster-like headache could be the presenting symptom of ICAD. However, ICAD occurring in a patient with a known episodic cluster headache was only once previously described. In the end of the manuscript, we propose red flags to help clinicians differentiate between primary cluster headache and cluster-like attacks masking underlying ICAD. Finally, we raise the question whether at least some proportion of those patients with cluster headache and Horner syndrome previously classified as a primary headache disorder might have been secondary cases to ICAD.

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“…Odd Kvamme har et tankevekkende innlegg om Praksiskonsulentordningen (PKO) i Tidsskriftet nr. 16/2015 (1). Tankevekkende fordi jeg som sykehuslege i de 20 årene ordningen har eksistert, aldri har sett en praksiskonsulent medvirke i sykehushverdagen.…”

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Re: Praksiskonsulentordningen ved et veiskille

Steen¹

2015

Tidsskriftet

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Klasehodepine

Cited by 8 publications

References 21 publications

Harlequin syndrome in a patient with probable hemicrania continua and exertional headache – is there a link? a case report

Harlequin syndrome in a patient with probable hemicrania continua and exertional headache – is there a link? a case report

Carotid dissection presenting as a prolonged cluster-like headache in a patient with episodic cluster headache

Re: Praksiskonsulentordningen ved et veiskille

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