Migraine-tic Syndrome: A Case Report of a New Headache Type

Migraine Accompanied by Hemifacial Spasm: A Case Report

“…Kobata et al describe the co‐occurrence of HFS with trigeminal neuralgia and/or glossopharyngeal neuralgia and refer to this as combined hyperactive dysfunction syndrome of the cranial nerves 6 . Citing Dandy, they postulate that aging, hypertension, and arteriosclerosis lead to dilatation, elongation, and tortuosity of vertebrobasilar arteries, which may compress the root entry zone of cranial nerves and result in “hyperactive dysfunction.” Levin and Ward describe a woman with consistently recurring episodes of trigeminal neuralgia and migraine and postulate that involvement of the trigeminal nerve in both entities supports a shared mechanism 7 …”

“…Trigeminal neuralgia (but not HFS) has also been described to occur concurrently in patients with coexisting paroxysmal hemicrania (paroxysmal hemicrania‐tic syndrome) 8 and cluster headache (cluster‐tic) 9 . Boes and colleagues, speculating on the possible relationship between paroxysmal hemicrania (PH) and tic, suggest that the brain abnormality (eg, impaired inhibitory mechanisms) that causes PH might allow a peripheral stimulus in trigeminal neuralgia to be more readily expressed 7 . Impaired inhibitory activity of the periaqueductal gray has been implicated in the pathophysiology of migraine 2 …”

Migraine Secondary to Superior Oblique Myokymia

“…However, thin-slice MRI has shown that the cause of SOM can be attributed to compression of the trunk of cranial nerve IV (trochlear nerve) by the superior cerebellar artery (4). In this sense, SOM should be considered a neurovascular compression condition potentially able to cause migraine, in analogy to trigeminal neuralgia (15) and facial myokymia (16). Another possibility is to consider SOM in the group of paroxysmal dyskynesias; in this case, too, there is some evidence of a correlation with migraine (17).…”

Unilateral nasal pain with migraine features

“…Patient 1 could trigger attacks by gently touching the tip of the nose. Such precipitating mechanism presumably activates nasal afferents of the trigeminal nerve, thus bringing to mind a trigeminal neuralgia, and a migraine-tic syndrome (12). Attacks of trigeminal neuralgia are triggereable, but they typically last for only a few seconds, lack autonomic features and are unresponsive to triptans.…”