Paroxysmal hemicrania in children and adolescents: A systematic review

Bemanalizadeh, Maryam; Oskouei, Homayoun Baghaei; Hadizadeh, Alireza; Dakkali, Mohammad Sedigh; Qahremani, Reihane; Mansouri, Vahid

doi:10.1111/head.14354

Cited by 6 publications

(3 citation statements)

References 50 publications

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“…For PH the largest number of reported cases in a single study with a documented tobacco exposure history was 74 patients (lacked sex distribution), SUNCT and SUNA 20 patients and for HC a study of 34 patients (no sex distribution was noted) (14)(15)(16). All pediatric and adolescent investigations had no personal or secondary cigarette smoke exposure data (17)(18)(19). None of the original case descriptions for each of these unique conditions mentioned a smoking history (20)(21)(22).…”

Section: Methodsmentioning

confidence: 99%

Cigarette smoking history (personal and secondary childhood exposure) in non-cluster headache trigeminal autonomic cephalalgias: A clinic based study

Rozen

2023

Cephalalgia

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Objective To look at cigarette smoking history (personal and secondary exposure as a child) in non-cluster headache trigeminal autonomic cephalalgias seen at a headache clinic and to determine smoking exposure prevalence utilizing previously published data. Methods Retrospective chart review and PubMed/Google Scholar search Results Forty-eight clinic patients met ICHD-3 criteria for non-cluster headache trigeminal autonomic cephalalgias. Four had paroxysmal hemicrania, 75% were smokers and secondary exposure was noted in all. 16 patients had short lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or short lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA), 12.5% were smokers and secondary exposure was noted in 91%. Twenty-eight patients had hemicrania continua, 21% were smokers and secondary exposure was found in 62.5%. Since 1974 there have been 88 paroxysmal hemicrania, 50 SUNCT or SUNA and 89 hemicrania continua patients with a documented smoking exposure history. From current data and previous studies, a smoking history was noted in 60% paroxysmal hemicrania, 18% SUNCT and SUNA and 21% hemicrania continua patients. Conclusion A cigarette smoking history appears to be connected to paroxysmal hemicrania (personal and secondary exposure) and possibly to SUNCT/SUNA (secondary) and hemicrania continua (secondary).

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Section: Methodsmentioning

confidence: 99%

Cigarette smoking history (personal and secondary childhood exposure) in non-cluster headache trigeminal autonomic cephalalgias: A clinic based study

Rozen

2023

Cephalalgia

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“…Table 2 summarises the published cohorts which provide the most complete information on phenotyping. The median age of onset is in the fourth decade, but the disorder can manifest in the first decade (38) and the ninth (39). Although pooling of earlier reports suggested a female predominance more recent cohorts suggest both sexes are equally affected.…”

Section: Epidemiologymentioning

confidence: 99%

Paroxysmal hemicrania and hemicrania continua: Review on pathophysiology, clinical features and treatment

Bahra

2023

Cephalalgia

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Background Paroxysmal hemicrania and hemicrania continua are indometacin-sensitive trigeminal autonomic cephalalgias, a terminology which reflects the predominant distribution of the pain, observable cranial autonomic features and shared pathophysiology. Understanding the latter is limited, both by low prevalence and the intricacies of studying brain function, requiring multimodal techniques to glean insights into such disorders. Similarly obscure is the curious response to indometacin. This review will address what is currently known about pathophysiology, the rationale for the current classification and, features which may confound the diagnosis, such as lack of cranial autonomic symptoms and those which are typically associated with migraine such as nausea, photophobia, phonophobia and aura. Despite these characteristics, a dramatic response to indometacin, which is not seen in migraine nor the other trigeminal autonomic cephalalgias , provides the hallmark of the diagnosis. The main clinical differential for paroxysmal hemicrania is based on temporal pattern and lies between cluster headache and short-lasting-neuralgiform headache attacks with tearing or additional cranial autonomic symptoms. For hemicrania continua it is more challenging as the main differential for which the disorder is often treated is migraine. A prior episodic pattern, often days at a time, and the tendency to exacerbation with analgesics will further deflect from the diagnosis. The relevance of this is that there is little overlap in therapeutics between paroxysmal hemicrania and hemicrania continua and other headache disorders and there are limited effective alternatives to indometacin. The most effective are other non-steroidal anti-inflammatory drugs including the newer COX-II inhibitors. Even though early reports suggest that a higher indometacin dose-requirement may herald a secondary precipitating pathology, this does not seem to be the case, with syndrome and response to treatment being similar with the primary disorder. In this context imaging of new onset paroxysmal hemicrania or hemicrania continua and implication of the results will be discussed as will alternative treatment options.

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“…A systematic review of 22 articles on paroxysmal hemicrania in children and adolescents reported that almost all patients benefited from acemetacin/indomethacin. Although paroxysmal hemicrania (PH) is a primary headache disorder belonging to the trigeminal autonomic cephalalgias (TACs) group, it is also reported that the pain was quite severe in the cases included in this review 22 .…”

Section: Joint Stiffnessmentioning

confidence: 99%

Acemetacin in Acute and Chronic Pain Management

Berk

2023

J. Drug Delivery Ther.

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Acemetacin is the carboxymethyl ester of indomethacin and is a pro-drug precursor compound, in other words, a prodrug. The pharmacologically active metabolite of acemetacin is also indomethacin. Acemetacin exerts its potent non-steroidal anti-inflammatory effects in the body as indomethacin. It is known that acemetacin is not only a prodrug of indomethacin, but also an agent with gastric protective mechanisms, possibly involving a reduction in leukocyte adhesion, and that acemetacin exerts gastric protective effects by exhibiting less efficacy on the COX-1 enzyme in the gastric mucosa compared to direct indomethacin use. It is clear that acemetacin is a valuable NSAID for acute and chronic pain. Keywords: Acemetacin, indomethacin, non-steroidal anti-inflammatory drugs.

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Paroxysmal hemicrania in children and adolescents: A systematic review

Cited by 6 publications

References 50 publications

Cigarette smoking history (personal and secondary childhood exposure) in non-cluster headache trigeminal autonomic cephalalgias: A clinic based study

Cigarette smoking history (personal and secondary childhood exposure) in non-cluster headache trigeminal autonomic cephalalgias: A clinic based study

Paroxysmal hemicrania and hemicrania continua: Review on pathophysiology, clinical features and treatment

Acemetacin in Acute and Chronic Pain Management

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