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Maestrini I, Viganò A, Di Stefano G, Toscano M, Di Piero V. Neurophysiological investigations in a case of primary paroxysmal hemicrania-tic syndrome. Neurol Sci 2024:10.1007/s10072-024-07470-3. [PMID: 38523207 DOI: 10.1007/s10072-024-07470-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND The association between paroxysmal hemicrania (PH) and trigeminal neuralgia-the so-called PH-tic syndrome-has rarely been described. However, a correct diagnosis is crucial since both disorders require specific treatments. Little is known about pathophysiological mechanisms, and, to date, there are no electrophysiological studies in patients with PH-tic syndrome. CASE We describe the case of a 52-year-old man with a PH-tic syndrome successfully treated with an association of carbamazepine (1200 mg/day) and indomethacin (150 mg/die). Patient underwent trigeminal reflex testing, including blink and masseter inhibitory reflex, and laser-evoked potential (LEP) recording after supraorbital region stimulation in the affected and unaffected side. Both neurophysiological investigations resulted normal; LEPs failed to detect any latency asymmetry between both sides. CONCLUSIONS Neurophysiological findings demonstrate for the first time the integrity of somatosensory system in a primary PH-tic syndrome case. Central pathophysiological mechanisms and hypothalamic dysregulation may contribute to the development of this rare syndrome.
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Affiliation(s)
- Ilaria Maestrini
- Department of Systems Medicine, University Hospital of Rome "Tor Vergata", Rome, Italy.
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.
| | - Alessandro Viganò
- Rehabilitation Neurology Unit, I.R.C.C.S. Fondazione Don Carlo Gnocchi, Via Alfonso Capecelatro 66, 20148, Milan, Italy
| | - Giulia Di Stefano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - Massimiliano Toscano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
- Department of Neurology, Fatebenefratelli Hospital-Gemelli Isola, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
- University Consortium for Adaptive Disorders and Head Pain (UCADH), Pavia, Italy
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Crespi J, Gulati S, Salvesen Ø, Bratbak DF, Dodick DW, Matharu MS, Tronvik E. Epidemiology of diagnosed cluster headache in Norway. Cephalalgia Reports 2022. [DOI: 10.1177/25158163221075569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Cluster headache (CH) is one of the most painful conditions in humans and there is limited epidemiological data on this debilitating condition. Objectives: To describe the epidemiology of CH in Norway Methods: We conducted a nationwide study to investigate the prevalence, incidence, and comorbidity of CH in Norway between January 1 2008 and December 31 2016. Treatment and outcome data from the Norwegian patient registry and the Norwegian prescription database were linked on an individual basis. Results: Among 3,892,260 individuals ≥18 years old of age, we identified a total of 1891 patients with CH. The prevalence of CH was 48.6 per 100,000, and the male-to-female ratio was 1.47. The estimated incidence of CH was 3.0 per 100,000/year. Among patients with CH, increased age and sex adjusted odds ratios ([OR], all with p-values <0.0001, were observed for medication-induced headache (OR 50.7, 95% CI 36.7–69.9), migraine (OR 25.2, 95% CI 22.5–28.3), chronic posttraumatic headache (OR 22.2, 95% CI 12.8–38.45), history of cranial trauma (OR 1.9, 95% CI 1.5–2.4), somatoform disorders (OR 4.2, 95% CI 3.0–5.8), suicide attempt (OR 3.9, 95% CI 2.6–5.8), personality disorder (OR 3.6, 95% CI 2.6–4.9), bipolar disorder (OR 3.6, 95% CI 2.8–4.8), peptic ulcer (OR 2.8, 95% CI 2.3–3.3), depression (OR 2.8, 95% CI 2.4–3.1), substance abuse (OR 2.6, 95% CI 2.0–3.3), and cerebrovascular disease (OR 2.4, 95% CI 1.8–3.1). Use of opioid analgesics during the study period was more common among patients with CH compared to others (81% vs. 22%, sex and age adjusted OR 23.4, 95% CI 20.8–26.2, p < 0.0001).
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Affiliation(s)
- Joan Crespi
- Department of Neurology, St. Olav’s University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, NTNU (Norwegian University of Science and Technology), Trondheim, Norway
| | - Sasha Gulati
- Department of Neuromedicine and Movement Science, NTNU (Norwegian University of Science and Technology), Trondheim, Norway
- Department of Neurosurgery, St. Olav’s University Hospital, Trondheim, Norway
| | - Øyvind Salvesen
- Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, NTNU (Norwegian University of Science and Technology), Trondheim, Norway
| | - Daniel Fossum Bratbak
- Department of Neuromedicine and Movement Science, NTNU (Norwegian University of Science and Technology), Trondheim, Norway
- Department of Neurosurgery, St. Olav’s University Hospital, Trondheim, Norway
| | | | - Manjit Singh Matharu
- UCL Queen Square Institute of Neurology and The National Hospital of Neurology and Neurosurgery, London, UK
| | - Erling Tronvik
- Department of Neurology, St. Olav’s University Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, NTNU (Norwegian University of Science and Technology), Trondheim, Norway
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Dinan JE, Smith A, Hawkins JM. Trigeminal Neuralgia With Extraoral Trigger Zone Successfully Treated With Intraoral Injections of Botulinum Toxin: A Case Report. Clin Neuropharmacol 2021; 43:162-163. [PMID: 32947428 DOI: 10.1097/wnf.0000000000000399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Trigeminal neuralgia is a pain condition that is frequently misdiagnosed and challenging to manage. We present the case of a patient with trigeminal neuralgia with multiple misdiagnoses and poorly managed pain. Despite the presence of trigger zones both inside and outside her mouth, complete symptom resolution was ultimately achieved through onabotulinumtoxinA injections, delivered solely intraorally.
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Affiliation(s)
- John E Dinan
- Naval Postgraduate Dental School and Uniformed Services University of the Health Sciences, Postgraduate Dental College, Bethesda, MD
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Wang C, Zhang X, Yang Y, Wan D. Secondary hemicrania continua-tic syndrome associated with fungal sphenoiditis: A case report. Clin Case Rep 2021; 9:e04297. [PMID: 34026209 PMCID: PMC8133077 DOI: 10.1002/ccr3.4297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/02/2021] [Accepted: 04/27/2021] [Indexed: 11/24/2022] Open
Abstract
The coexistence of hemicrania-continua and trigeminal neuralgia is called HC-tic syndrome. We describe a case of an elderly man who suffered both types of headache related to fungal sphenoiditis. This is the first case to be reported, to the best of our knowledge.
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Affiliation(s)
- Chunyu Wang
- Department of NeurologyThe 940th Hospital of Chinese PLALanzhouChina
- Department of EndocrineThe 940th Hospital of Chinese PLALanzhouChina
| | - Xiaoyan Zhang
- Department of NeurologyThe 940th Hospital of Chinese PLALanzhouChina
| | - Yanli Yang
- Department of PathologyThe 940th Hospital of Chinese PLALanzhouChina
| | - Dongjun Wan
- Department of NeurologyThe 940th Hospital of Chinese PLALanzhouChina
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Calejo M, Salgado P, Moreira B, Correia C, Barros J. Botulinum Toxin Type A Injections as an Effective Treatment of Refractory Multiple Sclerosis‐Related Trigeminal Pain – A Case Report. Headache 2019; 59:1379-1381. [DOI: 10.1111/head.13609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Margarida Calejo
- Department of Neurology Porto Hospitalar and Universitary Centre Porto Portugal
| | - Paula Salgado
- Department of Neurology Porto Hospitalar and Universitary Centre Porto Portugal
| | - Bruno Moreira
- Department of Neuroradiology Porto Hospitalar and Universitary Centre Porto Portugal
| | - Carlos Correia
- Department of Neurology Porto Hospitalar and Universitary Centre Porto Portugal
| | - José Barros
- Department of Neurology Porto Hospitalar and Universitary Centre Porto Portugal
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