1
|
Olson PA, Smith JH, Haan J. Special considerations in management of migraine in the elderly. Handb Clin Neurol 2024; 199:265-275. [PMID: 38307651 DOI: 10.1016/b978-0-12-823357-3.00010-0] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
Migraine in elderly patients requires an individualized approach, with unique considerations and challenges in both diagnosing and managing the disorder. Aging brains differ from younger ones in many ways, with distinct trajectories impacting brain volume, neurotransmitter systems, and functional systems, such as the descending pain inhibitory system. In this chapter, we will deconstruct migraine in the elderly by discussing the definitions of the elderly and migraine, the prevalence of migraine, and the management of migraine including the challenges posed by its comorbidities, limitations of treatments, and its effects on cognition. Studying, quantifying, characterizing, diagnosing, or managing migraine in the elderly is a challenge. However, it is clear that migraine in the elderly is not an uncommon occurrence, and providers should be aware that many elderly patients will not present with the complete phenotypic profile. Fortunately, the weight of evidence has not established migraine as a risk factor for dementia in the elderly, although migraine and its pharmacologic treatments may adversely impact cognition. Successful management requires understanding the interactions of migraine with comorbidities in the elderly and the adverse impacts of polypharmacy.
Collapse
Affiliation(s)
- Patricia A Olson
- Department of Neurology, University of Kentucky, Lexington, KY, United States
| | - Jonathan H Smith
- Department of Neurology, Mayo Clinic, Scottsdale, AZ, United States.
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands; Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| |
Collapse
|
2
|
Brandt RB, Wilbrink LA, de Coo IF, Haan J, Mulleners WM, Huygen FJPM, van Zwet EW, Ferrari MD, Fronczek R. A prospective open label 2-8 year extension of the randomised controlled ICON trial on the long-term efficacy and safety of occipital nerve stimulation in medically intractable chronic cluster headache. EBioMedicine 2023; 98:104895. [PMID: 38007947 PMCID: PMC10755111 DOI: 10.1016/j.ebiom.2023.104895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND We demonstrated in the randomised controlled ICON study that 48-week treatment of medically intractable chronic cluster headache (MICCH) with occipital nerve stimulation (ONS) is safe and effective. In L-ICON we prospectively evaluate its long-term effectiveness and safety. METHODS ICON participants were enrolled in L-ICON immediately after completing ICON. Therefore, earlier ICON participants could be followed longer than later ones. L-ICON inclusion was stopped after the last ICON participant was enrolled in L-ICON and followed for ≥2 years by completing six-monthly questionnaires on attack frequency, side effects, subjective improvement and whether they would recommend ONS to others. Primary outcome was the change in mean weekly attack frequency 2 years after completion of the ICON study compared to baseline. Missing values for log-transformed attack-frequency were imputed for up to 5 years of follow-up. Descriptive analyses are presented as (pooled) geometric or arithmetic means and 95% confidence intervals. FINDINGS Of 103 eligible participants, 88 (85%) gave informed consent and 73 (83%) were followed for ≥2 year, 61 (69%) ≥ 3 year, 33 (38%) ≥ 5 years and 3 (3%) ≥ 8.5 years. Mean (±SD) follow-up was 4.2 ± 2.2 years for a total of 370 person years (84% of potentially 442 years). The pooled geometric mean (95% CI) weekly attack frequency remained considerably lower after one (4.2; 2.8-6.3), two (5.1; 3.5-7.6) and five years (4.1; 3.0-5.5) compared to baseline (16.2; 14.4-18.3). Of the 49/88 (56%) ICON ≥50% responders, 35/49 (71%) retained this response and 15/39 (38%) ICON non-responders still became a ≥50% responder for at least half the follow-up period. Most participants (69/88; 78% [0.68-0.86]) reported a subjective improvement from baseline at last follow-up and 70/88 (81% [0.70-0.87]) would recommend ONS to others. Hardware-related surgery was required in 44/88 (50%) participants in 112/122 (92%) events (0.35 person-year-1 [0.28-0.41]). We didn't find predictive factors for effectiveness. INTERPRETATION ONS is a safe, well-tolerated and long-term effective treatment for MICCH. FUNDING The Netherlands Organisation for Scientific Research, the Dutch Ministry of Health, the NutsOhra Foundation from the Dutch Health Insurance Companies, and Medtronic.
Collapse
Affiliation(s)
- Roemer B Brandt
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
| | | | - Ilse F de Coo
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Medical Rehabilitation, Treant, Emmen, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands; Department of Neurology, Alrijne Hospital, Alphen a/d Rijn, the Netherlands
| | - Wim M Mulleners
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands
| | | | - Erik W van Zwet
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
3
|
Brandt RB, Naber WC, Ouwehand RLH, Haan J, Ferrari MD, Fronczek R. Transient side shift of cluster headache attacks after unilateral greater occipital nerve injection. Headache 2023; 63:1193-1197. [PMID: 37358558 DOI: 10.1111/head.14587] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 06/27/2023]
Abstract
Attacks of cluster headache (CH) are usually side-locked in most, but not all, patients. In a few patients, the side may alternate between or, rarely, within cluster episodes. We observed seven cases in whom the side of CH attacks temporarily shifted immediately or shortly after unilateral injection of the greater occipital nerve (GON) with corticosteroids. In five patients with previously side-locked CH attacks and in two patients with previously side-alternating CH attacks, a side shift for several weeks occurred immediately (N = 6) or shortly (N = 1) after GON injection. We concluded that unilateral GON injections might cause a transient side shift of CH attacks through inhibition of the ipsilateral hypothalamic attack generator causing relative overactivity of the contralateral side. The potential benefit of bilateral GON injection in patients who experienced a side shift after unilateral injection should be formally investigated.
Collapse
Affiliation(s)
- Roemer B Brandt
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Willemijn C Naber
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Rosa-Lin H Ouwehand
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
- Alrijne Hospital Leiderdorp, Leiderdorp, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| |
Collapse
|
4
|
Brandt RB, Ouwehand RLH, Ferrari MD, Haan J, Fronczek R. COVID-19 vaccination-triggered cluster headache episodes with frequent attacks. Cephalalgia 2022; 42:1420-1424. [PMID: 35833226 DOI: 10.1177/03331024221113207] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND The pathophysiology of cluster headache and how cluster episodes are triggered, are still poorly understood. Recurrent inflammation of the trigeminovascular system has been hypothesized. It was noted that some long-term attack-free cluster headache patients suddenly developed a new cluster episode shortly after COVID-19 vaccination. METHODS Cases are described from patients with cluster headache who reported a new cluster episode within days after COVID-19 vaccination. All cases were seen in a tertiary university referral center and a general hospital in the Netherlands between March 2021 and December 2021, when the first COVID-19 vaccinations were carried out in The Netherlands. Clinical characteristics of the previous and new cluster episodes, and time between the onset of a new cluster episode and a previous COVID-19 vaccination were reported. RESULTS We report seven patients with cluster headache, who had been attack-free for a long time, in whom a new cluster episode occurred within a few days after a COVID-19 vaccination. INTERPRETATION COVID-19 vaccinations may trigger new cluster episodes in patients with cluster headache, possibly by activating a pro-inflammatory state of the trigeminocervical complex. COVID-19 vaccinations may also exacerbate other neuroinflammatory conditions. .
Collapse
Affiliation(s)
- Roemer B Brandt
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Rosa-Lin H Ouwehand
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands.,Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands
| |
Collapse
|
5
|
Wilbrink LA, de Coo IF, Doesborg PGG, Mulleners WM, Teernstra OPM, Bartels EC, Burger K, Wille F, van Dongen RTM, Kurt E, Spincemaille GH, Haan J, van Zwet EW, Huygen FJPM, Ferrari MD. Safety and efficacy of occipital nerve stimulation for attack prevention in medically intractable chronic cluster headache (ICON): a randomised, double-blind, multicentre, phase 3, electrical dose-controlled trial. Lancet Neurol 2021; 20:515-525. [PMID: 34146510 DOI: 10.1016/s1474-4422(21)00101-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/14/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Occipital nerve stimulation (ONS) has shown promising results in small uncontrolled trials in patients with medically intractable chronic cluster headache (MICCH). We aimed to establish whether ONS could serve as an effective treatment for patients with MICCH. METHODS The ONS in MICCH (ICON) study is an investigator-initiated, international, multicentre, randomised, double-blind, phase 3, electrical dose-controlled clinical trial. The study took place at four hospitals in the Netherlands, one hospital in Belgium, one in Germany, and one in Hungary. After 12 weeks' baseline observation, patients with MICCH, at least four attacks per week, and history of being non-responsive to at least three standard preventive drugs, were randomly allocated (at a 1:1 ratio using a computer-generated permuted block) to 24 weeks of occipital nerve stimulation at either 100% or 30% of the individually determined range between paraesthesia threshold and near-discomfort (double-blind study phase). Because ONS causes paraesthesia, preventing masked comparison versus placebo, we compared high-intensity versus low-intensity ONS, which are hypothesised to cause similar paraesthesia, but with different efficacy. In weeks 25-48, participants received individually optimised open-label ONS. The primary outcome was the weekly mean attack frequency in weeks 21-24 compared with baseline across all patients and, if a decrease was shown, to show a group-wise difference. The trial is closed to recruitment (ClinicalTrials.gov NCT01151631). FINDINGS Patients were enrolled between Oct 12, 2010, and Dec 3, 2017. We enrolled 150 patients and randomly assigned 131 (87%) to treatment; 65 (50%) patients to 100% ONS and 66 (50%) to 30% ONS. One of the 66 patients assigned to 30% ONS was not implanted and was therefore excluded from the intention-to-treat analysis. Because the weekly mean attack frequencies at baseline were skewed (median 15·75; IQR 9·44 to 24·75) we used log transformation to analyse the data and medians to present the results. Median weekly mean attack frequencies in the total population decreased from baseline to 7·38 (2·50 to 18·50; p<0·0001) in weeks 21-24, a median change of -5·21 (-11·18 to -0·19; p<0·0001) attacks per week. In the 100% ONS stimulation group, mean attack frequency decreased from 17·58 (9·83 to 29·33) at baseline to 9·50 (3·00 to 21·25) at 21-24 weeks (median change from baseline -4·08, -11·92 to -0·25), and for the 30% ONS stimulation group, mean attack frequency decreased from 15·00 (9·25 to 22·33) to 6·75 (1·50 to 16·50; -6·50, -10·83 to -0·08). The difference in median weekly mean attack frequency between groups at the end of the masked phase in weeks 21-24 was -2·42 (95% CI -5·17 to 3·33). In the masked study phase, 129 adverse events occurred with 100% ONS and 95 occurred with 30% ONS. None of the adverse events was unexpected but 17 with 100% ONS and eight with 30% ONS were labelled as serious, given they required brief hospital admission for minor hardware-related issues. The most common adverse events were local pain, impaired wound healing, neck stiffness, and hardware damage. INTERPRETATION In patients with MICCH, both 100% ONS intensity and 30% ONS intensity substantially reduced attack frequency and were safe and well tolerated. Future research should focus on optimising stimulation protocols and disentangling the underlying mechanism of action. FUNDING The Netherlands Organisation for Scientific Research, the Dutch Ministry of Health, the NutsOhra Foundation from the Dutch Health Insurance Companies, and Medtronic.
Collapse
Affiliation(s)
- Leopoldine A Wilbrink
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands; Department of Neurology, Zuyderland Medical Centre, Heerlen, Netherlands
| | - Ilse F de Coo
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands; Basalt Rehabilitation Centre, the Hague, Netherlands
| | - Patty G G Doesborg
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands
| | - Wim M Mulleners
- Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, Netherlands
| | - Onno P M Teernstra
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Eveline C Bartels
- Department of Anaesthesiology, Leiden University Medical Centre, Leiden, Netherlands
| | - Katja Burger
- Department of Anaesthesiology, Alrijne Hospital, Leiderdorp, Netherlands
| | - Frank Wille
- Department of Anaesthesiology, Diakonessenhuis Hospital, Zeist, Netherlands
| | - Robert T M van Dongen
- Department of Anaesthesiology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Erkan Kurt
- Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Geert H Spincemaille
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands; Department of Neurology, Alrijne Hospital, Leiderdorp, Netherlands
| | - Erik W van Zwet
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, Netherlands.
| | | |
Collapse
|
6
|
Brandt RB, Haan J, Ferrari MD, Fronczek R. [Cluster headache and other trigeminal autonomic cephalalgias]. Ned Tijdschr Geneeskd 2020; 164:D4870. [PMID: 32779921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Trigeminal autonomic cephalalgias (TACs) are a group of 4 different primary headache syndromes that have a lot of pathophysiological and clinical features in common. The 4 different TACs are: cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks and hemicrania continua. TACs are characterized by frequent, strictly unilateral, (very) intense headache attacks with ipsilateral cranial autonomic symptoms or intrinsic restlessness or both. A distinction can be made between the 4 TACs on the basis of the duration and frequency of the headache attacks. The treatment of cluster headache consists of an acute treatment and a maintenance treatment. Headache attacks in the context of paroxysmal hemicrania and hemicrania continua (almost) always respond to treatment with indomethacin. More and more neuromodulation therapies are becoming available, such as vagus nerve stimulation, stimulation and blocking of the sphenopalatine ganglion, stimulation and blocking of the occipital nerve and deep brain stimulation.
Collapse
Affiliation(s)
- R B Brandt
- LUMC, afd. Neurologie, Leiden
- Contact: R.B. Brandt
| | - J Haan
- LUMC, afd. Neurologie, Leiden (tevens: Alrijne Ziekenhuis, afd. Neurologie, Leiderdorp)
| | | | | |
Collapse
|
7
|
Abstract
Migraine is a common headache disorder characterized by often-severe headaches that may be preceded or accompanied by a variety of visual symptoms. Although a typical migraine aura is not difficult to diagnose, patients with migraine may report several other visual symptoms, such as prolonged or otherwise atypical auras, "visual blurring", "retinal migraine", "ophthalmoplegic migraine", photophobia, palinopsia, and "visual snow". Here, we provide a short overview of these symptoms and what is known about the relationship with migraine pathophysiology. For some symptoms, the association with migraine is still debated; for other symptoms, recent studies indicate that migraine mechanisms play a role.
Collapse
Affiliation(s)
- Robin M. van Dongen
- Department of Neurology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
- Department of Neurology, Alrijne Ziekenhuis, Simon Smitweg 1, 2353 GA, Leiderdorp, The Netherlands
| |
Collapse
|
8
|
Naber WC, Fronczek R, Haan J, Doesborg P, Colwell CS, Ferrari MD, Meijer JH. The biological clock in cluster headache: A review and hypothesis. Cephalalgia 2019; 39:1855-1866. [DOI: 10.1177/0333102419851815] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objective To review and discuss the putative role of light, sleep, and the biological clock in cluster headache. Discussion Cluster headache attacks are believed to be modulated in the hypothalamus; moreover, the severe pain and typical autonomic cranial features associated with cluster headache are caused by abnormal activity of the trigeminal-autonomic reflex. The temporal pattern of cluster headache attacks suggests involvement of the biological clock, and the seasonal pattern is influenced by the number of daylight hours. Although sleep is often reported as a trigger for cluster headache attacks, to date no clear correlation has been established between these attacks and sleep stage. Conclusions We hypothesize that light, sleep, and the biological clock can change the brain’s state, thereby lowering the threshold for activating the trigeminal-autonomic reflex, resulting in a cluster headache attack. Understanding the mechanisms that contribute to the daily and seasonal fluctuations in cluster headache attacks may provide new therapeutic targets.
Collapse
Affiliation(s)
- Willemijn C Naber
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
- Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Patty Doesborg
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Christopher S Colwell
- Department of Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Johanna H Meijer
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
9
|
Pelzer N, Hoogeveen ES, Haan J, Bunnik R, Poot CC, van Zwet EW, Inderson A, Fogteloo AJ, Reinders MEJ, Middelkoop HAM, Kruit MC, van den Maagdenberg AMJM, Ferrari MD, Terwindt GM. Systemic features of retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations: a monogenic small vessel disease. J Intern Med 2019; 285:317-332. [PMID: 30411414 DOI: 10.1111/joim.12848] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S) is a small vessel disease caused by C-terminal truncating TREX1 mutations. The disease is typically characterized by vascular retinopathy and focal and global brain dysfunction. Systemic manifestations have also been reported but not yet systematically investigated. METHODS In a cross-sectional study, we compared the clinical characteristics of 33 TREX1 mutation carriers (MC+) from three Dutch RVCL-S families with those of 37 family members without TREX1 mutation (MC-). All participants were investigated using personal interviews, questionnaires, physical, neurological and neuropsychological examinations, blood and urine tests, and brain MRI. RESULTS In MC+, vascular retinopathy and Raynaud's phenomenon were the earliest symptoms presenting from age 20 onwards. Kidney disease became manifest from around age 35, followed by liver disease, anaemia, markers of inflammation and, in some MC+, migraine and subclinical hypothyroidism, all from age 40. Cerebral deficits usually started mildly around age 50, associated with white matter and intracerebral mass lesions, and becoming severe around age 60-65. CONCLUSIONS Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations is a rare, but likely underdiagnosed, systemic small vessel disease typically starting with vascular retinopathy, followed by multiple internal organ disease, progressive brain dysfunction, and ultimately premature death.
Collapse
Affiliation(s)
- N Pelzer
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E S Hoogeveen
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - J Haan
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - R Bunnik
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - C C Poot
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - E W van Zwet
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands
| | - A Inderson
- Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A J Fogteloo
- Department of Internal Medicine (Acute Care), Leiden University Medical Centre, Leiden, The Netherlands
| | - M E J Reinders
- Department of Internal Medicine (Nephrology), Leiden University Medical Centre, Leiden, The Netherlands
| | - H A M Middelkoop
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
| | - M C Kruit
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - A M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - M D Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - G M Terwindt
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
10
|
Abstract
Introduction Many patients with cluster headache report use of illicit drugs. We systematically assessed the use of illicit drugs and their effects in a well-defined Dutch cluster headache population. Methods In this cross-sectional explorative study, 756 people with cluster headache received a questionnaire on lifetime use and perceived effects of illicit drugs. Results were compared with age and sex-matched official data from the Dutch general population. Results Compared to the data from the general population, there were more illicit drug users in the cluster headache group (31.7% vs. 23.8%; p < 0.01). Reduction in attack frequency was reported by 56% (n = 22) of psilocybin mushroom, 60% (n = 3) of lysergic acid diethylamide and 50% (n = 2) of heroin users, and a decreased attack duration was reported by 46% (n = 18) of PSI, 50% (n = 2) of heroin and 36% (n = 8) of amphetamine users. Conclusion In the Netherlands, people with cluster headache use illicit drugs more often than the general population. The question remains whether this is due to an actual alleviatory effect, placebo response, conviction, or common pathophysiological background between cluster headache and addictive behaviours such as drug use.
Collapse
Affiliation(s)
- Ilse F de Coo
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,2 Sophia Rehabilitation Center, the Hague, the Netherlands
| | - Willemijn C Naber
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Leopoldine A Wilbrink
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Joost Haan
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,3 Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Michel D Ferrari
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rolf Fronczek
- 1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,4 Slaap-Waakcentrum SEIN, Heemstede, the Netherlands
| |
Collapse
|
11
|
Bleyenheuft C, Goemans N, Wanyama S, Van Damme P, De Bleecker J, Van Coster R, De Jonghe P, Beysen D, Van den Bergh P, Paquay S, Servais L, Maertens de Noordhout A, Haan J, De Meirleir L, Remiche G, Deconinck N, Arnould C. REGISTRIES AND CARE OF NEUROMUSCULAR DISORDERS. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
12
|
Stam AH, Kothari PH, Shaikh A, Gschwendter A, Jen JC, Hodgkinson S, Hardy TA, Hayes M, Kempster PA, Kotschet KE, Bajema IM, van Duinen SG, Maat-Schieman MLC, de Jong PTVM, de Smet MD, de Wolff-Rouendaal D, Dijkman G, Pelzer N, Kolar GR, Schmidt RE, Lacey J, Joseph D, Fintak DR, Grand MG, Brunt EM, Liapis H, Hajj-Ali RA, Kruit MC, van Buchem MA, Dichgans M, Frants RR, van den Maagdenberg AMJM, Haan J, Baloh RW, Atkinson JP, Terwindt GM, Ferrari MD. Retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations. Brain 2018; 139:2909-2922. [PMID: 27604306 DOI: 10.1093/brain/aww217] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Accepted: 07/11/2016] [Indexed: 02/02/2023] Open
Affiliation(s)
- Anine H Stam
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Parul H Kothari
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Aisha Shaikh
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Andreas Gschwendter
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians Universität, D-81377 München, Germany
| | - Joanna C Jen
- Department of Neurology, University of California at Los Angeles, Los Angeles, California 90095, USA
| | - Suzanne Hodgkinson
- Department of Neurology, Liverpool Hospital, Liverpool, New South Wales 2170, Australia
| | - Todd A Hardy
- Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales 2139, Australia.,Brain and Mind Centre, University of Sydney, Australia
| | - Michael Hayes
- Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales 2139, Australia
| | - Peter A Kempster
- Neurosciences Department, Monash Medical Centre, Clayton, Victoria 3168, Australia
| | - Katya E Kotschet
- Neurosciences Department, Monash Medical Centre, Clayton, Victoria 3168, Australia
| | - Ingeborg M Bajema
- Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sjoerd G van Duinen
- Department of Pathology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | - Paulus T V M de Jong
- Department of Ophthalmology, Academic Medical Centre, 1100 DD Amsterdam, The Netherlands.,Department of Retinal Signaling, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, 1000 GC Amsterdam, The Netherlands.,Department of Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Marc D de Smet
- Department of Ophthalmology, Academic Medical Centre, 1100 DD Amsterdam, The Netherlands
| | | | - Greet Dijkman
- Department of Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Nadine Pelzer
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Grant R Kolar
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - Robert E Schmidt
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - JoAnne Lacey
- West County Radiology Group, Mercy Hospital in St Louis, MO 63141, USA
| | - Daniel Joseph
- The Retina Institute, Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - David R Fintak
- The Retina Institute, Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - M Gilbert Grand
- The Retina Institute, Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - Elizabeth M Brunt
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - Helen Liapis
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, 63110 USA
| | - Rula A Hajj-Ali
- Department of Rheumatic and Immunologic Disease, Cleveland Clinic, Cleveland, Ohio, 44195 USA
| | - Mark C Kruit
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians Universität, D-81377 München, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Rune R Frants
- Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.,Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Robert W Baloh
- Department of Neurology, University of California at Los Angeles, Los Angeles, California 90095, USA
| | - John P Atkinson
- Department of Medicine, Division of Rheumatology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| |
Collapse
|
13
|
Haan J, Kluft C, Leebeek FWG, de Bart ACW, Buruma OJS, Roos RAC. Hereditary Cerebral Hemorrhage with Amyloidosis -Dutch Type: A Study of Fibrinolysis. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1648372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryIn view of reported associations between increased bleeding tendency and systemically decreased α2-antiplasmin in patients with systemic amyloid deposition we studied α2-antiplasmin, fibrinogen, C-reactive protein and blood levels of locally produced endothelial hemostasis factors in the acute and quiescent phase in 16 patients with hereditary cerebral hemorrhage with amyloidosis - Dutch type (HCHWA-D).None of the factors measured in the quiescent phase of the disease was abnormal. In the acute phase, shortly after a stroke, only factor VIII: Ag was evidently elevated. We concluded that systemic abnormalities in the part of the fibrinolysis system studied are not likely to be responsible for multifocal and recurrent cerebral hemorrhages in HCHWA-D. The role of an elevated factor VIII: Ag level in the acute phase is unclear.
Collapse
Affiliation(s)
- J Haan
- Department of Neurology, University Hospital Leiden, The Netherlands
| | - C Kluft
- The Gaubius Institute TNO, Leiden, The Netherlands
| | | | | | - O J S Buruma
- Department of Neurology, University Hospital Leiden, The Netherlands
| | - R A C Roos
- Department of Neurology, University Hospital Leiden, The Netherlands
- Members of the Research-Group on Hereditary Cerebral Amyloid Angiopathy, Leiden
| |
Collapse
|
14
|
Bleyenheuft C, Wanyama S, Van Damme P, Goemans N, De Bleecker J, Van Coster R, De Jonghe P, Beysen D, Van den Bergh P, Paquay S, Servais L, Maertens de Noordhout A, Haan J, De Meirleir L, Remiche G, Deconinck N, Arnould C. Quantifying the changes in activity level of neuromuscular patients using the ACTIVLIM questionnaire: A 5-years study. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
15
|
de Coo IF, Wilbrink LA, Ie GD, Haan J, Ferrari MD. Aura in Cluster Headache: A Cross-Sectional Study. Headache 2018; 58:1203-1210. [PMID: 29933513 PMCID: PMC6220953 DOI: 10.1111/head.13344] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 09/22/2017] [Revised: 04/29/2018] [Accepted: 04/30/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Aura symptoms have been reported in up to 23% of cluster headache patients, but it is not known whether clinical characteristics are different in participants with and without aura. METHODS Using validated web-based questionnaires we assessed the presence and characteristics of attack-related aura and other clinical features in 629 subjects available for analysis from an initial cohort of 756 cluster headache subjects. Participants who screened positive for aura were contacted by telephone for confirmation of the ICHD-III criteria for aura. RESULTS Typical aura symptoms before or during cluster headache attacks were found in 44/629 participants (7.0%) mainly involving visual symptoms (61.4%). Except for lower alcohol consumption and higher prevalence of frontal pain in participants with aura, no differences in clinical characteristics were found compared with participants without aura. CONCLUSION At least 7.0% of the participants with cluster headache in our large cohort reported typical aura symptoms, which most often involved visual symptoms. No major clinical differences were found between participants with and without aura.
Collapse
Affiliation(s)
- Ilse F de Coo
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Gaby D Ie
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
16
|
Pelzer N, Louter MA, van Zwet EW, Nyholt DR, Ferrari MD, van den Maagdenberg AM, Haan J, Terwindt GM. Linking migraine frequency with family history of migraine. Cephalalgia 2018; 39:229-236. [PMID: 29911421 PMCID: PMC6376592 DOI: 10.1177/0333102418783295] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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] [Indexed: 01/03/2023]
Abstract
Background Migraine is a complex genetic disorder that is brought about by multiple genetic and environmental factors. We aimed to assess whether migraine frequency is associated with genetic susceptibility. Methods We investigated in 2829 migraine patients (14% males) whether ‘migraine frequency’ (measured as the number of migraine days per month) was related to ‘genetic load’ (measured as the number of parents affected with migraine) using a validated web-based questionnaire. In addition, we investigated associations with age-at-onset, migraine subtype, use of acute headache medication, and comorbid depression. Results We found an association between the number of migraine days per month and family history of migraine for males (p = 0.03), but not for females (p = 0.97). This association was confirmed in a linear regression analysis. Also, a lower age-at-onset (p < 0.001), having migraine with aura (p = 0.03), and a high number of medication days (p = 0.006) were associated with a stronger family history of migraine, whereas lifetime depression (p = 0.13) was not. Discussion Migraine frequency, as measured by the number of migraine days per month, seems associated with a genetic predisposition only in males. A stronger family history of migraine was also associated with a lower age-at-onset, a higher number of medication days, and migraine with aura. Our findings suggest that specific clinical features of migraine seem more determined by genetic factors.
Collapse
Affiliation(s)
- Nadine Pelzer
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Mark A Louter
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.,2 Department of Psychiatry, Leiden University Medical Centre, Leiden, the Netherlands.,3 Viersprong Institute for Studies on Personality Disorders, De Viersprong, Halsteren, the Netherlands
| | - Erik W van Zwet
- 4 Department of Biostatistics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Dale R Nyholt
- 5 Institute of Health and Biomedical Innovation and School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michel D Ferrari
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Arn Mjm van den Maagdenberg
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.,6 Department of Human Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Joost Haan
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.,7 Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| | - Gisela M Terwindt
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
17
|
Abstract
Cluster headache is a severe headache disorder with considerable impact on quality of life. The pathophysiology of the disease remains poorly understood. With few specific targets for treatment, current guidelines mainly include off-label treatment with medication. However, new targets for possible treatment options are emerging. Calcitonin gene-related peptide (CGRP)-targeted medication could become the first (cluster) headache-specific treatment option. Other exciting new treatment options include invasive and non-invasive neuromodulation techniques. Here, we provide a short overview of new targets and treatment options that are being investigated for cluster headache.
Collapse
Affiliation(s)
- Patty Doesborg
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, Netherlands.,Department of Neurology, Alrijne Ziekenhuis, Leiderdorp, Netherlands
| |
Collapse
|
18
|
Pelzer N, Haan J, Stam AH, Vijfhuizen LS, Koelewijn SC, Smagge A, de Vries B, Ferrari MD, van den Maagdenberg AMJM, Terwindt GM. Clinical spectrum of hemiplegic migraine and chances of finding a pathogenic mutation. Neurology 2018; 90:e575-e582. [PMID: 29343472 DOI: 10.1212/wnl.0000000000004966] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/09/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To investigate whether the clinical characteristics of patients with hemiplegic migraine with and without autosomal dominant mutations in CACNA1A, ATP1A2, or SCN1A differ, and whether the disease may be caused by mutations in other genes. METHODS We compared the clinical characteristics of 208 patients with familial (n = 199) or sporadic (n = 9) hemiplegic migraine due to a mutation in CACNA1A, ATP1A2, or SCN1A with those of 73 patients with familial (n = 49) or sporadic (n = 24) hemiplegic migraine without a mutation in these genes. In addition, 47 patients (familial: n = 33; sporadic: n = 14) without mutations in CACNA1A, ATP1A2, or SCN1A were scanned for mutations in novel genes using whole exome sequencing. RESULTS Patients with mutations in CACNA1A, ATP1A2, or SCN1A had a lower age at disease onset, larger numbers of affected family members, and more often attacks (1) triggered by mild head trauma, (2) with extensive motor weakness, and (3) with brainstem features, confusion, and brain edema. Mental retardation and progressive ataxia were exclusively found in patients with a mutation. Whole exome sequencing failed to identify pathogenic mutations in new genes. CONCLUSIONS Most patients with hemiplegic migraine without a mutation in CACNA1A, ATP1A2, or SCN1A display a mild phenotype that is more akin to that of common (nonhemiplegic) migraine. A major fourth autosomal dominant gene for hemiplegic migraine remains to be identified. Our observations might guide physicians in selecting patients for mutation screening and in providing adequate genetic counseling.
Collapse
Affiliation(s)
- Nadine Pelzer
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Joost Haan
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Anine H Stam
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Lisanne S Vijfhuizen
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Stephany C Koelewijn
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Amber Smagge
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Boukje de Vries
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Michel D Ferrari
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Arn M J M van den Maagdenberg
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands
| | - Gisela M Terwindt
- From the Departments of Neurology (N.P., J.H., A.H.S., A.S., M.D.F., A.M.J.M.v.d.M., G.M.T.) and Human Genetics (L.S.V., S.C.K., B.d.V., A.M.J.M.v.d.M.), Leiden University Medical Centre; and Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands.
| |
Collapse
|
19
|
Pijpers JA, Wiendels NJ, Koppen H, Ferrari MD, Haan J, Terwindt GM. [Medication-overuse headache]. Ned Tijdschr Geneeskd 2018; 162:D1749. [PMID: 29350119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
- Medication-overuse headache is a highly prevalent disorder with a major impact on the quality of life.- Medication-overuse headache is defined as headache on ≥ 15 days per month with overuse of acute headache medication for ≥ 3 months. We talk about overuse in case of intake of simple analgesics on ≥ 15 days per month or triptans or combinations of analgesics on ≥ 10 days per month.- The underlying type of headache is usually migraine or tension-type headache.- One of the possible underlying mechanisms of medication-overuse headache is changed sensitivity as a consequence of central sensitisation.- The initial treatment is detoxification of the headache medication. The preferred detoxification method is outpatient, abrupt withdrawal of all acute-headache medication and caffeine-containing products. Essential for successful detoxification is education about the reasons for detoxification, the expected course and the subsequent treatment.
Collapse
Affiliation(s)
- J A Pijpers
- Leids Universitair Medisch Centrum, afd. Neurologie, Leiden
| | | | | | | | | | | |
Collapse
|
20
|
Abstract
Background Oliver Sacks (1933–2015) published a large number of books on a variety of neurological topics. Of these, numerous copies have been sold and they probably serve as the only or main source of information on neurological diseases for many persons without a medical background. His first book was on migraine and in his subsequent books many descriptions of migraine can be found, mainly those of auras. Methods We explored the descriptions of migraine in Sacks’ work in order to evaluate the image of migraine offered to the readers. Conclusion Oliver Sacks gave wonderful descriptions of migraine auras, but hardly any of migraine headache. Furthermore, he described rare auras such as ‘amusia’ and olfactory auras. Overall, this makes his descriptions of migraine not very useful to serve as medical information for laypersons. Oliver Sacks, however, wrote great literature.
Collapse
Affiliation(s)
- Joost Haan
- Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ad A Kaptein
- Department of Medical Psychology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bastiaan C ter Meulen
- Department of Neurology, St Lucas Andreas Hospital, Amsterdam and Zaans Medisch Centrum, Zaandam, The Netherlands
| |
Collapse
|
21
|
Ophoff R, Terwindt G, Vergouwe M, van Eijk R, Mohrenweiser H, Litt M, Hofker M, Haan J, Ferrari M, Frants R. A 3-Mb Region for the Familial
Hemiplegie Migraine Locus on
19p13.1-p13.2: Exclusion of
PRKCSH as a Candidate Gene. Eur J Hum Genet 2017. [DOI: 10.1159/000472226] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
22
|
Ignatiadis M, Rothé F, Peeters D, Rouas G, Smeets D, Haan J, Lambrechts D, Campbell P, Piccart M, Voet T, Dirix L, Venet D, Sotiriou C. Abstract P1-01-10: Exome sequencing of circulating tumor cells in metastatic breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-01-10] [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]
Abstract
Abstract
Aim: We interrogated whether Circulating Tumor Cells (CTCs) can complement metastatic biopsies for genomic analyses.
Patients and Methods: We compared single nucleotide variants (SNVs) and copy number aberrations (CNAs) identified using whole exome sequencing (WES) of DNA from frozen tumor tissue (primary/metastasis), amplified DNA from CTCs and normal DNA from 3 metastatic breast cancer (BC) patients (pts). All samples of the same patient were collected at the same timepoint. CTC isolation was performed using CellSearch and DEPArray systems followed by whole genome amplification (Ampli1 kit). WES was performed using the Illumina HiSeq2000 with 200X targeted coverage. Reads were aligned using bwa. SNVs had to be called by both Haplotype Caller (vs. reference genome) and Strelka (vs. paired normal). CNAs were determined by counting reads in 1MB windows and by comparing tumor/CTC samples with normal DNA. Pairwise concordance of CNAs profiles of different samples from the same patient was assessed using Spearman correlation (ρ). Significance of ρ differences between pts was obtained by Kruskal-Wallis test. Orthogonal validation for selected SNVs was performed.
Results: We studied 3 patients from the 3 major BC subtypes, patient (pt)1 with ER-/HER2+ BC (samples collected at diagnosis, initially metastatic disease), pt2 with triple-negative BC (samples collected 2 years from diagnosis) and pt3 with ER+/HER2- BC (samples collected 8 years from diagnosis).
We first compared tumor tissue and CTCs for SNVs. For pt1, of the 77 SNVs identified in the tumor, 51 were found on at least one of 12 CTCs samples. For pt2, of the 62 SNVs identified in the tumor, 19 were found on at least 1 of 11 CTCs samples. For pt3, of the 225 SNVs identified in the tumor, 48 were found on at least 1 of 3 CTCs samples. Interestingly, by increasing the number of CTCs analyzed, we increased the % of identified SNVs from synchronous tumor tissue. SNVs with high variant allele fraction (VAF) in tumor tissue were detected significantly more often in CTCs: 22% of the SNVs with VAFs <20% were found at least once, compared to 53% and 74% of SNVs with VAFs >20% and >40%, respectively (p=10-12, Fisher exact test).
Then, we compared tumor tissue and CTCs for CNAs. As time from diagnosis of metastatic disease to samples collection increased, we observed significantly higher heterogeneity within CTCs from the same patient (median ρ between CTCs was 86% for pt1, 84% for pt2 and 28% for pt3, p<0.01) and between CTCs and tumor tissue from the same patient (median ρ was 78% for pt1, 67% for pt2 and 21% for pt3, p<10-4). Interestingly, in pt3 one CTC was more similar to the metastasis than the other 2 (ρ of 53%, 21% and 21%). When a phylogenetic tree was constructed for pt3 by combining SNVs and CNAs data, three clones were identified: one clone with an AKT1 (E17K) and a TP53 (R248W) mutation and a 8p deletion, a second clone with the above profile plus an 8q amplification and a third clone with an AKT1 and an ESR1 (Y537N) mutation and 1p deletion. The metastasis was similar with the first clone.
Conclusions: These data suggest that tumor tissue and single CTC exome sequencing analyses provide complementary information to map tumor heterogeneity. Further validation for potential clinical applications is needed.
Citation Format: Ignatiadis M, Rothé F, Peeters D, Rouas G, Smeets D, Haan J, Lambrechts D, Campbell P, Piccart M, Voet T, Dirix L, Venet D, Sotiriou C. Exome sequencing of circulating tumor cells in metastatic breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-01-10.
Collapse
Affiliation(s)
- M Ignatiadis
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - F Rothé
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Peeters
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - G Rouas
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Smeets
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - J Haan
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Lambrechts
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - P Campbell
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - M Piccart
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - T Voet
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - L Dirix
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - D Venet
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| | - C Sotiriou
- Jules Bordet Institut, Brussels, Belgium; Antwerp University Hospital, Anwerp, Belgium; KU Leuven, Leuven, Belgium; Sanger Institute, United Kingdom
| |
Collapse
|
23
|
de Coo I, van Dijk JMC, Metzemaekers JD, Haan J. A Case Report About Cluster-Tic Syndrome Due to Venous Compression of the Trigeminal Nerve. Headache 2016; 57:654-657. [DOI: 10.1111/head.12990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 01/03/2023]
Affiliation(s)
- Ilse de Coo
- Department of Neurology; Leiden University Medical Center; Leiden The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery; University Medical Center Groningen; Groningen The Netherlands
| | | | - Joost Haan
- Department of Neurology; Leiden University Medical Center; Leiden The Netherlands
| |
Collapse
|
24
|
van Etten ES, Verbeek MM, van der Grond J, Zielman R, van Rooden S, van Zwet EW, van Opstal AM, Haan J, Greenberg SM, van Buchem MA, Wermer MJH, Terwindt GM. β-Amyloid in CSF: Biomarker for preclinical cerebral amyloid angiopathy. Neurology 2016; 88:169-176. [PMID: 27903811 DOI: 10.1212/wnl.0000000000003486] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/29/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To investigate CSF biomarkers in presymptomatic and symptomatic mutation carriers with hereditary cerebral hemorrhage with amyloidosis-Dutch type (HCHWA-D), a model for sporadic cerebral amyloid angiopathy, and to determine the earliest deposited form of β-amyloid (Aβ). METHODS HCHWA-D mutation carriers and controls were enrolled in the cross-sectional EDAN (Early Diagnosis of Amyloid Angiopathy Network) study. The HCHWA-D group was divided into symptomatic carriers with a previous intracerebral hemorrhage and presymptomatic carriers. CSF concentrations of Aβ40, Aβ42, total tau, and phosphorylated tau181 proteins were compared to those of controls of a similar age. Correlations between CSF biomarkers, MRI markers, and age were investigated with multivariate linear regression analyses. RESULTS We included 10 symptomatic patients with HCHWA-D (mean age 55 ± 6 years), 5 presymptomatic HCHWA-D carriers (mean age 36 ± 13 years), 31 controls <50 years old (mean age 31 ± 7 years), and 50 controls ≥50 years old (mean age 61 ± 8 years). After correction for age, CSF Aβ40 and Aβ42 were significantly decreased in symptomatic carriers vs controls (median Aβ40 1,386 vs 3,867 ng/L, p < 0.001; median Aβ42 289 vs 839 ng/L, p < 0.001) and in presymptomatic carriers vs controls (median Aβ40 3,501 vs 4,684 ng/L, p = 0.011; median Aβ42 581 vs 1,058 ng/L, p < 0.001). Among mutation carriers, decreasing CSF Aβ40 was associated with higher lobar microbleed count (p = 0.010), increasing white matter hyperintensity volume (p = 0.008), and presence of cortical superficial siderosis (p = 0.02). CONCLUSIONS Decreased levels of CSF Aβ40 and Aβ42 occur before HCHWA-D mutation carriers develop clinical symptoms, implicating vascular deposition of both Aβ species as early steps in cerebral amyloid angiopathy pathogenesis. CSF Aβ40 and Aβ42 may serve as preclinical biomarkers of cerebral amyloid angiopathy pathology.
Collapse
Affiliation(s)
- Ellis S van Etten
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston.
| | - Marcel M Verbeek
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Jeroen van der Grond
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Ronald Zielman
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Sanneke van Rooden
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Erik W van Zwet
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Anna M van Opstal
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Joost Haan
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Steven M Greenberg
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Mark A van Buchem
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Marieke J H Wermer
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| | - Gisela M Terwindt
- From the Departments of Neurology (E.S.v.E., R.Z., J.H., M.J.H.W., G.M.T.), Radiology (J.v.d.G., S.v.R., A.M.v.O., M.A.v.B.), and Biostatistics (E.W.v.Z.), Leiden University Medical Center; Departments of Neurology and Laboratory Medicine (M.M.V.), Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen; Department of Neurology (J.H.), Alrijne Hospital, Leiderdorp, the Netherlands; and J. Philip Kistler Stroke Research Center (S.M.G.), Massachusetts General Hospital, Boston
| |
Collapse
|
25
|
Louter MA, Wilbrink LA, Haan J, van Zwet EW, van Oosterhout WP, Zitman FG, Ferrari MD, Terwindt GM. Cluster headache and depression. Neurology 2016; 87:1899-1906. [DOI: 10.1212/wnl.0000000000003282] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/18/2016] [Indexed: 11/15/2022] Open
|
26
|
van Etten ES, Gurol ME, van der Grond J, Haan J, Viswanathan A, Schwab KM, Ayres AM, Algra A, Rosand J, van Buchem MA, Terwindt GM, Greenberg SM, Wermer MJH. Recurrent hemorrhage risk and mortality in hereditary and sporadic cerebral amyloid angiopathy. Neurology 2016; 87:1482-1487. [PMID: 27590282 DOI: 10.1212/wnl.0000000000003181] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 06/16/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether hereditary cerebral hemorrhage with amyloidosis-Dutch type (HCHWA-D), a monogenetic disease model for the sporadic variant of amyloid angiopathy (sCAA), has a comparable recurrent intracerebral hemorrhage (ICH) risk and mortality after a first symptomatic ICH. METHODS We included patients with HCHWA-D from the Leiden University Medical Center and patients with sCAA from the Massachusetts General Hospital in a cohort study. Baseline characteristics, hemorrhage recurrence, and short- and long-term mortality were compared. Hazard ratios (HRs) adjusted for age and sex were calculated with Cox regression analyses. RESULTS We included 58 patients with HCHWA-D and 316 patients with sCAA. Patients with HCHWA-D had fewer cardiovascular risk factors (≥1 risk factor 24% vs 70% in sCAA) and were younger at the time of presenting hemorrhage (mean age 54 vs 72 years in sCAA). Eight patients (14%) with HCHWA-D and 46 patients (15%) with sCAA died before 90 days. During a mean follow-up time of 5 ± 4 years (total 1,550 person-years), the incidence rate of recurrent ICH in patients with HCHWA-D was 20.9 vs 8.9 per 100 person-years in sCAA. Patients with HCHWA-D had a long-term mortality of 8.2 vs 8.4 per 100 person-years in patients with sCAA. After adjustments, patients with HCHWA-D had a higher risk of recurrent ICH (HR 2.8; 95% confidence interval 1.6-4.9; p < 0.001) and a higher long-term mortality (HR 2.8; 95% confidence interval 1.5-5.2; p = 0.001). CONCLUSIONS Patients with HCHWA-D have worse long-term prognosis after a first ICH than patients with sCAA. The absence of cardiovascular risk factors in most patients with HCHWA-D suggests that vascular amyloid is responsible for the recurrent hemorrhages. HCHWA-D is therefore a pure form of cerebral amyloid angiopathy with an accelerated clinical course and provides a good model to study the pathophysiology and future therapeutic interventions of amyloid-related hemorrhages.
Collapse
Affiliation(s)
- Ellis S van Etten
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston.
| | - M Edip Gurol
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jeroen van der Grond
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Joost Haan
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Anand Viswanathan
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Kristin M Schwab
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Alison M Ayres
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Ale Algra
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jonathan Rosand
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Mark A van Buchem
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Gisela M Terwindt
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Steven M Greenberg
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Marieke J H Wermer
- From the Departments of Neurology (E.S.v.E., J.H., G.M.T., M.J.H.W.), Radiology (J.v.d.G., M.A.v.B.), and Clinical Epidemiology (A.A.), Leiden University Medical Center; Department of Neurology (J.H.), Alrijne Hospital; Department of Neurology and Neurosurgery (A.A.), Brain Center Rudolf Magnus and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands; Hemorrhagic Stroke Research Program (M.E.G., A.V., K.M.S., A.M.A., S.M.G.), Department of Neurology, Massachusetts General Hospital Stroke Research Center; and Division of Neurocritical Care and Emergency Neurology (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston
| |
Collapse
|
27
|
Abstract
Objective To evaluate the presence, localization, and specificity of structural hypothalamic and whole brain changes in cluster headache and chronic paroxysmal hemicrania (CPH). Methods We compared T1-weighted magnetic resonance images of subjects with cluster headache (episodic n = 24; chronic n = 23; probable n = 14), CPH ( n = 9), migraine (with aura n = 14; without aura n = 19), and no headache ( n = 48). We applied whole brain voxel-based morphometry (VBM) using two complementary methods to analyze structural changes in the hypothalamus: region-of-interest analyses in whole brain VBM, and manual segmentation of the hypothalamus to calculate volumes. We used both conservative VBM thresholds, correcting for multiple comparisons, and less conservative thresholds for exploratory purposes. Results Using region-of-interest VBM analyses mirrored to the headache side, we found enlargement ( p < 0.05, small volume correction) in the anterior hypothalamic gray matter in subjects with chronic cluster headache compared to controls, and in all participants with episodic or chronic cluster headache taken together compared to migraineurs. After manual segmentation, hypothalamic volume (mean±SD) was larger ( p < 0.05) both in subjects with episodic (1.89 ± 0.18 ml) and chronic (1.87 ± 0.21 ml) cluster headache compared to controls (1.72 ± 0.15 ml) and migraineurs (1.68 ± 0.19 ml). Similar but non-significant trends were observed for participants with probable cluster headache (1.82 ± 0.19 ml; p = 0.07) and CPH (1.79 ± 0.20 ml; p = 0.15). Increased hypothalamic volume was primarily explained by bilateral enlargement of the anterior hypothalamus. Exploratory whole brain VBM analyses showed widespread changes in pain-modulating areas in all subjects with headache. Interpretation The anterior hypothalamus is enlarged in episodic and chronic cluster headache and possibly also in probable cluster headache or CPH, but not in migraine.
Collapse
Affiliation(s)
- Enrico B Arkink
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicole Schmitz
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Guus G Schoonman
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,3 Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Jorine A van Vliet
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,4 Department of Neurology, Slingeland Hospital, Doetinchem, The Netherlands
| | - Joost Haan
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Mark A van Buchem
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michel D Ferrari
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark C Kruit
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
28
|
Koppen H, Stolwijk J, Wilms EB, van Driel V, Ferrari MD, Haan J. Cardiac monitoring of high-dose verapamil in cluster headache: An international Delphi study. Cephalalgia 2016; 36:1385-1388. [DOI: 10.1177/0333102416631968] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/04/2016] [Accepted: 01/07/2016] [Indexed: 11/16/2022]
Abstract
Background In many patients, high-dose verapamil (HDV) is the only effective prophylactic treatment for cluster headache. Although cardiac adverse events and EKG abnormalities are relatively common, evidence-based guidelines for screening and monitoring patients on HDV are lacking. Goal and methods Using the Delphi approach, we interviewed 22 international clinical experts in cardiac rhythm disorders to formulate EKG guidelines for the pretreatment screening and monitoring of cluster headache patients using HDV. Results The panel agreed only on performing pretreatment EKG to screen for pre-existing cardiac arrhythmia. Pretreatment EKG was deemed not necessary by most panel members for patients who did not have cardiac adverse events during a previous period of cluster headache attacks treated with HDV. Half the panel advised Holter EKG for patients on verapamil ≥ 480 mg/day. The highest recommended daily doses varied between 240 and 960 mg. Contraindications for use of verapamil largely followed FDA guidelines. Discussion Experts in cardiac rhythm disorders agreed on pretreatment EKG monitoring, but no consensus was reached on EKG monitoring during HDV treatment and around dose adjustments.
Collapse
Affiliation(s)
- H Koppen
- Department of Neurology, Haga Hospital, The Netherlands
| | - J Stolwijk
- Department of Neurology, Haga Hospital, The Netherlands
| | - EB Wilms
- Department of Clinical Pharmacy, Haga Hospital, The Netherlands
| | - V van Driel
- Department of Cardiology Haga Hospital, The Netherlands
| | - MD Ferrari
- Department of Neurology, Leiden University Medical Center, The Netherlands
| | - J Haan
- Department of Neurology, Rijnland Hospital Leiderdorp and Leiden University Medical Center, The Netherlands
| |
Collapse
|
29
|
van Vliet JA, Eekers PJE, Haan J, Ferrari MD. Evaluating the IHS Criteria for Cluster Headache – a Comparison between Patients Meeting all Criteria and Patients Failing One Criterion. Cephalalgia 2016; 26:241-5. [PMID: 16472329 DOI: 10.1111/j.1468-2982.2006.00932.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [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: 11/29/2022]
Abstract
Cluster headache (CH) is diagnosed according to criteria of the International Headache Society (IHS), but, in clinical practice, these criteria seem too restrictive. As part of a nation-wide study, we identified a group of patients who met all criteria minus one (IHS-CH-1), and assessed in which way they differed from CH patients meeting all criteria (IHS-CH). We performed a nation-wide questionnaire study for CH and CH-like syndromes, including questions based on the IHS criteria, and additional features such as restlessness during attacks, nocturnal onset of attacks, circadian rhythmicity of attacks and response to treatment. IHS-CH and IHS-CH-1 patients were compared. Of 1452 responders to two questionnaires, 1163 were IHS-CH and 289 were IHS-CH-1. The majority of the IHS-CH-1 patients were classified as such because their attacks exceeded 3 h (64%, median attack duration: 5 h), or came in a frequency of less than 1 per 2 days (16%). Age at onset was similar between the groups. The male to female ratio was 3.7 : 1 in the IHS-CH group and around 1.6 : 1 in the IHS-CH-1 groups ( P < 0.005). Patients with attacks exceeding 3 h less often reported a circadian rhythmicity (IHS-CH-1: 49%, IHS-CH: 64%), episodic periodicity (IHS-CH-1: 65%, IHS-CH: 78%), nocturnal attacks (IHS-CH-1: 67%, IHS-CH: 78%), smoking (IHS-CH-1: 90%, IHS-CH: 80%) and restlessness during attacks (IHS-CH-1: 64%, IHS-CH: 76%) than IHS-CH patients ( P < 0.005). Photo- or phono-phobia (IHS-CH-1: 67%, IHS-CH: 54%) and nausea (IHS-CH-1: 38%, IHS-CH: 27%) were more frequently reported by patients who reported to have attacks exceeding 3 h ( P < 0.005). Similar proportions reported effect of verapamil on their attacks (IHS-CH-1: 54%, IHS-CH 61%). We conclude that average attack duration exceeding 3 h was frequently the reason for not fulfilling IHS CH criteria. Symptoms often accompanying CH such as restlessness, nocturnal attacks and an episodic attack pattern were relatively frequently present in IHS-CH-1 patients with longer attacks. These patients may therefore be diagnosed with CH. Attack frequency may not be a useful criterion for the diagnosis of CH. The upper limit of 3 h should be increased in future diagnostic criteria.
Collapse
Affiliation(s)
- J A van Vliet
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | | | | | | |
Collapse
|
30
|
Hottenga JJ, Vanmolkot KRJ, Kors EE, Kheradmand Kia S, de Jong PTVM, Haan J, Terwindt GM, Frants RR, Ferrari MD, van den Maagdenberg AMJM. The 3p21.1-p21.3 Hereditary Vascular Retinopathy Locus Increases the Risk for Raynaud's Phenomenon and Migraine. Cephalalgia 2016; 25:1168-72. [PMID: 16305605 DOI: 10.1111/j.1468-2982.2005.00994.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 11/27/2022]
Abstract
Previously, we described a large Dutch family with hereditary vascular retinopathy (HVR), Raynaud's phenomenon and migraine. A locus for HVR was mapped on chromosome 3p21.1-p21.3, but the gene has not yet been identified. The fact that all three disorders share a vascular aetiology prompted us to study whether the HVR haplotype also contributed to Raynaud's phenomenon and migraine in this family. Whereas the parent-child transmission disequilibrium test (TDT) did not reach significance, the sibling TDT revealed that the HVR haplotype harbours a susceptibility factor for Raynaud's phenomenon and migraine. Identification of the HVR gene will improve the understanding of the pathophysiology of HVR, Raynaud's phenomenon and migraine.
Collapse
Affiliation(s)
- J J Hottenga
- Department of Human Genetics, Leiden University Medical Centre, Leiden, and Department of Neurology, Rijnland Hospital, Leiderdorp, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Abstract
Although migraine is less prevalent in older than in younger age groups, the absolute increase in the number of subjects in older age groups may lead to an increase in the total number of migraine patients. Consequently, more elderly migraine patients may seek medical attention. In this review, the epidemiology and clinical aspects of migraine in the age group of ≥60 years are summarized, with special attention to comorbidity. The review will focus on treatment choices in elderly migraine patients. These must be based on knowledge of mechanisms of physiological and pathological ageing.
Collapse
Affiliation(s)
- J Haan
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands.
| | | | | |
Collapse
|
32
|
de Coo IF, Haan J. Long Lasting Impairment of Taste and Smell as Side Effect of Lithium Carbonate in a Cluster Headache Patient. Headache 2016; 56:1201-3. [PMID: 27317012 DOI: 10.1111/head.12872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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: 04/06/2016] [Accepted: 04/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Preventive treatment with lithium carbonate is a therapeutic option for chronic cluster headache. Lithium can lead to a broad spectrum of severe side effects, many of which are generally unknown. CASE DESCRIPTION One week after starting treatment with lithium, a 55-year-old man with chronic cluster headache noticed a strange and unpleasant taste of various foods and a diminished smell. After 4 weeks, he decided to stop the therapy because of these complaints, but 9 months later both taste and smell still had not returned to normal. DISCUSSION We present the first description of long-lasting dysgeusia and hyposmia as a side effect of lithium therapy in cluster headache. Dysgeusia has only rarely been reported as a side effect of lithium in other conditions and hyposmia has not previously been reported. Physicians should be aware of this rare, but severe, side effect when prescribing lithium.
Collapse
Affiliation(s)
- Ilse F de Coo
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| |
Collapse
|
33
|
Pelzer N, Blom DE, Stam AH, Vijfhuizen LS, Hageman A, van Vliet JA, Ferrari MD, van den Maagdenberg A, Haan J, Terwindt GM. Recurrent coma and fever in familial hemiplegic migraine type 2. A prospective 15-year follow-up of a large family with a novel ATP1A2 mutation. Cephalalgia 2016; 37:737-755. [PMID: 27226003 DOI: 10.1177/0333102416651284] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Familial hemiplegic migraine (FHM) is a rare monogenic migraine subtype characterised by attacks associated with transient motor weakness. Clinical information is mainly based on reports of small families with only short follow-up. Here, we document a prospective 15-year follow-up of an extended family with FHM type 2. Patients and methods After diagnosing FHM in a patient with severe attacks associated with coma and fever, we identified eight more family members with FHM and one with possible FHM. All family members were prospectively followed for 15 years. In total 13 clinically affected and 21 clinically non-affected family members were genetically tested and repeatedly investigated. Results A novel p.Arg348Pro ATP1A2 mutation was found in 14 family members: 12 with clinical FHM, one with psychomotor retardation and possible FHM, and one without FHM features. In 9/12 (75%) family members with genetically confirmed FHM, attacks were severe, long-lasting, and often associated with impaired consciousness and fever. Such attacks were frequently misdiagnosed and treated as viral meningitis or stroke. Epilepsy was reported in three family members with FHM and in the one with psychomotor retardation and possible FHM. Ataxia was not observed. Conclusion FHM should be considered in patients with recurrent coma and fever.
Collapse
Affiliation(s)
- N Pelzer
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - D E Blom
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - A H Stam
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - L S Vijfhuizen
- 2 Department of Human Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Atm Hageman
- 3 Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands
| | - J A van Vliet
- 4 Department of Neurology, Slingeland Hospital, Doetinchem, the Netherlands
| | - M D Ferrari
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Amjm van den Maagdenberg
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.,2 Department of Human Genetics, Leiden University Medical Centre, Leiden, the Netherlands
| | - J Haan
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands.,5 Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| | - G M Terwindt
- 1 Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
34
|
van Oosterhout WPJ, Cheung C, Haan J. Primary headache syndromes in the elderly: epidemiology, diagnosis and treatment. J Clin Transl Res 2016; 2:45-51. [PMID: 30873460 PMCID: PMC6410655] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 02/18/2016] [Accepted: 02/19/2016] [Indexed: 12/04/2022] Open
Abstract
Although secondary headaches due to e.g. temporal arteritis or a brain tumor are common among the elderly, primary headache disorders also occur in this age group, albeit less frequently than in younger individuals. A different presentation in the older age groups often makes a diagnosis difficult. Some headache syndromes, such as hypnic headache, are typical for the elderly. Furthermore, age-related physiologic changes, co-morbidities and contra indications require appropriate and targeted treatment in the elderly. Although treatments for the most common primary headaches are available, many limitations hamper their use in this group. For many headaches syndromes randomized controlled treatment trials in elderly are not available. In this article we review the clinical aspects of common primary headaches and medication overuse headache in the elderly and their treatments, with emphasis on age-specific problems. Relevance for patients: Primary headache syndromes in older patients ask for specific treatment considerations due to comorbidity, polypharmacy and an increased risk of side effects. Clinically, the headaches can be different and atypical. Results from clinical trials cannot be generalized to the elderly because these groups usually are not included in studies. In migraine, non-pharmacologic treatment should be considered, with depression and cerebrovascular disease as major comorbidities. Tension type headache, being the most common headache presentation in elderly, also includes a relatively large proportion of patients with a secondary headache warranting further testing. Trigeminal autonomous cephalalgias are rare, and can present with pseudo dementia. Medication overuse and medication-induced headaches are relatively common, for which patient education, ceasing drugs and withdrawal from caffeine containing substances are pivotal. Furthermore, hypnic headache, exploding head syndrome and benign thunderclap headache are specific for this patient group and require specific treatment.
Collapse
Affiliation(s)
| | - Carlo Cheung
- Department of Neurology, Medical Center Haaglanden, the Hague, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands,Department of Neurology, Alrijne Hospital, Leiderdorp, the Netherlands
| |
Collapse
|
35
|
Arkink EB, Schoonman GG, van Vliet JA, Bakels HS, Sneeboer MA, Haan J, van Buchem MA, Ferrari MD, Kruit MC. The cavernous sinus in cluster headache - a quantitative structural magnetic resonance imaging study. Cephalalgia 2016; 37:208-213. [PMID: 27009562 DOI: 10.1177/0333102416640513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background It has been hypothesized that a constitutionally narrow cavernous sinus might predispose individuals to cluster headache. Cavernous sinus dimensions, however, have never been assessed. Methods In this case-control study, we measured the dimensions of the cavernous sinus, skull base, internal carotid and pituitary gland with high-resolution T2-weighted magnetic resonance imaging in 25 episodic, 24 chronic and 13 probable cluster headache patients, 8 chronic paroxysmal hemicrania patients and 22 headache-free controls. Dimensions were compared between groups, correcting for age, sex and transcranial diameter. Results On qualitative inspection, no relevant pathology or anatomic variants that were previously associated with cluster headache or chronic paroxysmal hemicranias were observed in the cavernous sinus or paracavernous structures. The left-to-right transcranial diameter at the temporal fossa level (mean ± SD) was larger in the headache groups (episodic cluster headache: 147.5 ± 7.3 mm, p = 0.044; chronic cluster headache: 150.2 ± 7.3 mm, p < 0.001; probable cluster headache: 146.0 ± 5.3 mm, p = 0.012; and chronic paroxysmal hemicrania: 145.2 ± 9.4 mm, p = 0.044) compared with controls (140.2 ± 8.0 mm). After adjusting for transcranial diameter and correcting for multiple comparisons, there were no differences in the dimensions of the cavernous sinus and surrounding structures between headache patients and controls. Conclusion Patients with cluster headache or chronic paroxysmal hemicrania had wider skulls than headache-free controls, but the proportional dimensions of the cavernous sinus were similar.
Collapse
Affiliation(s)
- Enrico B Arkink
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Guus G Schoonman
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,3 Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Jorine A van Vliet
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,4 Department of Neurology, Slingeland Hospital, Doetinchem, The Netherlands
| | - Hannah S Bakels
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marjolein Am Sneeboer
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Joost Haan
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,5 Department of Neurology, Alrijne Hospital, Leiderdorp, The Netherlands
| | - Mark A van Buchem
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michel D Ferrari
- 2 Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark C Kruit
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
36
|
Abstract
Trigeminal autonomic cephalalgias (TACs) are primary headache syndromes that share some clinical features such as a trigeminal distribution of the pain and accompanying ipsilateral autonomic symptoms. By definition, no underlying structural lesion for the phenotype is found. There are, however, many descriptions in the literature of patients with structural lesions causing symptoms that are indistinguishable from those of idiopathic TACs. In this article, we review the recent insights in symptomatic TACs by comparing and categorizing newly published cases. We confirm that symptomatic TACs can have typical phenotypes. It is of crucial importance to identify symptomatic TACs, as the underlying cause will influence treatment and outcome. Our update focuses on when a structural lesion should be sought.
Collapse
Affiliation(s)
- Ilse F de Coo
- Department of Neurology Leiden University Medical Centre, Leiden, The Netherlands,
| | | | | |
Collapse
|
37
|
van Oosterhout WPJ, Haan J, Kruyt ND. [A patient with Melkersson-Rosenthal syndrome]. Ned Tijdschr Geneeskd 2016; 160:D427. [PMID: 27781965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Melkersson-Rosenthal syndrome (MRS) is a relatively rare syndrome characterised by the clinical triad of persisting or recurrent facial oedema, recurrent peripheral facial palsy, and a fissured tongue. CASE DESCRIPTION A 30-year-old male patient presented with a left peripheral facial palsy spreading to the right side of the face. The left-sided facial paralysis recurred twice after initial recovery. The patient had also suffered from oedema of the lip and face, which sometimes occurred simultaneously with the paralysis, and he had always had a fissured tongue. Extensive biochemical tests, tests for infection and imaging tests revealed no abnormalities, and MRS was diagnosed. No treatment was required as the symptoms always disappeared spontaneously. CONCLUSION Patients with MRS can present to the general practitioner, dermatologist, or ENT-specialist as well as to the neurologist. As this is a relatively unknown syndrome, the diagnosis is often made late, and it is often over-diagnosed and over-treated. There is no proven effective treatment, but systemic corticosteroids can be considered.
Collapse
|
38
|
|
39
|
de Coo IF, Wilbrink LA, Haan J, Ferrari MD, Terwindt GM. Evaluation of the new ICHD-III beta cluster headache criteria. Cephalalgia 2015; 36:547-51. [DOI: 10.1177/0333102415607856] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 08/27/2015] [Indexed: 11/15/2022]
Abstract
Aim In the revised criteria of the International Classification of Headache Disorders (ICHD-III beta) the following items are added to the diagnostic criteria of cluster headache: ipsilateral sensation of fullness in the ear and ipsilateral forehead/facial flushing. We evaluated the possible additional value of these symptoms for diagnosing cluster headache. Methods In this cross-sectional cohort study of (potential) cluster headache patients we investigated these additional symptoms using a Web-based questionnaire. Patients not fulfilling the ICHD-II criteria for cluster headache but fulfilling the ICHD-III beta criteria were interviewed. Results Response rate was 916/1138 (80.5%). Of all 573 patients with cluster headache according to ICHD-II criteria, 192 (33.5%) reported ipsilateral ear fullness and 113 (19.7%) facial flushing during attacks. There was no difference in reporting ipsilateral ear fullness and facial flushing between patients who received a diagnosis of cluster headache and patients who did not. None of the patients who did not fulfill all ICHD-II criteria could be categorized as cluster headache according to the ICHD-III beta criteria. Conclusion The results of this study do not support the addition of ear fullness and facial flushing to the new ICHD-III beta criteria.
Collapse
Affiliation(s)
- IF de Coo
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - LA Wilbrink
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - J Haan
- Department of Neurology, Leiden University Medical Center, the Netherlands
- Department of Neurology, Alrijne Hospital, the Netherlands
| | - MD Ferrari
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - GM Terwindt
- Department of Neurology, Leiden University Medical Center, the Netherlands
| |
Collapse
|
40
|
Affiliation(s)
- Ilse F de Coo
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | | | - Joost Haan
- Department of Neurology, Leiden University Medical Center, the Netherlands
- Department of Neurology, Alrijne Hospital, the Netherlands
| |
Collapse
|
41
|
Weller CM, Wilbrink LA, Houwing-Duistermaat JJ, Koelewijn SC, Vijfhuizen LS, Haan J, Ferrari MD, Terwindt GM, van den Maagdenberg AMJM, de Vries B. Cluster headache and the hypocretin receptor 2 reconsidered: A genetic association study and meta-analysis. Cephalalgia 2014; 35:741-7. [DOI: 10.1177/0333102414557839] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 10/04/2014] [Indexed: 11/15/2022]
Abstract
Background Cluster headache is a severe neurological disorder with a complex genetic background. A missense single nucleotide polymorphism (rs2653349; p.Ile308Val) in the HCRTR2 gene that encodes the hypocretin receptor 2 is the only genetic factor that is reported to be associated with cluster headache in different studies. However, as there are conflicting results between studies, we re-evaluated its role in cluster headache. Methods We performed a genetic association analysis for rs2653349 in our large Leiden University Cluster headache Analysis (LUCA) program study population. Systematic selection of the literature yielded three additional studies comprising five study populations, which were included in our meta-analysis. Data were extracted according to predefined criteria. Results A total of 575 cluster headache patients from our LUCA study and 874 controls were genotyped for HCRTR2 SNP rs2653349 but no significant association with cluster headache was found (odds ratio 0.91 (95% confidence intervals 0.75–1.10), p = 0.319). In contrast, the meta-analysis that included in total 1167 cluster headache cases and 1618 controls from the six study populations, which were part of four different studies, showed association of the single nucleotide polymorphism with cluster headache (random effect odds ratio 0.69 (95% confidence intervals 0.53–0.90), p = 0.006). The association became weaker, as the odds ratio increased to 0.80, when the meta-analysis was repeated without the initial single South European study with the largest effect size. Conclusions Although we did not find evidence for association of rs2653349 in our LUCA study, which is the largest investigated study population thus far, our meta-analysis provides genetic evidence for a role of HCRTR2 in cluster headache. Regardless, we feel that the association should be interpreted with caution as meta-analyses with individual populations that have limited power have diminished validity.
Collapse
Affiliation(s)
- Claudia M Weller
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | | | | | | | | | - Joost Haan
- Department of Neurology, Leiden University Medical Centre, the Netherlands
- Department of Neurology, Rijnland Hospital, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Arn MJM van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
- Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| |
Collapse
|
42
|
Haan J, Koehler PJ. Traces of hysteria in novels. Front Neurol Neurosci 2014; 35:99-108. [PMID: 25273493 DOI: 10.1159/000360063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There have been many descriptions of presumed 'hysterics' in fiction, many appearing in French literature, but also in a number of other languages. It is clear that contemporary medical ideas and insights about hysteria had a major influence on its depiction in novels. This is particularly true for naturalistic literature, which has been the subject of previous reviews. Here, we focus on a more recent novel: Human Traces by Sebastian Faulks (2005). What is special about the depiction of hysteria in this work is that the presumed 'hysteric' turns out not to be hysteric at all. In the novel, as well as in this chapter, the diagnosis of hysteria is discussed in the light of theories about hysteria of around 1900. For comparison, we present some examples of true 'hysterics' as they occur in fiction. Since it has become clear that severe nonpsychiatric diseases such as an ovarian teratoma can lead to bizarre phenotypes, the association of 'hysteria' with the womb has to be seen in another light.
Collapse
Affiliation(s)
- Joost Haan
- Department of Neurology, Rijnland Hospital Leiderdorp, Leiderdorp, The Netherlands
| | | |
Collapse
|
43
|
Pelzer N, de Vries B, Kamphorst JT, Vijfhuizen LS, Ferrari MD, Haan J, van den Maagdenberg AMJM, Terwindt GM. PRRT2 and hemiplegic migraine: A complex association. Neurology 2014; 83:288-90. [DOI: 10.1212/wnl.0000000000000590] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
44
|
Rutten JW, Haan J, Terwindt GM, van Duinen SG, Boon EMJ, Lesnik Oberstein SAJ. Interpretation ofNOTCH3mutations in the diagnosis of CADASIL. Expert Rev Mol Diagn 2014; 14:593-603. [DOI: 10.1586/14737159.2014.922880] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
45
|
Weller CM, Leen WG, Neville BGR, Duncan JS, de Vries B, Geilenkirchen MA, Haan J, Kamsteeg EJ, Ferrari MD, van den Maagdenberg AMJM, Willemsen MAAP, Scheffer H, Terwindt GM. A novel SLC2A1 mutation linking hemiplegic migraine with alternating hemiplegia of childhood. Cephalalgia 2014; 35:10-5. [PMID: 24824604 DOI: 10.1177/0333102414532379] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Hemiplegic migraine (HM) and alternating hemiplegia of childhood (AHC) are rare episodic neurological brain disorders with partial clinical and genetic overlap. Recently, ATP1A3 mutations were shown to account for the majority of AHC patients. In addition, a mutation in the SLC2A1 gene was reported in a patient with atypical AHC. We therefore investigated whether mutations in these genes may also be involved in HM. Furthermore, we studied the role of SLC2A1 mutations in a small set of AHC patients without ATP1A3 mutations. METHODS We screened 42 HM patients (21 familial and 21 sporadic patients) for ATP1A3 and SLC2A1 mutations. In addition, four typical AHC patients and one atypical patient with overlapping symptoms of both disorders were screened for SLC2A1 mutations. RESULTS A pathogenic de novo SLC2A1 mutation (p.Gly18Arg) was found in the atypical patient with overlapping symptoms of AHC and hemiplegic migraine. No mutations were found in the HM and the other AHC patients. CONCLUSION Screening for a mutation in the SLC2A1 gene should be considered in patients with a complex phenotype with overlapping symptoms of hemiplegic migraine and AHC.
Collapse
Affiliation(s)
- Claudia M Weller
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | - Wilhelmina G Leen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, the Netherlands
| | - Brian G R Neville
- Neurosciences Unit, Institute of Child Health, UCL Medical School and Great Ormond Street Hospital for Children NHS Trust, UK
| | | | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | | | - Joost Haan
- Neurosciences Unit, Institute of Child Health, UCL Medical School and Great Ormond Street Hospital for Children NHS Trust, UK Department of Neurology, Rijnland Hospital, the Netherlands
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Institute for Genetic and Metabolic Disease, Radboud University Medical Centre, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Centre, the Netherlands Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Michèl A A P Willemsen
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, the Netherlands
| | - Hans Scheffer
- Department of Human Genetics, Institute for Genetic and Metabolic Disease, Radboud University Medical Centre, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, the Netherlands
| |
Collapse
|
46
|
Weller CM, Pelzer N, de Vries B, López MA, De Fàbregues O, Pascual J, Arroyo MAR, Koelewijn SC, Stam AH, Haan J, Ferrari MD, Terwindt GM, van den Maagdenberg AMJM. Two novel SCN1A mutations identified in families with familial hemiplegic migraine. Cephalalgia 2014; 34:1062-9. [PMID: 24707016 DOI: 10.1177/0333102414529195] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Familial hemiplegic migraine (FHM) is a rare monogenic subtype of migraine with aura, characterized by motor auras. The majority of FHM families have mutations in the CACNA1A and ATP1A2 genes; less than 5% of FHM families are explained by mutations in the SCN1A gene. Here we screened two Spanish FHM families for mutations in the FHM genes. METHODS We assessed the clinical features of both FHM families and performed direct sequencing of all coding exons (and adjacent sequences) of the CACNA1A, ATP1A2, PRRT2 and SCN1A genes. RESULTS FHM patients in both families had pure hemiplegic migraine with highly variable severity and frequency of attacks. We identified a novel SCN1A missense mutation p.Ile1498Met in all three tested hemiplegic migraine patients of one family. In the other family, novel SCN1A missense mutation p.Phe1661Leu was identified in six out of eight tested hemiplegic migraine patients. Both mutations affect amino acid residues that either reside in an important functional domain (in the case of Ile(1498)) or are known to be important for kinetic properties of the NaV1.1 channel (in the case of Phe(1661)). CONCLUSIONS We identified two mutations in families with FHM. SCN1A mutations are an infrequent but important cause of FHM. Genetic testing is indicated in families when no mutations are found in other FHM genes.
Collapse
Affiliation(s)
- Claudia M Weller
- Department of Human Genetics, Leiden University Medical Center, the Netherlands
| | - Nadine Pelzer
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Center, the Netherlands
| | | | | | - Julio Pascual
- Department of Neurology, University Hospital Central de Asturias and INEUROPA, Spain
| | | | | | - Anine H Stam
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, the Netherlands Department of Neurology, Rijnland Hospital, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Center, the Netherlands Department of Neurology, Leiden University Medical Center, the Netherlands
| |
Collapse
|
47
|
Pelzer N, Stam AH, Carpay JA, Vries BD, van den Maagdenberg AMJM, Ferrari MD, Haan J, Terwindt GM. Familial hemiplegic migraine treated by sodium valproate and lamotrigine. Cephalalgia 2014; 34:708-711. [DOI: 10.1177/0333102413520086] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Familial hemiplegic migraine (FHM) is a rare monogenic subtype of migraine with aura that includes motor auras. Prophylactic treatment of FHM often has marginal effects and involves a trial-and-error strategy based on therapeutic guidelines for non-hemiplegic migraine and on case reports in FHM. Methods We assessed the response to prophylactic medication in an FHM family and sequenced the FHM2 ATP1A2 gene in all available relatives. Results A novel p.Met731Val ATP1A2 mutation was identified. Attack frequency was reduced significantly with sodium valproate monotherapy ( n = 1) and attacks ceased completely with a combination of sodium valproate and lamotrigine ( n = 2). Conclusions We report dramatic prophylactic effects of sodium valproate and lamotrigine in an FHM2 family, making these drugs worth considering in the treatment of other FHM patients.
Collapse
Affiliation(s)
- Nadine Pelzer
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Anine H Stam
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Johannes A Carpay
- Department of Neurology, Leiden University Medical Center, the Netherlands
- Department of Neurology, Tergooi Hospitals, the Netherlands
| | - Boukje de Vries
- Department of Human Genetics, Leiden University Medical Center, the Netherlands
| | - Arn MJM van den Maagdenberg
- Department of Neurology, Leiden University Medical Center, the Netherlands
- Department of Human Genetics, Leiden University Medical Center, the Netherlands
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, the Netherlands
| | - Joost Haan
- Department of Neurology, Leiden University Medical Center, the Netherlands
- Department of Neurology, Rijnland Hospital, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, the Netherlands
| |
Collapse
|
48
|
Kamp JA, Moursel LG, Haan J, Terwindt GM, Lesnik Oberstein SA, van Duinen SG, van Roon-Mom WM. Amyloid β in hereditary cerebral hemorrhage with amyloidosis-Dutch type. Rev Neurosci 2014; 25:641-51. [DOI: 10.1515/revneuro-2014-0008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 04/17/2014] [Indexed: 12/23/2022]
|
49
|
Lansink JGH, van Oosterhout WPJR, Borggreve AGMF, Haan J. [Footballer's migraine instead of concussion]. Ned Tijdschr Geneeskd 2014; 158:A8434. [PMID: 25424634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
CASE DESCRIPTION Our patient, a 27-year-old amateur soccer player, was hit hard against the head by a ball. Within a few minutes he developed visual and sensory symptoms followed by headache, nausea, vomiting, photophobia and phonophobia. After treatment with paracetamol and metoclopramide, he was free of symptoms within 24 hours. CONCLUSION This picture is stereotypically associated with migraine provoked by minor head injury. TTM may also occur without aura. Trauma triggered migraine is seen more frequently in children, adolescents and young adults. The cause of trauma triggered migraine is unknown. Treatment of the headache and nausea with common analgesics and anti-emetic drugs might be effective. Proper explanation and reassurance are most important.
Collapse
|
50
|
Pelzer N, de Vries B, Boon EMJ, Kruit MC, Haan J, Ferrari MD, van den Maagdenberg AMJM, Terwindt GM. Heterozygous TREX1 mutations in early-onset cerebrovascular disease. J Neurol 2013; 260:2188-90. [PMID: 23881107 DOI: 10.1007/s00415-013-7050-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/12/2013] [Indexed: 11/24/2022]
|