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Published in: The Journal of Headache and Pain 3/2010

Open Access 01-06-2010 | Case Report

Different forms of trigeminal autonomic cephalalgias in the same patient: description of a case

Authors: Giuseppe Cosentino, Brigida Fierro, Angela Rita Puma, Simona Talamanca, Filippo Brighina

Published in: The Journal of Headache and Pain | Issue 3/2010

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Abstract

The trigeminal autonomic cephalalgias (TACs), including cluster headache, paroxysmal hemicrania and SUNCT, are characterized by the cardinal combination of short-lasting unilateral pain and autonomic phenomena affecting the head. Hemicrania continua (HC) shares many clinical characteristics with TACs, including unilateral pain and ipsilateral autonomic features. Nevertheless, HC is separately classified in the revised International Classification of Headache Disorders (ICHD-II). Here, we describe the case of a 45-year-old man presenting an unusual concurrence of different forms of primary headaches associated with autonomic signs, including subsequently ipsilateral cluster headache, SUNCT and HC. This report supports the theory that common mechanisms could be involved in pathophysiology of different primary headache syndromes.
Literature
1.
go back to reference Goadsby PJ, Lipton RB (1997) A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases. Brain 120(Pt 1):193–209, 10.1093/brain/120.1.193, 9055807PubMedCrossRef Goadsby PJ, Lipton RB (1997) A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases. Brain 120(Pt 1):193–209, 10.1093/brain/120.1.193, 9055807PubMedCrossRef
2.
go back to reference Headache Classification Committee of The International Headache Society (2004) The International Classification of Headache Disorders, 2nd edn. Cephalalgia. 24(Suppl 1):1–160 Headache Classification Committee of The International Headache Society (2004) The International Classification of Headache Disorders, 2nd edn. Cephalalgia. 24(Suppl 1):1–160
3.
go back to reference Goadsby PJ, Cittadini E, Burns B, Cohen AS (2008) Trigeminal autonomic cephalalgias: diagnostic and therapeutic developments. Curr Opin Neurol 21(3):323–330, 10.1097/WCO.0b013e3282fa6d76, 18451717PubMedCrossRef Goadsby PJ, Cittadini E, Burns B, Cohen AS (2008) Trigeminal autonomic cephalalgias: diagnostic and therapeutic developments. Curr Opin Neurol 21(3):323–330, 10.1097/WCO.0b013e3282fa6d76, 18451717PubMedCrossRef
4.
go back to reference Leone M, Bussone G (2009) Pathophysiology of trigeminal autonomic cephalalgias. Lancet Neurol 8(8):755–764, 10.1016/S1474-4422(09)70133-4, 19608101PubMedCrossRef Leone M, Bussone G (2009) Pathophysiology of trigeminal autonomic cephalalgias. Lancet Neurol 8(8):755–764, 10.1016/S1474-4422(09)70133-4, 19608101PubMedCrossRef
5.
go back to reference Sprenger T, Boecker H, Tolle TR, Bussone G, May A, Leone M (2004) Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology 62(3):516–517, 1:STN:280:DC%2BD2c%2FntVCrtA%3D%3D, 14872051PubMedCrossRef Sprenger T, Boecker H, Tolle TR, Bussone G, May A, Leone M (2004) Specific hypothalamic activation during a spontaneous cluster headache attack. Neurology 62(3):516–517, 1:STN:280:DC%2BD2c%2FntVCrtA%3D%3D, 14872051PubMedCrossRef
6.
go back to reference Sprenger T, Valet M, Platzer S, Pfaffenrath V, Steude U, Tolle TR (2005) SUNCT: bilateral hypothalamic activation during headache attacks and resolving of symptoms after trigeminal decompression. Pain 113(3):422–426, 10.1016/j.pain.2004.09.021, 15661452PubMedCrossRef Sprenger T, Valet M, Platzer S, Pfaffenrath V, Steude U, Tolle TR (2005) SUNCT: bilateral hypothalamic activation during headache attacks and resolving of symptoms after trigeminal decompression. Pain 113(3):422–426, 10.1016/j.pain.2004.09.021, 15661452PubMedCrossRef
7.
go back to reference Matharu MS, Cohen AS, Frackowiak RS, Goadsby PJ (2006) Posterior hypothalamic activation in paroxysmal hemicrania. Ann Neurol 59(3):535–545, 10.1002/ana.20763, 16489610PubMedCrossRef Matharu MS, Cohen AS, Frackowiak RS, Goadsby PJ (2006) Posterior hypothalamic activation in paroxysmal hemicrania. Ann Neurol 59(3):535–545, 10.1002/ana.20763, 16489610PubMedCrossRef
8.
go back to reference Sprenger T, Ruether KV, Boecker H, Valet M, Berthele A, Pfaffenrath V, Wöller A, Tölle TR (2007) Altered metabolism in frontal brain circuits in cluster headache. Cephalalgia 27(9):1033–1042 (Epub July 30), Epub Jul 30;10.1111/j.1468-2982.2007.01386.x, 1:STN:280:DC%2BD2srgslGnuw%3D%3D, 17666083PubMedCrossRef Sprenger T, Ruether KV, Boecker H, Valet M, Berthele A, Pfaffenrath V, Wöller A, Tölle TR (2007) Altered metabolism in frontal brain circuits in cluster headache. Cephalalgia 27(9):1033–1042 (Epub July 30), Epub Jul 30;10.1111/j.1468-2982.2007.01386.x, 1:STN:280:DC%2BD2srgslGnuw%3D%3D, 17666083PubMedCrossRef
9.
go back to reference May A, Ashburner J, Büchel C, McGonigle DJ, Friston KJ, Frackowiak RS, Goadsby PJ (1999) Correlation between structural and functional changes in brain in an idiopathic headache syndrome. Nat Med 5(7):836–838, 10.1038/10561, 1:CAS:528:DyaK1MXksVCrur0%3D, 10395332PubMedCrossRef May A, Ashburner J, Büchel C, McGonigle DJ, Friston KJ, Frackowiak RS, Goadsby PJ (1999) Correlation between structural and functional changes in brain in an idiopathic headache syndrome. Nat Med 5(7):836–838, 10.1038/10561, 1:CAS:528:DyaK1MXksVCrur0%3D, 10395332PubMedCrossRef
10.
go back to reference Waldenlind E, Gustafsson SA, Ekbom K, Wetterberg L (1987) Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission. J Neurol Neurosurg Psychiatry 50(2):207–213, 10.1136/jnnp.50.2.207, 1:STN:280:DyaL2s7psleksw%3D%3D, 3572435PubMedCentralPubMedCrossRef Waldenlind E, Gustafsson SA, Ekbom K, Wetterberg L (1987) Circadian secretion of cortisol and melatonin in cluster headache during active cluster periods and remission. J Neurol Neurosurg Psychiatry 50(2):207–213, 10.1136/jnnp.50.2.207, 1:STN:280:DyaL2s7psleksw%3D%3D, 3572435PubMedCentralPubMedCrossRef
11.
go back to reference Leone M, Bussone G (1993) A review of hormonal findings in cluster headache. Evidence for hypothalamic involvement. Cephalalgia 13(5):309–317 (Review), (Review);10.1046/j.1468-2982.1993.1305309.x, 1:STN:280:DyaK2c%2FmtF2lsA%3D%3D, 8242722PubMedCrossRef Leone M, Bussone G (1993) A review of hormonal findings in cluster headache. Evidence for hypothalamic involvement. Cephalalgia 13(5):309–317 (Review), (Review);10.1046/j.1468-2982.1993.1305309.x, 1:STN:280:DyaK2c%2FmtF2lsA%3D%3D, 8242722PubMedCrossRef
12.
go back to reference Brighina F, Palermo A, Cosentino G, Fierro B (2007) Prophylaxis of hemicrania continua: two new cases effectively treated with topiramate. Headache 47(3):441–443, 17371364, 10.1111/j.1526-4610.2007.00733.xPubMedCrossRef Brighina F, Palermo A, Cosentino G, Fierro B (2007) Prophylaxis of hemicrania continua: two new cases effectively treated with topiramate. Headache 47(3):441–443, 17371364, 10.1111/j.1526-4610.2007.00733.xPubMedCrossRef
13.
go back to reference Robbins MS, Grosberg BM, Lipton RB (2010) Coexisting trigeminal autonomic cephalalgias and hemicrania continua. Headache (Epub Jan 20) Robbins MS, Grosberg BM, Lipton RB (2010) Coexisting trigeminal autonomic cephalalgias and hemicrania continua. Headache (Epub Jan 20)
14.
go back to reference Lambru G, Castellini P, Bini A, Evangelista A, Manzoni GC, Torelli P (2008) Hemicrania continua evolving from cluster headache responsive to valproic acid. Headache 48(9):1374–1376, 10.1111/j.1526-4610.2008.01249.x, 19006550PubMedCrossRef Lambru G, Castellini P, Bini A, Evangelista A, Manzoni GC, Torelli P (2008) Hemicrania continua evolving from cluster headache responsive to valproic acid. Headache 48(9):1374–1376, 10.1111/j.1526-4610.2008.01249.x, 19006550PubMedCrossRef
15.
go back to reference Castellanos-Pinedo F, Zurdo M, Martínez-Acebes E (2006) Hemicrania continua evolving from episodic paroxysmal hemicrania. Cephalalgia 26(9):1143–1145, 10.1111/j.1468-2982.2006.01178.x, 1:STN:280:DC%2BD28vpsVaitQ%3D%3D, 16919066PubMedCrossRef Castellanos-Pinedo F, Zurdo M, Martínez-Acebes E (2006) Hemicrania continua evolving from episodic paroxysmal hemicrania. Cephalalgia 26(9):1143–1145, 10.1111/j.1468-2982.2006.01178.x, 1:STN:280:DC%2BD28vpsVaitQ%3D%3D, 16919066PubMedCrossRef
16.
go back to reference Rozen TD (2006) Verapamil-responsive hemicrania continua in a patient with episodic cluster headache. Cephalalgia 26(3):351–353, 1:STN:280:DC%2BD28%2FosFKisA%3D%3D, 16472347PubMed Rozen TD (2006) Verapamil-responsive hemicrania continua in a patient with episodic cluster headache. Cephalalgia 26(3):351–353, 1:STN:280:DC%2BD28%2FosFKisA%3D%3D, 16472347PubMed
17.
go back to reference Saito Y, Manaka S, Kimura S (2005) Coexistance of cluster headache and hemicrania continua: a case report. Rinsho Shinkeigaku 45(3):250–252, 15835298PubMed Saito Y, Manaka S, Kimura S (2005) Coexistance of cluster headache and hemicrania continua: a case report. Rinsho Shinkeigaku 45(3):250–252, 15835298PubMed
18.
go back to reference Lisotto C, Mainardi F, Maggioni F, Zanchin G (2003) Hemicrania continua with contralateral episodic cluster headache: a case report. Cephalalgia 23(9):929–930, 10.1046/j.1468-2982.2003.00595.x, 1:STN:280:DC%2BD3srjs12iuw%3D%3D, 14616936PubMedCrossRef Lisotto C, Mainardi F, Maggioni F, Zanchin G (2003) Hemicrania continua with contralateral episodic cluster headache: a case report. Cephalalgia 23(9):929–930, 10.1046/j.1468-2982.2003.00595.x, 1:STN:280:DC%2BD3srjs12iuw%3D%3D, 14616936PubMedCrossRef
19.
go back to reference Sjaastad O, Antonaci F (1993) Chronic paroxysmal hemicrania (CPH) and hemicrania continua: transition from one stage to another. Headache 33(10):551–554, 10.1111/j.1526-4610.1993.hed3310551.x, 1:STN:280:DyaK2c7isVaguw%3D%3D, 8294193PubMedCrossRef Sjaastad O, Antonaci F (1993) Chronic paroxysmal hemicrania (CPH) and hemicrania continua: transition from one stage to another. Headache 33(10):551–554, 10.1111/j.1526-4610.1993.hed3310551.x, 1:STN:280:DyaK2c7isVaguw%3D%3D, 8294193PubMedCrossRef
20.
go back to reference Göbel H, Heinze A, Heinze-Kuhn K (2000) Trigeminal neuralgia, SUNCT-syndrome, chronic paroxysmal hemicrania, cluster headache, and migraine in one patient: a case report. Cephalalgia 20:330–331 Göbel H, Heinze A, Heinze-Kuhn K (2000) Trigeminal neuralgia, SUNCT-syndrome, chronic paroxysmal hemicrania, cluster headache, and migraine in one patient: a case report. Cephalalgia 20:330–331
21.
go back to reference Sprenger T, Valet M, Hammes M, Erhard P, Berthele A, Conrad B, Tolle TR (2004) Hypothalamic activation in trigeminal autonomic cephalgia: functional imaging of an atypical case. Cephalalgia 24(9):753–757, 10.1111/j.1468-2982.2004.00753.x, 1:STN:280:DC%2BD2cvntlagtA%3D%3D, 15315531PubMedCrossRef Sprenger T, Valet M, Hammes M, Erhard P, Berthele A, Conrad B, Tolle TR (2004) Hypothalamic activation in trigeminal autonomic cephalgia: functional imaging of an atypical case. Cephalalgia 24(9):753–757, 10.1111/j.1468-2982.2004.00753.x, 1:STN:280:DC%2BD2cvntlagtA%3D%3D, 15315531PubMedCrossRef
22.
go back to reference Matharu M, May A (2008) Functional and structural neuroimaging in trigeminal autonomic cephalalgias. Curr Pain Headache Rep 12(2):132–137, 10.1007/s11916-008-0025-2, 18474194PubMedCrossRef Matharu M, May A (2008) Functional and structural neuroimaging in trigeminal autonomic cephalalgias. Curr Pain Headache Rep 12(2):132–137, 10.1007/s11916-008-0025-2, 18474194PubMedCrossRef
23.
go back to reference Goadsby PJ (2002) Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol 1(4):251–257, 10.1016/S1474-4422(02)00104-7, 12849458PubMedCrossRef Goadsby PJ (2002) Pathophysiology of cluster headache: a trigeminal autonomic cephalgia. Lancet Neurol 1(4):251–257, 10.1016/S1474-4422(02)00104-7, 12849458PubMedCrossRef
24.
go back to reference May A (2005) Cluster headache: pathogenesis, diagnosis, and management. Lancet 366(9488):843–855, 10.1016/S0140-6736(05)67217-0, 16139660PubMedCrossRef May A (2005) Cluster headache: pathogenesis, diagnosis, and management. Lancet 366(9488):843–855, 10.1016/S0140-6736(05)67217-0, 16139660PubMedCrossRef
25.
go back to reference May A, Bahra A, Büchel C, Frackowiak RS, Goadsby PJ (1998) Hypothalamic activation in cluster headache attacks. Lancet 352(9124):275–278, 10.1016/S0140-6736(98)02470-2, 1:STN:280:DyaK1czlt1OitQ%3D%3D, 9690407PubMedCrossRef May A, Bahra A, Büchel C, Frackowiak RS, Goadsby PJ (1998) Hypothalamic activation in cluster headache attacks. Lancet 352(9124):275–278, 10.1016/S0140-6736(98)02470-2, 1:STN:280:DyaK1czlt1OitQ%3D%3D, 9690407PubMedCrossRef
26.
go back to reference May A, Bahra A, Büchel C, Turner R, Goadsby PJ (1999) Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 46(5):791–794, 10.1002/1531-8249(199911)46:5<791::AID-ANA18>3.0.CO;2-8, 1:STN:280:DC%2BD3c%2FhvFChug%3D%3D, 10554000PubMedCrossRef May A, Bahra A, Büchel C, Turner R, Goadsby PJ (1999) Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 46(5):791–794, 10.1002/1531-8249(199911)46:5<791::AID-ANA18>3.0.CO;2-8, 1:STN:280:DC%2BD3c%2FhvFChug%3D%3D, 10554000PubMedCrossRef
27.
go back to reference Cohen AS (2007) Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Cephalalgia 27(7):824–832, 10.1111/j.1468-2982.2007.01352.x, 1:STN:280:DC%2BD2szot1eksQ%3D%3D, 17598764PubMedCrossRef Cohen AS (2007) Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. Cephalalgia 27(7):824–832, 10.1111/j.1468-2982.2007.01352.x, 1:STN:280:DC%2BD2szot1eksQ%3D%3D, 17598764PubMedCrossRef
28.
go back to reference Matharu MS, Cohen AS, McGonigle DJ, Ward N, Frackowiak RS, Goadsby PJ (2004) Posterior hypothalamic and brainstem activation in hemicrania continua. Headache 44(8):747–761, 10.1111/j.1526-4610.2004.04141.x, 15330820PubMedCrossRef Matharu MS, Cohen AS, McGonigle DJ, Ward N, Frackowiak RS, Goadsby PJ (2004) Posterior hypothalamic and brainstem activation in hemicrania continua. Headache 44(8):747–761, 10.1111/j.1526-4610.2004.04141.x, 15330820PubMedCrossRef
29.
go back to reference Dubé AA, Duquette M, Roy M, Lepore F, Duncan G, Rainville P (2008) Brain activity associated with the electrodermal reactivity to acute heat pain. Neuroimage 45(1):169–180 (Epub Nov 5) Dubé AA, Duquette M, Roy M, Lepore F, Duncan G, Rainville P (2008) Brain activity associated with the electrodermal reactivity to acute heat pain. Neuroimage 45(1):169–180 (Epub Nov 5)
30.
go back to reference Leone M, Franzini A, Bussone G (2001) Stereotactic stimulation of posterior hypothalamic gray matter in a patient with intractable cluster headache. N Engl J Med 345(19):1428–1429, 10.1056/NEJM200111083451915, 1:STN:280:DC%2BD38%2FmsFGhtQ%3D%3D, 11794190PubMedCrossRef Leone M, Franzini A, Bussone G (2001) Stereotactic stimulation of posterior hypothalamic gray matter in a patient with intractable cluster headache. N Engl J Med 345(19):1428–1429, 10.1056/NEJM200111083451915, 1:STN:280:DC%2BD38%2FmsFGhtQ%3D%3D, 11794190PubMedCrossRef
31.
go back to reference Petrovic P, Petersson KM, Hansson P, Ingvar M (2004) Brainstem involvement in the initial response to pain. Neuroimage 22(2):995–1005, 10.1016/j.neuroimage.2004.01.046, 15193631PubMedCrossRef Petrovic P, Petersson KM, Hansson P, Ingvar M (2004) Brainstem involvement in the initial response to pain. Neuroimage 22(2):995–1005, 10.1016/j.neuroimage.2004.01.046, 15193631PubMedCrossRef
32.
go back to reference Larner AJ (2009) Concurrence of primary headaches: Lane and Davies (2006) revisited. J Headache Pain 10(2):133 (Epub Feb 24), Epub Feb 24;10.1007/s10194-009-0106-6, 19238509PubMedCentralPubMedCrossRef Larner AJ (2009) Concurrence of primary headaches: Lane and Davies (2006) revisited. J Headache Pain 10(2):133 (Epub Feb 24), Epub Feb 24;10.1007/s10194-009-0106-6, 19238509PubMedCentralPubMedCrossRef
33.
go back to reference Matharu MS, Boes CJ, Goadsby PJ (2003) Management of trigeminal autonomic cephalgias and hemicrania continua. Drugs 63(16):1637–1677, 10.2165/00003495-200363160-00002, 1:CAS:528:DC%2BD3sXntlKisL4%3D, 12904085PubMedCrossRef Matharu MS, Boes CJ, Goadsby PJ (2003) Management of trigeminal autonomic cephalgias and hemicrania continua. Drugs 63(16):1637–1677, 10.2165/00003495-200363160-00002, 1:CAS:528:DC%2BD3sXntlKisL4%3D, 12904085PubMedCrossRef
34.
go back to reference Bahra A, May A, Goadsby PJ (2002) Cluster headache: a prospective clinical study with diagnostic implications. Neurology 58(3):354–361, 11839832PubMedCrossRef Bahra A, May A, Goadsby PJ (2002) Cluster headache: a prospective clinical study with diagnostic implications. Neurology 58(3):354–361, 11839832PubMedCrossRef
Metadata
Title
Different forms of trigeminal autonomic cephalalgias in the same patient: description of a case
Authors
Giuseppe Cosentino
Brigida Fierro
Angela Rita Puma
Simona Talamanca
Filippo Brighina
Publication date
01-06-2010
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 3/2010
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1007/s10194-010-0210-7

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