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Sokolov AY, Mengal M, Berkovich R. Menthol dural application alters meningeal arteries tone and enhances excitability of trigeminocervical neurons in rats. Brain Res 2024; 1825:148725. [PMID: 38128811 DOI: 10.1016/j.brainres.2023.148725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/28/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023]
Abstract
Headaches, including migraines, can have a causal relationship to exposure to cold, and this relationship may be both positive and negative, as cold can both provoke and alleviate cephalgia. The role of thermoreceptors responsible for transduction of low temperatures belongs to the transient receptor potential cation channel subfamily melastatin member 8 (TRPM8). These channels mediate normal cooling sensation and have a role in both cold pain and cooling-mediated analgesia; they are seen as a potential target for principally new anti-migraine pharmaceuticals. Using a validated animal migraine models, we evaluated effects of menthol, the TRPM8-agonist, on trigeminovascular nociception. In acute experiments on male rats, effects of applied durally menthol solution in various concentrations on the neurogenic dural vasodilatation (NDV) and firing rate of dura-sensitive neurons of the trigeminocervical complex (TCC) were assessed. Application of menthol solution in concentrations of 5 % and 10 % was associated with NDV suppression, however amplitude reduction of the dilatation response caused not by the vascular dilatation degree decrease, but rather due to the significant increase of the meningeal arterioles' basal tone. In electrophysiological experiments the 1 % and 30 % menthol solutions intensified TCC neuron responses to the dural electrical stimulation while not changing their background activity. Revealed in our study excitatory effects of menthol related to the vascular as well as neuronal branches of the trigeminovascular system indicate pro-cephalalgic effects of TRPM8-activation and suggest feasibility of further search for new anti-migraine substances among TRPM8-antagonists.
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Affiliation(s)
- Alexey Y Sokolov
- Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia; Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Saint Petersburg, Russia; St. Petersburg Medico-Social Institute, Saint Petersburg, Russia.
| | - Miran Mengal
- Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Regina Berkovich
- LAC+USC General Hospital and Neurology Clinic, Regina Berkovich MD, PhD Inc., Los Angeles, CA, USA
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Bonemazzi I, Pelizza MF, Berti G, Ancona C, Nosadini M, Sartori S, Toldo I. Cold-Stimulus Headache in Children and Adolescents. Life (Basel) 2023; 13:life13040973. [PMID: 37109502 PMCID: PMC10144624 DOI: 10.3390/life13040973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
The literature on cold-stimulus headache (CSH) is relatively sparse compared to other primary headache disorders and the studies on the pediatric population are very limited. This systematic review aims to analyze the evidence on CSH in children and adolescents focusing on epidemiology, clinical features, pathogenic mechanisms, and treatments. Our review included 25 studies, among which 9 papers include pediatric cases (4 pediatric samples, 5 mixed samples of children and adults). The aim of this work is to highlight the features of CSH in children and adolescents. In children, the prevalence of CSH is higher than in adults and it is not gender-specific. There is a relevant family history for CSH and the comorbidity with migraine is significant. The triggers and clinical features of CSH due to ingesting a cold stimulus in children overlap with those in adults. CSH due to external application of a cold stimulus (or to environmentally low temperatures) is not studied in children and adolescents. We describe in detail a new pediatric case of CSH triggered by low ambient temperatures; to the best of our knowledge, this represents the first description in the literature. In conclusion, CSH in children is probably underestimated and has peculiar features compared to adults; further studies are needed to better understand its clinical features and pathophysiology.
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Affiliation(s)
- Ilaria Bonemazzi
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Maria Federica Pelizza
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Giulia Berti
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Claudio Ancona
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Margherita Nosadini
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Stefano Sartori
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
| | - Irene Toldo
- Juvenile Headache Center, Department of Woman's and Child's Health, University Hospital of Padua, 35128 Padua, Italy
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Kraya T, Schulz-Ehlbeck M, Burow P, Watzke S, Zierz S. Prevalence and characteristics of headache attributed to ingestion or inhalation of a cold stimulus (HICS): A cross-sectional study. Cephalalgia 2019; 40:299-306. [PMID: 31645112 DOI: 10.1177/0333102419884938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Headache attributed to ingestion or inhalation of a cold stimulus (HICS), colloquially called ice-cream headache, is a common form of a primary headache in adults and children. However, previous studies on adults are limited due to the small number of patients. Furthermore, most of the subjects in previous studies had a history of other primary headaches. METHODS Biographic data, clinical criteria of HICS and prevalence of primary headache were collected by a standardized questionnaire. A total of 1213 questionnaires were distributed; the return rate was 51.9% (n = 629); 618 questionnaires could be analyzed. RESULTS In a cohort of 618 people aged between 17-63 years (females: n = 426, 68.9%), the prevalence of HICS was 51.3% (317 out of 618). There was no difference between men and women (51.3% vs. 51.6%). The duration of HICS was shorter than 30 sec in 92.7%. In the HICS group, localization of the pain was occipital in 17%. Trigemino-autonomic symptoms occurred in 22%, and visual phenomena (e.g. flickering lights, spots or lines) were reported by 18% of the HICS group. The pain intensity, but not the prevalence of HICS, was higher when tension-type headache and migraine or both were present as co-morbid primary headaches (Numeric Rating Scale (NRS) 4.58 and 6.54, p = 0.006). There was no higher risk of participants with migraine getting HICS than for those who did not have migraine (odds ratio = 1.17, 95% confidence interval (CI) 0.75-1.83; p = 0.496). CONCLUSION The results of this study modified the current criteria for HICS in the ICHD-3 regarding duration and localization. In addition, accompanying symptoms in about one fifth of the participants are not mentioned in the ICHD-3. Neither migraine nor tension-type headache seems to be a risk factor for HICS. However, accompanying symptoms in HICS are more frequent in subjects with another primary headache than in those without such a headache.
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Affiliation(s)
- Torsten Kraya
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany.,Department of Neurology, St. Georg Hospital, Leipzig, Germany
| | - Malte Schulz-Ehlbeck
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Philipp Burow
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Stefan Watzke
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Halle, Halle (Saale), Germany
| | - Stephan Zierz
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
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Hensel O, Burow P, Mages S, Wienke A, Kraya T, Zierz S. Increased Blood Flow Velocity in Middle Cerebral Artery and Headache Upon Ingestion of Ice Water. Front Neurol 2019; 10:677. [PMID: 31316454 PMCID: PMC6611440 DOI: 10.3389/fneur.2019.00677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/10/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction: “Headache attributed to ingestion or inhalation of a cold stimulus” (HICS) is one of the most common primary headache disorders. Little is known about the pathophysiology of HICS and other headache disorders. The aim of this study was to analyze mean flow velocity (MFV) and cerebrovascular resistance (RI) in both middle cerebral arteries (MCA) upon ingestion of ice water. Methods: The MFV and RI in both MCAs was continuously measured by transcranial sonography. HICS was induced by drinking 200 ml of ice water. Results: In all volunteers, the ingestion of ice water led to a decrease in RI, which was accompanied by an increase in MFV. In volunteers with induced HICS, MFV were significantly higher compared to volunteers that did not experience HICS. In volunteers with HICS, MFV increased even more significantly when lacrimation occurred compared to volunteers in which it did not. In volunteers without induced HICS, MFV was higher in those volunteers with a positive history of HICS than in those with a negative HICS history. Conclusion: This study revealed a raised MFV upon ingestion of ice water. Volunteers with a provoked case of HICS had a higher MFV than volunteers without HICS. The increase in MFV was even higher when the headache was accompanied by lacrimation. This may indicate an involvement of the trigeminal-parasympathetic vasodilator reflex.
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Affiliation(s)
- Ole Hensel
- Department of Neurology, Martin Luther University, Halle, Germany
| | - Philipp Burow
- Department of Neurology, Martin Luther University, Halle, Germany
| | - Stephan Mages
- Department of Neurology, Martin Luther University, Halle, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin Luther University, Halle, Germany
| | - Torsten Kraya
- Department of Neurology, Martin Luther University, Halle, Germany
| | - Stephan Zierz
- Department of Neurology, Martin Luther University, Halle, Germany
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Abstract
PURPOSE OF REVIEW To provide an updated review on cold stimulus headache. RECENT FINDINGS Age, type of stimulus, comorbidities, and study design but not necessarily gender appear to influence the reported prevalence of cold stimulus headache (CSH). Different cold stimuli appear to provoke different types of CSH. Ice water appears to provoke more frequent and higher pain intensity with a shorter latency compared to CSH provoked by ice cubes. Cold stimulus headache is very common unusual headache with limited literature. The severity, frequency, and latency appear to be influenced by the speed and size of the exposed area.
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Affiliation(s)
- Amokrane Chebini
- Division of Neurology, University of British Columbia, 8219-2775, Laurel Street, Vancouver, BC, V5Z 1M9, Canada
| | - Esma Dilli
- Division of Neurology, University of British Columbia, 8219-2775, Laurel Street, Vancouver, BC, V5Z 1M9, Canada.
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Abstract
PURPOSE OF REVIEW Unusual headache disorders are less commonly discussed and may be misdiagnosed. These headache disorders frequently have a benign natural history; however, without reassurance, therapeutic education, and treatment, they can negatively affect the health and function of patients. RECENT FINDINGS This article reviews the clinical features, diagnosis, workup, and proposed treatments for several unusual headache disorders including primary cough headache, primary headache associated with sexual activity, primary exercise headache, cold-stimulus headache, primary stabbing headache, nummular headache, hypnic headache, and headache attributed to travel in space. Exploding head syndrome is also discussed, which is a sleep disorder commonly confused with a headache disorder. SUMMARY Unusual headache disorders are usually benign, yet without the correct diagnosis can be very worrisome for many patients. Through greater awareness of these headache disorders, neurologists can evaluate and effectively manage unusual headache disorders, which offers significant benefits to patients and practice satisfaction to neurologists.
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Lupi C, Evangelista L, Favoni V, Granato A, Negro A, Pellesi L, Ornello R, Russo A, Cevoli S, Guerzoni S, Benemei S. Rare primary headaches in Italian tertiary Headache Centres: Three year nationwide retrospective data from the RegistRare Network. Cephalalgia 2018; 38:1429-1441. [PMID: 29754500 DOI: 10.1177/0333102418768824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Rare primary headaches are mainly included in Chapters 3, Trigeminal autonomic cephalalgias, and 4, Other primary headache disorders, Part One of the International Classification of Headache Disorders 3rd edition. Epidemiological data are scarce, mostly emerging from case series or small studies, with the exception of cluster headache. In order to overcome the knowledge gap about rare primary headaches, the RegistRare Network was launched in 2017 to promote research in the field. Methods A retrospective cohort study including patients who, from April 30, 2014 to May 1, 2017, visited seven Italian tertiary Headache Centres, was undertaken to estimate in that clinical setting prevalence and incidence of headaches included in Chapters 3 and 4, Part One of the International Classification of Headache Disorders 3rd edition. Prevalent headache is defined as a headache recorded within the study timeframe, regardless of when the diagnosis was made. Incident headache is defined as a headache diagnosed for the first time in the patient during the study period. Results Twenty thousand and eighty-three patients visited the participating centres, and 822 (4.1%) prevalent cases, of which 461 (2.3%) were incident cases, were registered. Headaches listed in Chapter 3 affected 668 patients, representing 81.3% of the total number of prevalent cases. Headaches listed in Chapter 4 affected 154 patients and represent 18.7% of the total number of prevalent cases. Cluster headaches represent the most frequently diagnosed rare headaches (70.4%). For 13 entities out of 20, no cases were registered in more than 50% (n ≥ 4) of the centres, and for 14 entities more than 50% of diagnoses were incident. Conclusions This large, multicentre study gives the first wide-ranging snapshot of the burden in clinical practice of rare headaches and confirms that cooperative networks are necessary to study rare headaches, as their prevalence is often very low. The launch of a disease registry by the RegistRare Network will favour research in this neglected population of headache patients. Trial registration NCT03416114.
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Affiliation(s)
- Chiara Lupi
- 1 Headache Centre, Careggi University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luana Evangelista
- 2 Regional Headache Referral Center, Department of Neurology, University of L'Aquila, L'Aquila, Italy
| | - Valentina Favoni
- 3 IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Antonio Granato
- 4 Department of Medical, Technological and Translational Sciences, Headache Centre, University of Trieste, Trieste, Italy
| | - Andrea Negro
- 5 Regional Referral Headache Centre, Sant'Andrea Hospital, Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Lanfranco Pellesi
- 6 Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Raffaele Ornello
- 2 Regional Headache Referral Center, Department of Neurology, University of L'Aquila, L'Aquila, Italy
| | - Antonio Russo
- 7 Headache Centre, Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Sabina Cevoli
- 3 IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Simona Guerzoni
- 6 Headache and Drug Abuse Research Centre, Policlinico Hospital, Department of Diagnostic Medicine, Clinical and Public Health, University of Modena e Reggio Emilia, Modena, Italy
| | - Silvia Benemei
- 1 Headache Centre, Careggi University Hospital, Department of Health Sciences, University of Florence, Florence, Italy
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8
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Hawley K, Huang JS, Goodwin M, Diaz D, de Sa VR, Birnie KA, Chambers CT, Craig KD. Youth and Parent Appraisals of Participation in a Study of Spontaneous and Induced Pediatric Clinical Pain. ETHICS & BEHAVIOR 2018; 29:259-273. [PMID: 31768092 DOI: 10.1080/10508422.2018.1463163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The current study examined youths' and their parents' perceptions concerning participation in an investigation of spontaneous and induced pain during recovery from laparoscopic appendectomy. Youth (age range 5-17 years) and their parents independently completed surveys about their study participation. On a 0 (very negative) -to-10 (very positive) scale, both parents 9.4(1.3) [mean(SD)] and youth 7.9(2.4) rated their experience as positive. Among youth, experience ratings did not differ by pain severity and survey responses did not differ by age. Most youth (83%) reported they would tell another youth to participate. Ethical issues regarding instigation of pain in youth for research purposes are examined.
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Affiliation(s)
- Kara Hawley
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Jeannie S Huang
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093.,Division of Gastroenterology, Rady Children's Hospital, San Diego, CA 92123
| | - Matthew Goodwin
- Department of Health Sciences, Northeastern University, Boston, MA, 02115
| | - Damaris Diaz
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093
| | - Virginia R de Sa
- Department of Cognitive Science, University of California San Diego, La Jolla, CA 92093
| | - Kathryn A Birnie
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON
| | - Christine T Chambers
- Departments of Pediatrics, and Psychology & Neuroscience, Dalhousie University, Halifax, NS.,Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS
| | - Kenneth D Craig
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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9
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Abstract
Headache, an almost universal human experience, is one of the most common complaints encountered in medicine and neurology. Described and categorized since antiquity, with the first classification by Aretaeus of Cappadocia, other classifications followed. The evaluation of this condition may be straightforward or challenging, and, though often benign, headache may prove to be an ominous symptom. This review discusses the current diagnosis and classification of headache disorders and principles of management, with a focus on migraine, tension-type headache, trigeminal autonomic cephalgias, and various types of daily headache.
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Affiliation(s)
- Paul Rizzoli
- Graham Headache Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, Mass
| | - William J Mullally
- Graham Headache Center, Brigham and Women's Faulkner Hospital, Harvard Medical School, Boston, Mass.
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10
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Mages S, Hensel O, Zierz AM, Kraya T, Zierz S. Experimental provocation of ‘ice-cream headache’ by ice cubes and ice water. Cephalalgia 2016; 37:464-469. [DOI: 10.1177/0333102416650704] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background There are various studies on experimentally provoked ‘ice-cream headache’ or ‘headache attributed to ingestion or inhalation of a cold stimulus’ (HICS) using different provocation protocols. The aim of this study was to compare two provocation protocols. Methods Ice cubes pressed to the palate and fast ingestion of ice water were used to provoke HICS and clinical features were compared. Results The ice-water stimulus provoked HICS significantly more often than the ice-cube stimulus (9/77 vs. 39/77). Ice-water-provoked HICS had a significantly shorter latency (median 15 s, range 4–97 s vs. median 68 s, range 27–96 s). There was no difference in pain localisation. Character after ice-cube stimulation was predominantly described as pressing and after ice-water stimulation as stabbing. A second HICS followed in 10/39 (26%) of the headaches provoked by ice water. Lacrimation occurred significantly more often in volunteers with than in those without HICS. Discussion HICS provoked by ice water was more frequent, had a shorter latency, different pain character and higher pain intensity than HICS provoked by ice cubes. The finding of two subsequent HICS attacks in the same volunteers supports the notion that two types of HICS exist. Lacrimation during HICS indicates involvement of the trigeminal-autonomic reflex.
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Affiliation(s)
- Stephan Mages
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Ole Hensel
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Antonia Maria Zierz
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Torsten Kraya
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Stephan Zierz
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
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11
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Ice cream headache in students and family history of headache: a cross-sectional epidemiological study. J Neurol 2016; 263:1106-10. [PMID: 27039390 DOI: 10.1007/s00415-016-8098-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 01/03/2023]
Abstract
Headache attributed to ingestion of a cold stimulus (ICHD-3 beta 4.5.1) is also known as ice cream headache (ICH). This cross-sectional epidemiological study included 283 students (10-14-year-olds) attending a grammar school in Germany, their parents (n = 401), and 41 teachers. A self-administered questionnaire was used to analyze the prevalence and characteristics of ICH based on the ICHD classification. Additionally, the association between ICH and other headaches was investigated in students and parents. Prevalence of ICH in students was 62 % without gender difference. In adults, only 36 % of females and 22 % of males reported ICH. There was an increased risk for ICH in students when mother (OR 10.7) or father (OR 8.4) had ICH. Other headaches in parents had no influence on the prevalence of ICH in students. However, in the groups of students and parents itself there was a highly significant association between ICH and other headaches (students: OR 2.4, mothers: OR 2.9, fathers: OR 6.8). There was a decreased risk for ICH when parents and students had no headache at all (OR < 0.4). ICH in students clearly shows a familial disposition by both father and mother. There was also an association between ICH and other headaches within the student and adult groups. The absence of headache history seems to be a protective factor for ICH.
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12
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Lugovskaya N, Vinson DR. Paroxysmal Atrial Fibrillation and Brain Freeze: A Case of Recurrent Co-Incident Precipitation From a Frozen Beverage. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:23-6. [PMID: 26757615 PMCID: PMC4718113 DOI: 10.12659/ajcr.896035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Patient: Male, 29 Final Diagnosis: Paroxysmal atrial fibrillation • cold-stimulus headache Symptoms: Palpitations • headache Medication: Diltiazem • Ibutilide Clinical Procedure: None Specialty: Emergency Medicine • Internal Medicine
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Affiliation(s)
- Nelya Lugovskaya
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA
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13
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Valença MM, de Oliveira DA, Martins HADL. Alice in Wonderland Syndrome, Burning Mouth Syndrome, Cold Stimulus Headache, and HaNDL: Narrative Review. Headache 2015; 55:1233-48. [DOI: 10.1111/head.12688] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Marcelo M. Valença
- Neurology and Neurosurgery Unit, Department of Neuropsychiatry; Federal University of Pernambuco; Brazil
- Neurology and Neurosurgery Unit; Hospital Esperança; Brazil
| | - Daniella A. de Oliveira
- Neurology and Neurosurgery Unit, Department of Neuropsychiatry; Federal University of Pernambuco; Brazil
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14
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Valença MM, de Oliveira DA. The Frequent Unusual Headache Syndromes: A Proposed Classification Based on Lifetime Prevalence. Headache 2015; 56:141-52. [PMID: 26335933 DOI: 10.1111/head.12646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND There is no agreement on a single cutoff point or prevalence for regarding a given disease as rare. The concept of what is a rare headache disorder is even less clear and the spectrum from a very frequent, frequent, occasional to rare headache syndrome is yet to be established. OBJECTIVE An attempt has been made to estimate the lifetime prevalence of each of the headache subtypes classified in the ICHD-II. METHOD Using the ICHD-II, 199 different headache subtypes were identified. The following classification was made according to the estimated lifetime prevalence of each headache disorder: very frequent (prevalence >10%); frequent (between 1 and 10%); occasional (between 0.07 and 1%); and unusual or rare (<0.07%). RESULTS One hundred and fifty-four of 199 (77%) were categorized as unusual headache disorders, 7/199 (4%) as very frequent, 9/199 (5%) as frequent, and 29/199 (15%) as occasional forms of headache disorder. CONCLUSION The unusual headache syndromes do not appear to be as infrequent in clinical practice as has been generally believed. About three-fourths of the classified headache disorders found in the ICHD-II can be considered as rare. This narrative review article may be regarded as an introduction to the concept of unusual headaches and a proposed classification of all headaches (at least those listed in the ICHD-II).
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Affiliation(s)
- Marcelo M Valença
- Department of Neuropsychiatry, Neurology and Neurosurgery Unit, Federal University of Pernambuco, Brazil.,Neurology and Neurosurgery Unit, Hospital Esperança, Brazil
| | - Daniella A de Oliveira
- Department of Neuropsychiatry, Neurology and Neurosurgery Unit, Federal University of Pernambuco, Brazil
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Valença MM, da Silva AA, Bordini CA. Headache Research and Medical Practice in Brazil: An Historical Overview. Headache 2015; 55 Suppl 1:4-31. [DOI: 10.1111/head.12512] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2014] [Indexed: 12/28/2022]
Affiliation(s)
- Marcelo Moraes Valença
- Neurology and Neurosurgery Unit; Department of Neuropsychiatry; Federal University of Pernambuco; Recife Brazil
- Neurology and Neurosurgery Unit, Hospital Esperança; Brazil
| | - Amanda Araújo da Silva
- Neurology and Neurosurgery Unit; Department of Neuropsychiatry; Federal University of Pernambuco; Recife Brazil
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Abstract
PURPOSE OF REVIEW Little is known about most disorders classified as rare primary headaches. This review summarizes current knowledge about clinical presentation, pathophysiology, epidemiology and treatment options of rare headache disorders. Increasing public awareness on the different types of rare primary headache disorders may lead to more research and better patient identification and treatment. RECENT FINDINGS The International Headache Society updated the classification criteria for primary headache disorders adding some clinical entities and moving others to different parts of the classification. SUMMARY Neuroimaging should be performed in all patients suspected to suffer from rare primary headache to rule out secondary causes of headache. Indometacin might have a good therapeutic effect in some of these headache entities, but larger randomized controlled trials are missing.
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