Trigeminal autonomic cephalgia: A rare cause of headache in children

2018 ◽  
Vol 54 (8) ◽  
pp. 918-921
Author(s):  
Josephine A Stringer ◽  
Sophie Calvert ◽  
Adriane Sinclair
Keyword(s):  
Trigeminal Autonomic Cephalgia

Hypothalamic Activation in Trigeminal Autonomic Cephalgia: Functional Imaging of an Atypical Case

Cephalalgia ◽  
2004 ◽  
Vol 24 (9) ◽  
pp. 753-757 ◽  
Author(s):  
T Sprenger ◽  
M Valet ◽  
M Hammes ◽  
P Erhard ◽  
A Berthele ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Paroxysmal Hemicrania ◽  
Cerebral Activation ◽  
Atypical Case ◽  
Clear Cut ◽  
Oxygen Administration ◽  
Autonomic Reflex ◽  
Trigeminal Autonomic Cephalgia ◽  
Hypothalamic Activation

We report headache induced BOLD changes in an atypical case of trigeminal autonomic cephalgia (TAC). A 68-year-old patient was imaged using fMRi during three attacks of a periorbital head-pain with a average duration of 3 min. During the attacks, left sided conjunctival injection, rhinorrhea, lacrimation, facial sweating and hypersalivation were apparent. These attacks were usually partly responsive to oxygen administration but otherwise refractory to any drug. The patient described either attacks with a duration of one minute or less or longer attacks persisting for maximum of 20 min with headaches occurring up to 100 times a day. When considering the symptoms, frequency, duration and therapeutic response of the patient's headache, no clear-cut classification to one of the subtypes of trigeminal autonomic cephalgias (cluster headache, paroxysmal hemicrania, SUNCT) or trigeminal neuralgia was possible. The cerebral activation pattern was similar but not identical to those previously observed in cluster headache and SUNCT with a prominent activation in the hypothalamic grey matter. This case study underlines the conceptual value of the term TAC for the group of headaches focusing around the trigeminal-autonomic reflex. Our results emphasize the importance of the hypothalamus as key region in the pathophysiology of this entity.

scholarly journals 063 Headache with periorbital ecchymosis; a rare clinical entity

2019 ◽  
Vol 90 (e7) ◽  
pp. A20.3-A21
Author(s):  
Srimathy Vijayan ◽  
Carolyn Orr ◽  
Catherine Franconi
Keyword(s):  
Case Reports ◽  
Tension Headache ◽  
Primary Headache ◽  
Young Female ◽  
Clinical Entity ◽  
List Type ◽  
Treatment Regimens ◽  
Primary Headache Disorders ◽  
Headache Pain ◽  
Trigeminal Autonomic Cephalgia

ObjectivesPrimary headache disorders are common with migraine and tension headache accounting for the vast majority of cases. A smaller proportion suffer from trigeminal autonomic cephalgia (TAC). We present a 23-year-old Caucasian female who described characteristic, episodic headaches starting with a dull retro-orbital/bi-frontal pressure evolving, over the course of 1 minute, to experience florid periorbital ecchymosis. While this phenomenon has been described in the literature, the characteristics of our case are unique and noteworthy of reporting.MethodsWe reviewed the literature surrounding this rare entity by using PubMed/OVID databases and the search terms ‘Headache AND ecchymosis’.ResultsCase reports exist in older patients1–3, where the headache is side locked and associated with other autonomic characteristics such as periorbital oedema, conjunctival injection and tearing. Our case is a young female with only ecchymosis in a unilateral and/or bilateral manner and no other autonomic or indeed migraine features. The patient underwent vascular/cranial imaging and blood tests to exclude haematological, autoimmune, vasculitic causes for this presentation which were unrewarding.ConclusionVariations on this clinical entity are described;1–4 we hope this report may bring attention to this fascinating phenomenon. The pathophysiological process is likely to be similar to those implicated in TACs, namely activation of the trigemino-neurovascular system and facial autonomic pathways. The release of neuromediators such as CGRP, VIP and Substance P cause blood vessel fragility resulting in diapedesis. Optimal treatment regimens are unknown but various agents have been trialled. Our patient declined treatment and continues to be followed.ReferencesDeBroff B, et al. Migraine Associated with Periorbital Ecchymosis. Headache 1990;30:260–263.Dafer R, et al. Atypical Chronic Headache and Recurrent Facial Ecchymosis: A Case Report. Neuro-Ophthalmology 2011;35:76–77.Nozzolillo D, et al. Migraine associated with facial ecchymoses ipsilateral to the symptomatic side. J Headache Pain ( 2004) 5:256–259.Sethi PK, et al. Teaching neuroimages: Red forehead dot syndrome and migraine revisited. Neurology 2015;85;e28.

Acupuncture for Episodic Cluster Headache: A Trigeminal Approach

2016 ◽  
Vol 34 (1) ◽  
pp. 55-58 ◽  
Author(s):  
Simon Hayhoe
Keyword(s):  
Cluster Headache ◽  
Prophylactic Treatment ◽  
Tension Headache ◽  
Cost Effective ◽  
Contralateral Side ◽  
Infraorbital Nerve ◽  
Episodic Cluster Headache ◽  
Trigeminal Autonomic Cephalgia ◽  
The Uk ◽  
Severe Migraine

Following evidence that acupuncture is clinically feasible and cost-effective in the treatment of headache, the UK National Institute for Health and Care Excellence recommends acupuncture as prophylactic treatment for migraine and tension headache. There has thus been expectation that other forms of headache should benefit also. Unfortunately, acupuncture has not generally been successful for cluster headache. This may be due to acupuncturists approaching the problem as one of severe migraine. In fact, cluster headache is classed as a trigeminal autonomic cephalgia. In this case report, episodic cluster headache is treated in the same way as has been shown effective for trigeminal neuralgia. Acupuncture is applied to the contralateral side at points appropriate for stimulating branches of the trigeminal nerve. Thus, ST2 is used for the infraorbital nerve, BL2 and Yuyao for the supratrochlear and supraorbital nerves, and Taiyang for the temporal branch of the zygomatic nerve.

scholarly journals Temporary resolution of hemicrania continua following ipsilateral ear piercing

2021 ◽  
Vol 3 (2) ◽  
pp. e000193
Author(s):  
Alexander Bryson
Keyword(s):  
Adverse Effects ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Symptom Relief ◽  
Hemicrania Continua ◽  
Trigeminovascular System ◽  
Neuropsychiatric Complications ◽  
Ear Piercing ◽  
Trigeminal Autonomic Cephalgia

BackgroundHemicrania continua is an uncommon subtype of trigeminal autonomic cephalgia that exhibits dramatic therapeutic response to indomethacin. Unfortunately, indomethacin is associated with a range of adverse effects, including neuropsychiatric complications, which limits its use in many patients. Although no other effective pharmacologic agents exist, there is emerging evidence for interventional treatments such as occipital nerve and vagus nerve stimulation, which may act by modulating neural activity within the trigeminovascular system.CaseWe present a 30-year-old woman with long-standing refractory hemicrania continua who suffered adverse effects to indomethacin. She experienced temporary, but near-complete, symptom resolution following piercing of the crus of the ear helix ipsilateral to her headache, whereas contralateral piercing produced no benefit.ConclusionsTo our knowledge, this case is the first to describe a therapeutic benefit following ear piercing in a patient with trigeminal autonomic cephalgia. We argue that symptom relief was obtained through a similar mechanism to occipital or vagus nerve stimulation.

Trigeminal autonomic cephalgia caused by recurrent posterior scleritis

2016 ◽  
Vol 16 (6) ◽  
pp. 455-457 ◽  
Author(s):  
Ali Alim-Marvasti ◽  
Jason Ho ◽  
Mark Weatherall ◽  
Maneesh Patel ◽  
Sheena George ◽  
...  
Keyword(s):  
Posterior Scleritis ◽  
Trigeminal Autonomic Cephalgia

scholarly journals A Rare Association of Trigeminal Autonomic Cephalgia: Pontine Capillary Telangiectasia

2015 ◽  
Vol 28 (2) ◽  
pp. 145-147
Author(s):  
Rahsan Gocmen ◽  
Erdal Kurt ◽  
Sabina Arslan ◽  
Isin Unal-Cevik ◽  
Kader Karli Oguz ◽  
...  
Keyword(s):  
Rare Association ◽  
Trigeminal Autonomic Cephalgia ◽  
Capillary Telangiectasia
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