The Experts below are selected from a list of 288 Experts worldwide ranked by ideXlab platform
Peter J. Goadsby - One of the best experts on this subject based on the ideXlab platform.
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Paroxysmal Hemicrania: a prospective clinical study of 31 cases
2016Co-Authors: Elisabetta Cittadini, Manjit Matharu, Peter J. GoadsbyAbstract:Paroxysmal Hemicrania is a rare syndrome characterized by repeated attacks of strictly unilateral, severe, short-lasting pain occurring with cranial autonomic features.The hallmarks of this syndrome are the relatively short attacks and the exquisite response to indometacin.We describe the phenotype of this condition in a series of 31patients.Themean duration of attack was17min.Themean attack frequency was11.The distribution of the pain was orbital and temporal in 77 % of the patients, retro-orbital in 61%, frontal in 55%, occipital in 42%; although pain was also reported in the vertex, second division of trigeminal nerve, neck, nose, jaw, parietal region, ear, teeth, eyebrow, shoulder (ipsilateral and bilateral), arm and third division of trigeminal nerve. O
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Trigeminal Autonomic Cephalalgias (TACs) – Paroxysmal Hemicrania
Encyclopedia of the Neurological Sciences, 2014Co-Authors: Peter J. Goadsby, E. CittadiniAbstract:Paroxysmal Hemicrania (PH) is a rare primary headache disorder that belongs to a group of related conditions called trigeminal autonomic cephalalgias. These headache syndromes share lateralized clinical features, relatively short-lasting attacks, and prominent cranial parasympathetic autonomic features as their key phenotype. According to the current International Classification of Headache Disorders (ICHD-II), this group includes cluster headache, PH, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing.
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trigeminal autonomic cephalalgias tacs Paroxysmal Hemicrania
Reference Module in Neuroscience and Biobehavioral Psychology#R##N#Encyclopedia of the Neurological Sciences (Second Edition), 2014Co-Authors: Peter J. Goadsby, E. CittadiniAbstract:Paroxysmal Hemicrania (PH) is a rare primary headache disorder that belongs to a group of related conditions called trigeminal autonomic cephalalgias. These headache syndromes share lateralized clinical features, relatively short-lasting attacks, and prominent cranial parasympathetic autonomic features as their key phenotype. According to the current International Classification of Headache Disorders (ICHD-II), this group includes cluster headache, PH, and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing.
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Trigeminal autonomic cephalalgias: Paroxysmal Hemicrania, SUNCT/SUNA, and Hemicrania continua.
Seminars in Neurology, 2010Co-Authors: Peter J. Goadsby, Elisabetta Cittadini, Anna S. CohenAbstract:The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders that include cluster headache (CH), Paroxysmal Hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features (SUNCT/SUNA). Hemicrania continua (HC) is often included with this group, although the second edition of The International Classification of Headache Disorders did not link the entities. Trigeminal autonomic cephalalgias are generally characterized by relatively short-lasting attacks of severe pain and lateralized associated features including the pain, cranial autonomic symptoms, and where present, migrainous symptoms, such as photophobia. Paroxysmal Hemicrania has intermediate duration and intermediate attack frequency. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing has the shortest attack duration and the highest attack frequency. Hemicrania continua has a continuous pain with exacerbations that can include cranial autonomic symptoms as part of the phenotype. The syndromes share much in their pathophysiology and investigation paths; however, their treatment is distinct, so that the accurate differentiation is important for optimal management.
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trigeminal autonomic cephalalgias Paroxysmal Hemicrania sunct suna and Hemicrania continua
Seminars in Neurology, 2010Co-Authors: Peter J. Goadsby, Elisabetta Cittadini, Anna S. CohenAbstract:The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders that include cluster headache (CH), Paroxysmal Hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing/cranial autonomic features (SUNCT/SUNA). Hemicrania continua (HC) is often included with this group, although the second edition of The International Classification of Headache Disorders did not link the entities. Trigeminal autonomic cephalalgias are generally characterized by relatively short-lasting attacks of severe pain and lateralized associated features including the pain, cranial autonomic symptoms, and where present, migrainous symptoms, such as photophobia. Paroxysmal Hemicrania has intermediate duration and intermediate attack frequency. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing has the shortest attack duration and the highest attack frequency. Hemicrania continua has a continuous pain with exacerbations that can include cranial autonomic symptoms as part of the phenotype. The syndromes share much in their pathophysiology and investigation paths; however, their treatment is distinct, so that the accurate differentiation is important for optimal management.
Amre Nouh - One of the best experts on this subject based on the ideXlab platform.
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A Rare Case of Seasonal Episodic Paroxysmal Hemicrania (P1.206)
Neurology, 2017Co-Authors: Subhendu Rath, Amre NouhAbstract:Objective: To describe a case of seasonal episodic Paroxysmal Hemicrania and highlight the rarity of this entity. Background: Paroxysmal Hemicrania belongs to the Trigeminal Autonomic Cephalgia (TAC) spectrum of headache disorders characterized by short lasting unilateral headaches associated with autonomic features. Seasonal variants of this entity are rare with only a handful of cases reported in the literature. Design/Methods: A 53-year old healthy woman with no headache or seasonal allergies history presented with 2 years of severe pressure-like left Hemicranial short lasting headaches occurring 10–15 times a day only during the spring and summer season with no episodes of headache during the remainder of the year. The headaches are associated with left orbital pain and otalgia, lacrimation, nasal congestion and nausea. No triggers are identified and no nocturnal awakenings from these headaches occur. Results: Neurological examination was normal. Contrast enhanced MRI of the brain was normal. Based on the ICHD 3-beta criteria the patient was diagnosed with Paroxysmal Hemicrania and advised to use indomethacin during the spring and summer seasons for preventing the headaches with good response. Conclusions: Seasonal episodic Paroxysmal Hemicrania is a rare headache disorder which should be considered by neurologists when assessing a patient with intermittent unilateral headaches associated with autonomic features, occurring only during particular seasons; especially when no identified cause is found. Potential misdiagnosis of this headache as seasonal allergies may occur. Involvement of the hypothalamus with variation of melatonin production from the hypothalamic nuclei in response to change in daylight duration during various seasons has been proposed as the mechanism of circannual rhythmicity of these headaches. Disclosure: Dr. Rath has nothing to disclose. Dr. Nouh has nothing to disclose.
M Fabio D Antonaci - One of the best experts on this subject based on the ideXlab platform.
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chronic Paroxysmal Hemicrania and Hemicrania continua orbital phlebography and mri studies
Headache, 1994Co-Authors: M Fabio D AntonaciAbstract:SYNOPSIS Six patients with chronic Paroxysmal Hemicrania (CPH) and 10 patients with Hemicrania continua (HC), two indomethacin-responsive, unilateral, headache syndromes, were investigated with orbital phlebography and magnetic resonance imaging of the brain. Orbital phlebography apparently showed pathological findings more frequently in CPH than in HC. Such abnormalities did not always show preference for the side of headache. MR scans were grossly normal in these headaches.
A. R. Costa - One of the best experts on this subject based on the ideXlab platform.
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chronic Paroxysmal Hemicrania tic syndrome
Neurology, 2000Co-Authors: Eliova Zukerman, Mario F P Peres, A O Kaup, Paulo Helio Monzillo, A. R. CostaAbstract:Article abstract The association of chronic Paroxysmal Hemicrania and ticlike pain—chronic Paroxysmal Hemicrania–tic (CPH-tic)—is a recently described syndrome. The authors found only two previously reported cases. They report three new cases of this rare syndrome with both chronic Paroxysmal Hemicrania and ticlike pain concurrently and ipsilaterally. The trigeminal–autonomic cephalalgias (TAC) are considered as differential diagnoses. CPH-tic syndrome could be a different clinical entity.
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Chronic Paroxysmal Hemicrania–tic syndrome
Neurology, 2000Co-Authors: Eliova Zukerman, Mario F P Peres, A O Kaup, Paulo Helio Monzillo, A. R. CostaAbstract:Article abstract The association of chronic Paroxysmal Hemicrania and ticlike pain—chronic Paroxysmal Hemicrania–tic (CPH-tic)—is a recently described syndrome. The authors found only two previously reported cases. They report three new cases of this rare syndrome with both chronic Paroxysmal Hemicrania and ticlike pain concurrently and ipsilaterally. The trigeminal–autonomic cephalalgias (TAC) are considered as differential diagnoses. CPH-tic syndrome could be a different clinical entity.
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Chronic Paroxysmal Hemicrania-tic syndrome.
Neurology, 2000Co-Authors: Eliova Zukerman, Mario F P Peres, A O Kaup, Paulo Helio Monzillo, A. R. CostaAbstract:The association of chronic Paroxysmal Hemicrania and ticlike pain-chronic Paroxysmal Hemicrania-tic (CPH-tic)-is a recently described syndrome. The authors found only two previously reported cases. They report three new cases of this rare syndrome with both chronic Paroxysmal Hemicrania and ticlike pain concurrently and ipsilaterally. The trigeminal-autonomic cephalalgias (TAC) are considered as differential diagnoses. CPH-tic syndrome could be a different clinical entity.
Ottar Sjaastad - One of the best experts on this subject based on the ideXlab platform.
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chronic Paroxysmal Hemicrania and Hemicrania continua lack of efficacy of sumatriptan
Headache, 1998Co-Authors: Fabio Antonaci, Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:Attacks of chronic Paroxysmal Hemicrania are prevented by the continuous administration of indomethacin. Sumatriptan, an agonist of 5-HT1-like receptors, has proven effective in the treatment of cluster headache attacks. There are clear clinical similarities between chronic Paroxysmal Hemicrania and cluster headache. A natural consequence of these considerations would be to establish whether chronic Paroxysmal Hemicrania also responds similarly to sumatriptan. Since Hemicrania continua is another unilateral headache responsive to indomethacin, it would be meaningful to also include Hemicrania continua in such a study. Sumatriptan, 6 mg subcutaneous, was tried in an open fashion in 7 patients (6 women and 1 man) with chronic Paroxysmal Hemicrania and 7 patients (5 women and 2 men) with Hemicrania continua. In chronic Paroxysmal Hemicrania, the mean interval between the last three attacks prior to sumatriptan treatment (40 ± 23 minutes) was not statistically different from the mean interval between the three attacks subsequent to sumatriptan treatment of an attack (32 ± 20 minutes). In none of the patients did the mean duration of the “test attack” decrease as compared to the attacks antedating the test attach (25 ± 11 minutes and 19 ± 9 minutes, respectively) (P=0.027, Wilcoxon). In 2 patients with chronic Paroxysmal Hemicrania, placebo (saline) administration did not lead to any change in the interval between attacks. There was a mild, but statistically significant reduction in visual analog scale values for headache intensity in Hemicrania continua (P=0.04, Wilcoxon). There was no clear, ie, clinically meaningful, reduction in visual analog scale values in any particular patient with Hemicrania continua. Taken together, these results seem to show that sumatriptan is of no benefit in chronic Paroxysmal Hemicrania, but may have a partial efficacy in Hemicrania continua. However, the latter effect is clinically unimportant This minor difference in regard to the clinical effect may, nevertheless, be of some interest pathogenetically, indicating minor differences between the two headaches. The lack of sumatriptan effect in chronic Paroxysmal Hemicrania clearly and markedly strengthens the nonalignment concept in regard to chronic Paroxysmal Hemicrania and cluster headache.
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chronic Paroxysmal Hemicrania and Hemicrania continua parenteral indomethacin the indotest
Headache, 1998Co-Authors: Fabio Antonaci, Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:The interval between indomethacin administration and clinical response may be clinically relevant in the assessment of chronic Paroxysmal Hemicrania and Hemicrania continua and other unilateral headache disorders with which they can be confounded. Eight patients with chronic Paroxysmal Hemicrania (6 women and 2 men) and 12 patients with Hemicrania continua (8 women and 4 men) were entered into the study. The patients were given 50 mg of indomethacin intramuscularly (IM) on day 1 and some of them 100 mg IM on day 2 in an open fashion. The usual attack pattern was reestablished prior to the second test. The mean interval between attacks before the two injections (51 ± 18 minutes) in chronic Paroxysmal Hemicrania was significantly shorter than the mean after each of the two indomethacin injections (50 mg = 493 ± 251 minutes; 100 mg = 668 ± 211 minutes; P0.001; Mann-Whitney test). In every patient, there was a clear refractory period after indomethacin. Since the first “expected” attack after indomethacin administration did not occur, it can, with reasonable certainty, be assumed that the protective phase was initiated already prior to the time of the next “anticipated” attack. The mean attack duration was 22 minutes (last three attacks prior to test). The mean interval between the onset of two consecutive pretest attacks was 73 minutes. Since the interval between attacks was rather stable, one is, therefore, probably allowed to assume that the absolute protective effect of indomethacin on average had begun somewhere between 22 (mean attack duration) and 73 minutes after indomethacin injection. Similarly, in Hemicrania continua, the time between 50-mg indomethacin injection and complete pain relief was 73 ± 66 minutes. The pain-free period after indomethacin injection was around 13 hours (ie, 13 ± 8 hours after 50 mg and 13 ± 10 hours after 100 mg). The use of a test dosage of 50 mg of indomethacin IM (‘indotest’) gives a clear-cut answer and may be a useful tool in the diagnostic arsenal in every unilateral headache for a proper clinical assessment. A diagnosis of chronic Paroxysmal Hemicrania or Hemicrania continua is a serious matter because it may imply life-long treatment with a potentially noxious drug. It is, therefore, of the utmost importance that an ‘indotest’ is carried out in a standard fashion. In the future, the rules set forth in the present context should be followed, at least in scientific studies. Pain pressure thresholds at cranial and extracranial levels were not significantly modified after indomethacin injection in any of the headaches.
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a piroxicam derivative partly effective in chronic Paroxysmal Hemicrania and Hemicrania continua
Headache, 1995Co-Authors: Ottar Sjaastad, Fabio AntonaciAbstract:Piroxicam beta-cyclodextrin has recently been observed to be equal to, or even possibly to be superior to, indomethacin (mainly with regard to side effects) in a single case of Hemicrania continua. Piroxicam beta-cyclodextrin, 20 to 40 mg per day, was, accordingly, tried in six patients with chronic Paroxysmal Hemicrania and six patients with Hemicrania continua with a previously proven response to indomethacin. The study was conducted over a period of 3 weeks and in an open fashion. A placebo effect is considered to be negligible in these disorders. In such a comparison, piroxicam beta-cyclodextrin seemed inferior to indomethacin, in particular in chronic Paroxysmal Hemicrania.
