The Experts below are selected from a list of 180 Experts worldwide ranked by ideXlab platform
Juan A. Pareja - One of the best experts on this subject based on the ideXlab platform.
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Primary Stabbing Headache.
Handbook of clinical neurology, 2010Co-Authors: Juan A. Pareja, Ottar SjaastadAbstract:Primary Stabbing Headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vaga study). Attacks are generally characterized by moderate to severe, jabbing or Stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary Stabbing Headache may concur, synchronously or independently, with other primary Headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other Headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration.
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sunct syndrome diagnosis and treatment
Headache, 2003Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:8: CNS Drugs. 2002;16(6):373-383 Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache (Ajabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter. Comment: Another excellent review article. If you want to learn about the rare, short trigeminal autonomic cephalgia (TAC), this is a thorough and thoughtful place to start. SJT
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sunct syndrome diagnosis and treatment
CNS Drugs, 2002Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache ('jabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter.
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sunct syndrome versus idiopathic Stabbing Headache jabs and jolts syndrome
Cephalalgia, 1999Co-Authors: Juan A. Pareja, Piotr Kruszewski, A B CamineroAbstract:Both SUNCT syndrome and idiopathic Stabbing Headache (ISH) (jabs and jolts syndrome) have to be considered when encountering shortlasting Headaches. Since there are no specific tests for these Headaches, the differential diagnosis depends entirely upon assessment of the clinical features. These Headaches are generally easily distinguishable clinically. There seem to be symptomatic forms of SUNCT.
Ottar Sjaastad - One of the best experts on this subject based on the ideXlab platform.
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Primary Stabbing Headache.
Handbook of clinical neurology, 2010Co-Authors: Juan A. Pareja, Ottar SjaastadAbstract:Primary Stabbing Headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vaga study). Attacks are generally characterized by moderate to severe, jabbing or Stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary Stabbing Headache may concur, synchronously or independently, with other primary Headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other Headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration.
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sunct syndrome diagnosis and treatment
Headache, 2003Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:8: CNS Drugs. 2002;16(6):373-383 Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache (Ajabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter. Comment: Another excellent review article. If you want to learn about the rare, short trigeminal autonomic cephalgia (TAC), this is a thorough and thoughtful place to start. SJT
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sunct syndrome diagnosis and treatment
CNS Drugs, 2002Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache ('jabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter.
A B Caminero - One of the best experts on this subject based on the ideXlab platform.
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sunct syndrome diagnosis and treatment
Headache, 2003Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:8: CNS Drugs. 2002;16(6):373-383 Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache (Ajabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter. Comment: Another excellent review article. If you want to learn about the rare, short trigeminal autonomic cephalgia (TAC), this is a thorough and thoughtful place to start. SJT
-
sunct syndrome diagnosis and treatment
CNS Drugs, 2002Co-Authors: Juan A. Pareja, A B Caminero, Ottar SjaastadAbstract:Short-lasting Unilateral Neuralgiform Headache attacks with Conjunctival injection and Tearing (SUNCT) is a syndrome predominant in males, with a mean age of onset around 50 years. The attacks are strictly unilateral, generally with the pain persistently confined to the ocular/periocular area. Most attacks are moderate to severe in intensity and burning, Stabbing or electrical in character. The mean duration of paroxysms is 1 minute, with a usual range of 10 to 120 seconds (total range 5 to 250 seconds). Prominent, ipsilateral conjunctival injection and lacrimation regularly accompany the attacks. Nasal stuffiness/rhinorrhoea are frequently noted. In addition, there is subclinical forehead sweating. During attacks, there is increased intraocular pressure on the symptomatic side and swelling of the eyelids. No changes in pupil diameter have been observed. Attacks can be triggered mostly from trigeminally innervated areas, but also from the extratrigeminal territory. There are also spontaneous attacks. An irregular temporal pattern is the rule, with symptomatic periods alternating with remissions in an unpredictable fashion. During active periods, the frequency of attacks may vary from 30 attacks/hour. The attacks predominate during the daytime, nocturnal attacks being seldom reported. A SUNCT-like picture has been described in some patients with either intra-axial or extra-axial posterior fossa lesions, mostly vascular disturbances/ malformations. In the vast majority of patients, however, aetiology and pathogenesis are unknown. In SUNCT syndrome, there is a lack of persistent, convincingly beneficial effect of drugs or anaesthetic blockades that are generally effective in cluster Headache, chronic paroxysmal hemicrania, trigeminal neuralgia, idiopathic Stabbing Headache ('jabs and jolts syndrome'), and other Headaches more faintly resembling SUNCT syndrome. Single reports have claimed that carbamazepine, lamotrigine, gabapentin, corticosteroids or surgical procedures may be of help. However, caution is recommended when assessing any therapy in a disorder such as SUNCT syndrome, in which the rather chaotic and unpredictable temporal pattern makes the assessment of any drug/therapeutic effect per se a particularly difficult matter.
-
sunct syndrome versus idiopathic Stabbing Headache jabs and jolts syndrome
Cephalalgia, 1999Co-Authors: Juan A. Pareja, Piotr Kruszewski, A B CamineroAbstract:Both SUNCT syndrome and idiopathic Stabbing Headache (ISH) (jabs and jolts syndrome) have to be considered when encountering shortlasting Headaches. Since there are no specific tests for these Headaches, the differential diagnosis depends entirely upon assessment of the clinical features. These Headaches are generally easily distinguishable clinically. There seem to be symptomatic forms of SUNCT.
J Espejo - One of the best experts on this subject based on the ideXlab platform.
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idiopathic Stabbing Headache jabs and jolts syndrome
Cephalalgia, 1996Co-Authors: J A Pareja, J Ruiz, C De Isla, H Alsabbah, J EspejoAbstract:The clinical features of idiopathic Stabbing Headache ("jabs and jolts syndrome") were studied in 38 patients who were diagnosed throughout a 1-year period. Mean age at the onset of symptoms was 47.1 years +/- 14.5 (SD), and a clear female preponderance was demonstrated (female/male ratio = 6.6). Painful attacks were ultrashort, i.e. virtually all attacks in more than two thirds of cases lasted only one second. The frequency of attacks varied immensely, ranging from 1 attack per year to 50 attacks daily. The pain paroxysms usually occurred with an irregular or sporadic temporal pattern. The localization of painful attacks was reported frequently as unifocal, usually in the orbital area, but also multifocal patterns were observed, the attacks frequently changing location from one area to the next. The majority of attacks occurred spontaneously, and accompanying phenomena were reported only rarely. Indomethacin treatment (75 mg daily) seemed to have a complete or partial effect in most patients treated as such (n = 17).
Matthew S Robbins - One of the best experts on this subject based on the ideXlab platform.
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primary and secondary Stabbing Headache
Headache, 2015Co-Authors: Matthew S Robbins, Randolph W EvansAbstract:Eight out of the 33 cases of primary Stabbing Headache seen in a general neurology clinic (40% have Headache as their chief complaint) in the last 3.5 years are presented. The epidemiology, association with other primary Headache disorders, secondary associations, testing, and treatment of primary Stabbing Headache are reviewed.
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Primary Stabbing Headache in Adults and Pediatrics: a Review
Current Pain and Headache Reports, 2014Co-Authors: Suzanne Hagler, Karen Ballaban-gil, Matthew S RobbinsAbstract:Primary Stabbing Headache (PSH) is an under-recognized primary Headache disorder, which often goes undiagnosed. It is mainly characterized by its ultrashort Stabbing quality and can be easily overlooked both by patients and providers as it is often not severe enough to interfere significantly with daily life. However, PSH may be severe and require therapy, and it is important for providers to recognize this Headache type, both in adult and pediatric populations, as well as to be able to distinguish it from secondary Headache disorders. PSH also may be more common than previously thought.
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Transient Stabbing Headache from an acute thalamic hemorrhage
The Journal of Headache and Pain, 2011Co-Authors: Matthew S RobbinsAbstract:Stabbing Headache can be encountered in both primary and secondary forms, but has been infrequently reported among patients with stroke, and is not known to be associated with a small well-circumscribed brain lesion. A 95-year-old woman taking warfarin presented with the sudden onset of Stabbing Headache strictly in the right frontal and supraorbital regions, along with gait imbalance and dysarthria. Neuroimaging revealed a small left thalamic hematoma. This association of an acute thalamic lesion with Stabbing Headache in the contralateral trigeminal distribution is discussed, along with a brief review of Stabbing Headache occurring in cerebrovascular disease.