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Background: Ophthalmoplegic migraine (OM) is an uncommon variant of migraine characterised by headache and cranial nerve palsy, posing significant diagnostic and therapeutic challenges. Objective: This study aimed to describe an extremely rare OM variant with a partial therapeutic response. Clinical Case: A 34-year-old pregnant woman in gestational week 19.1 (G6P2A3) with a history of three consecutive spontaneous abortions presented at the emergency services with insidious onset and mild-to-moderate-intensity pulsatile bifrontal headache for 15 days, and the positional changes exacerbated this. At peak intensity, she experienced nausea, vomiting, tinnitus, and photophobia without phonophobia or osmophobia, prompting multiple visits to the emergency department. Despite a broad range of treatments, including intravenous fluids, analgesia, pericranial blocks, and preventive management, there was a non-significative improvement in the symptomatology described above. However, spontaneous resolution of this clinical picture was observed during the postpartum period. Results: This case highlights the complexity of ophthalmoplegic migraine, especially in the context of pregnancy, and raises questions about the underlying pathophysiological mechanisms. The absence of structural lesions on neuroimaging and postpartum resolution suggests a potential association with the hormonal and physiological changes associated with pregnancy. Conclusions: Despite limited scientific evidence, this report contributes to expanding the knowledge of this rare entity and emphasises the importance of a multidisciplinary approach to its management. [ABSTRACT FROM AUTHOR]

Background Pulsed radiofrequency neuromodulation (PRFN) of greater occipital nerve (GON) is considered in patients with headaches failing to achieve sustained analgesic benefit from nerve blocks with local anesthetic and steroids. However, the evidence supporting this practice is unclear.Aims This narrative systematic review aims to explore the effectiveness and safety of GON PRFN on headaches.Methods Databases were searched for studies, published up to February 1, 2024, investigating PRFN of GON for adults with headaches. Abstracts and posters were excluded. Primary outcome was change in headache intensity. Secondary outcomes included effect on monthly headache frequency (MHF), mental and physical health, mood, sleep, analgesic consumption, and side-effects. Two reviewers screened and extracted data.Results Twenty-two papers (2 randomized controlled trials (RCT), 11 cohort, and 9 case reports/series) including 608 patients were identified. Considerable heterogeneity in terms of study design, headache diagnosis, PRF target and settings, and image-guidance was noted. PRFN settings varied (38–42°C, 40–60 V, and 150–400 Ohms). Studies demonstrated PRFN to provide significant analgesia and reduction of MHF in chronic migraine (CM) from 3 to 6 months; and significant pain relief for ON from six to ten months. Mild adverse effects were reported in 3.1% of cohort. A minority of studies reported on secondary outcomes. The quality of the evidence was low.Conclusions Low-quality evidence indicates an analgesic benefit from PRFN of GON for ON and CM, but its role for other headache types needs more investigation. Optimal PRFN target and settings remain unclear. High-quality RCTs are required to further explore the role of this intervention. PROSPERO ID CRD42022363234.

Background: Growing evidence suggests that headache disorders and atopic dermatitis share similar pathological mechanisms and risk factors. The aim of this study was to assess the risk for headache disorders in patients with atopic dermatitis. Methods: We systematically searched the PubMed and Embase databases from inception to December 1, 2023, for observational studies that examined risk of migraine in subjects with atopic dermatitis. Risk estimates from individual studies were pooled using random-effects models. Results: Ten studies with 12,717,747 subjects were included in the meta-analysis. Our results showed that patients with atopic dermatitis were associated with a higher risk of headache disorder (OR, 1.46, 95% CI = 1.36-1.56; P < 0.001; I2 = 98%) or migraine (OR, 1.32, 95% CI = 1.18-1.47; P < 0.001; I2 = 98.9%). Most of the results of the subgroup analyses were consistent with the overall results. Conclusion: The findings of this meta-analysis suggest that atopic dermatitis is a potential risk indicator for headache disorder or migraine. Further studies are still needed to verify our findings due to the substantial heterogeneity in our analyses. [ABSTRACT FROM AUTHOR]

Individuals who experience migraines often seek out a variety of treatment options including manual or physical therapy. Evidence suggests that manual therapy, including osteopathy, can play a role in the management of migraines. Whilst there is some literature on the role osteopathy therapy plays in migraine management, none describes the treatment approaches used by practitioners. To explore the demographic, practice and clinical management characteristics of Australian osteopaths who report treating migraine 'often' in clinical practice. Secondary analysis of a cross-sectional survey of 988 osteopaths from the Osteopathy Research and Innovation Network (ORION), an Australian practice-based research network. Regression analysis was used to identify demographic, practice and clinical management characteristics of Australian osteopaths who reported 'often' treating migraine patients. Over 40% of respondents (n = 400) indicated treating patients with migraines 'often'. These osteopaths were less likely to be involved in research and be co-located with a dietician compared to osteopaths who do 'not often' treat migraine. Osteopaths who reported 'often' treating migraine were: five times as likely to treat non-English speaking ethnic groups; 2.5 times as likely to treat chronic pain, temporomandibular joint disorders and hand musculoskeletal complaints; compared to those that do not treat migraines 'often'. Australian osteopaths who treat migraine are five times more likely to treat non-English speaking ethnic groups; twice as likely to treat chronic pain; temporomandibular joint disorders, and hand musculoskeletal complaints. More research is needed to identify the practices and patient outcomes associated with osteopathy care for those experiencing migraines. • Osteopaths who reported 'often' treating migraine were five times as likely to treat non-English speaking ethnic groups and 2.5 times as likely to treat chronic pain. • Australian osteopaths who reported 'often' treating migraine patients were also more likely to report sending referrals to psychologists. • Australian osteopaths who reported 'often' treating patients with migraines were more likely to engage in discussions with patients about a range of lifestyle measures. [ABSTRACT FROM AUTHOR]

Background: Pulsed radiofrequency neuromodulation (PRFN) of greater occipital nerve (GON) is considered in patients with headaches failing to achieve sustained analgesic benefit from nerve blocks with local anesthetic and steroids. However, the evidence supporting this practice is unclear. Aims: This narrative systematic review aims to explore the effectiveness and safety of GON PRFN on headaches. Methods: Databases were searched for studies, published up to February 1, 2024, investigating PRFN of GON for adults with headaches. Abstracts and posters were excluded. Primary outcome was change in headache intensity. Secondary outcomes included effect on monthly headache frequency (MHF), mental and physical health, mood, sleep, analgesic consumption, and side-effects. Two reviewers screened and extracted data. Results: Twenty-two papers (2 randomized controlled trials (RCT), 11 cohort, and 9 case reports/series) including 608 patients were identified. Considerable heterogeneity in terms of study design, headache diagnosis, PRF target and settings, and image-guidance was noted. PRFN settings varied (38–42°C, 40–60 V, and 150–400 Ohms). Studies demonstrated PRFN to provide significant analgesia and reduction of MHF in chronic migraine (CM) from 3 to 6 months; and significant pain relief for ON from six to ten months. Mild adverse effects were reported in 3.1% of cohort. A minority of studies reported on secondary outcomes. The quality of the evidence was low. Conclusions: Low-quality evidence indicates an analgesic benefit from PRFN of GON for ON and CM, but its role for other headache types needs more investigation. Optimal PRFN target and settings remain unclear. High-quality RCTs are required to further explore the role of this intervention. PROSPERO ID CRD42022363234. [ABSTRACT FROM AUTHOR]

There were examined 142 patients with recurrent headache (cephalgia) and arterial hypertension, a mean – 49.26±1.33 years, of whom 69 men, 73 women who used intermittent fasting (patients spent 24 hours without food, 1 time per week, four repetitions). The control group consisted of 32 people of comparable age without hypertension (n=32; mean age 51.0±1.99 years). The purpose of the study was to increase the effectiveness of diagnostic and therapeutic methods in patients with hypertension and headache by establishing the meaning and peculiarities of the influence of intermittent fasting on headaches, neck carotid and intracranial circulation. There were 51 (35.9%±4.03) patients aged 25-44 years’; 45-59 years – 42 (29.58%±3.83) patients; 60-75 years – 49 (34.51%±3.99) patients. It was found that the structural pathology of the main arteries of the head consisted mainly in the thickening of the intima-media from 0,8 to 1,4 mm in 62.7% at the age of 25-44 years; in 71,4% at the age of 45-59; in 51% at the age of 60-75 years. Local thickenings in the bifurcation zone from 1.5 mm without hemodynamically significant stenosis were found in 9.8% at the age of 24-44 years, in 28.6% at the age of 45-59 years and in 49% at the age of 60-75 years. Statistical differences in linear circulatory velocity between the control group and the group of patients were significant already at the age of 25-44 years, for peak systolic velocity in the internal carotid artery (78.03±4.67 vs. 61.0±2.54 in control, p

Objective: To describe a patient's clinical case with migraine who improved with a milk-gluten-sugar-free diet. Clinical Features: A patient with migraine for 25 years has had episodic pain 1?2 days long, in addition to photophobia and phonophobia. She was treated with analgesics, topiramate, and antidepressants, with no improvement in her condition. Intervention and outcome: She was treated with a milk-gluten-sugar-free diet and improved in about 3 weeks. Conclusion: This is a case report of a patient with migraine treated with a milk-gluten-sugar-free diet who had a remarkable clinical response.

There were examined 142 patients with recurrent headache (cephalgia) and arterial hypertension, a mean – 49.26±1.33 years, of whom 69 men, 73 women who used intermittent fasting (patients spent 24 hours without food, 1 time per week, four repetitions). The control group consisted of 32 people of comparable age without hypertension (n=32; mean age 51.0±1.99 years). The purpose of the study was to increase the effectiveness of diagnostic and therapeutic methods in patients with hypertension and headache by establishing the meaning and peculiarities of the influence of intermittent fasting on headaches, neck carotid and intracranial circulation. There were 51 (35.9%±4.03) patients aged 25-44 years’; 45-59 years – 42 (29.58%±3.83) patients; 60-75 years – 49 (34.51%±3.99) patients. It was found that the structural pathology of the main arteries of the head consisted mainly in the thickening of the intima-media from 0,8 to 1,4 mm in 62.7% at the age of 25-44 years; in 71,4% at the age of 45-59; in 51% at the age of 60-75 years. Local thickenings in the bifurcation zone from 1.5 mm without hemodynamically significant stenosis were found in 9.8% at the age of 24-44 years, in 28.6% at the age of 45- 59 years and in 49% at the age of 60-75 years. Statistical differences in linear circulatory velocity between the control group and the group of patients were significant already at the age of 25-44 years, for peak systolic velocity in the internal carotid artery (78.03±4.67 vs. 61.0±2.54 in control, p<0.05). At the age of 45-59 years, linear circulatory velocity affected all carotid and vertebral arteries, as in the group aged 60-75. The effect of intermittent fasting on aged hemodynamics consists mainly in changes of velocity of flow in arteries with better results in younger patients. Changes in the elastic-tonic characteristics of the main arteries of the head according to the index of resistance (index was 0.72±0.01 for common carotid artery and 0.63±0.01 after intermittent fasting in patients at the age of 25-44 years; 0.78±0.01 before and 0.67±0.01 after at the age of 60-75 years were revealed). The use of the intermittent fasting method caused mainly an increase in diastolic flow rates in the main arteries (with age dependences) and a decrease in systolic velocity in the age group 25-44 years. The pathophysiological interpretation of such changes is in the reducing the resistance, values of the main arteries of the head. [ABSTRACT FROM AUTHOR]

There is a range of current treatment options for cervicogenic headache, and of these, Mulligan mobilization has been frequently used in treatment in recent years. There is no previous review evaluating the efficacy of Mulligan mobilization in cervicogenic headache. The aim of this review was to investigate the efficacy of the Mulligan mobilization technique on patients with cervicogenic headache. A systematic review of English articles published by Google Scholar, PubMed, Scopus, Pedro, Web of Science and Cochrane through December 2018. This review included randomized controlled trials published in English, which focused Mulligan mobilization in patients with cervicogenic headache. The risk of bias of the studies included was evaluated using two different classification systems. The summary of results was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.10 randomized controlled trials included in the review. It is seen that Mulligan mobilization may decreases pain, disability and may increases the quality of life in individuals with cervicogenic headache. Mulligan mobilization may be an effective manual therapy method on reducing the severity and frequency of pain and improving functional status in individuals with cervicogenic headache. Also, the self-techniques and applying mobilization with rotation may increase the success of the treatment. [ABSTRACT FROM AUTHOR]

Aim: Headache attributed to temporomandibular disorders and myalgia are two diagnoses included in the diagnostic criteria for temporomandibular disorders (DC/TMD). However, it is not clear if these two diagnoses are different clinical entities given their similar presentation and way in which they are diagnosed, when the myalgia is within the temporalis muscle. The purpose of this retrospective study was to assess the overlap between headache attributed to temporomandibular disorders and myalgia of the temporalis muscle. Methods: The charts of 671 patients seeking treatment at the Section of Orofacial Pain and Jaw Function, Aarhus University, Denmark, between January 2015 and February 2020 were screened for a diagnosis of headache attributed to temporomandibular disorders, myalgia of the temporalis muscle, or both. Results: A total of 89 patients fulfilled the DC/TMD criteria for either headache attributed to TMD, myalgia of the temporalis or both. Of these, two had a diagnosis of headache attributed to TMD, 16 of myalgia of the temporalis, and 71 were diagnosed with both. In 97.3% of the times that headache attributed to temporomandibular disorders was diagnosed, the patient was also diagnosed with myalgia of the temporalis. The Jaccard index was 0.8, indicating a substantial overlap between the two diagnoses. Finally, the overlap of pain location between the two diagnoses was substantial, with a Jaccard index of 0.9. Conclusions: In the present study, headache attributed to temporomandibular disorders was almost exclusively diagnosed together with myalgia of the temporalis. Therefore, we propose that headache attributed to temporomandibular disorders and myalgia of the temporalis muscle have more clinical similarities than differences and as such could be considered one single clinical entity. Further studies will be needed to address the clinical consequences of this proposal. [ABSTRACT FROM AUTHOR]

The study of the effectiveness and safety of intermittent fasting (IF) at 185 patients aged from 25 to 75 years (mean age – 48,6 years) with arterial hypertension (AH) and headache was carried out. AH was seen as the most likely factor of cerebral discirculation and associated cephalgia. Patients volunteered to maintain a short-term dietary restriction with terms of 16 or 24 hours once in 7 days over a period of 4 weeks. During this period, 43 patients stopped participation in the study, of which 31 - at 24-hour IF and 12 - at 16-hour IF. The assessment of the influence on cephalgia was considered positive when the score of visual analog scale (VAS) was decreased by 2 or more points and / or there was a significant decrease in the duration and frequency of cephalgia attacks. In a rhythmic diet with a 16-hour food intake missing, a positive result was registered at 35% (37,25% of young patients, 40,48% – of average and 28,57% of the elderly) without a significant difference between ages. The effectiveness of a 24-hour type of IF was higher and made up about 75% in all age groups. Negative side effects of IF that would require its termination due to objective reasons (threatening changes in blood pressure, syncope states and others) were not recorded, the most common complaints were the feeling of hunger (from 50 to 76% with a difference in age), psychological tension, uncertain anxiety (on average about 32%). The authors consider that such a psychological feature - namely, the impossibility and unwillingness to endure short-term fasting was a main factor of refusal to continue the treatment regimen, and within certain limits prevents the wider use of IF method in the treatment of cephalgia. In general, the efficacy of a 24-hour IF compared with a 16-hour type was significantly higher, without severe side effects.

Introduction: Trigeminal neuralgia is described as severe, stabbing unilateral pain along the distribution of trigeminal nerve branches. The three subtypes include- Classical, secondary and idiopathic. Aim: To study the clinical profile, presentation and radiological imaging features in trigeminal neuralgia patients. Materials and Methods: This cross-sectional study included outpatient medical records of 60 trigeminal neuralgia patients between June 2015 to June 2020 (five years) in a Tertiary care Medical College Hospital. Various parameters studied were: (a) Age; (b) Gender; (c) Dental treatment; (d) Pain severity; (e) Trigger factors; (f) Side and branch involved; (g) Sensory abnormalities; (h) MRI. Data was entered in Microsoft excel and analysed using SPSS statistical software 20.0. Chi-square test was used for categorical variables. Results: Among the 60 patients studied, the common demographic and clinical features were as follows: 34 were females (56.7%); 36 with right side presentation (60%); 25 had maxillary nerve division distribution (41.7%); 57 patients experienced shock/lancinating pain (95%); and 40 had numeric pain severity scale of 4-6 (66.7%). Classical Trigeminal Neuralgia was the most common subtype seen in 31 patients (51.7%). Involvement of dual divisions (maxillary and mandibular), absence of trigger factors and presence of hypoesthesia were more suggestive of Secondary Trigeminal Neuralgia (p

Introduction: Trigeminal neuralgia is described as severe, stabbing unilateral pain along the distribution of trigeminal nerve branches. The three subtypes include- Classical, secondary and idiopathic. Aim: To study the clinical profile, presentation and radiological imaging features in trigeminal neuralgia patients. Materials and Methods: This cross-sectional study included outpatient medical records of 60 trigeminal neuralgia patients between June 2015 to June 2020 (five years) in a Tertiary care Medical College Hospital. Various parameters studied were: (a) Age; (b) Gender; (c) Dental treatment; (d) Pain severity; (e) Trigger factors; (f) Side and branch involved; (g) Sensory abnormalities; (h) MRI. Data was entered in Microsoft excel and analysed using SPSS statistical software 20.0. Chi-square test was used for categorical variables. Results: Among the 60 patients studied, the common demographic and clinical features were as follows: 34 were females (56.7%); 36 with right side presentation (60%); 25 had maxillary nerve division distribution (41.7%); 57 patients experienced shock/lancinating pain (95%); and 40 had numeric pain severity scale of 4-6 (66.7%). Classical Trigeminal Neuralgia was the most common subtype seen in 31 patients (51.7%). Involvement of dual divisions (maxillary and mandibular), absence of trigger factors and presence of hypoesthesia were more suggestive of Secondary Trigeminal Neuralgia (p<0.05). Based on MRI imaging, 31 (51.7%) showed neurovascular compression with atrophy or displacement of trigeminal nerve root. Only 5 (8.4%) had secondary causes (schwannoma, meningioma, demyelination, infarct). Conclusion: The key clinical features of trigeminal neuralgia include female preponderance, right side presentation, maxillary nerve division distribution, shock/lancinating pain with touch and breeze as common trigger factors. As some of them had a previous dental treatment or procedure, dentists need to be aware of this entity. Certain clinical features would help to differentiate the secondary from classic and idiopathic neuralgia subtype. [ABSTRACT FROM AUTHOR]

Acute encephalitis is a severe pathology represented by the inflammation of the brain parenchyma associated with neurological dysfunction. The etiology is predominantly viral or autoimmune, with different therapeutic approach. The typical manifestations include fever, epileptic seizures and neurological focal signs. The treatment consists in specific drug therapies regarding the etiology and rehabilitation therapies in case of incomplete recovery. We present a case of a 43-year-old woman with occipital cephalalgia and dizziness, associated with vesperal high blood pressure levels at the same hour daily. The brain MRI described possible acute encephalitis, with FLAIR and T2 hypersignal area on right parietal region and diffusion restriction. The lumbar puncture revealed no modifications and the EEG recordings showed irritative patterns. The acyclovir intravenous treatment and an antiepileptic drug were initiated. The repeated MRI revealed laminar necrosis which explained the vegetative epileptic seizures manifested with high blood pressure. The clinical status of the patient majorly improved due to specific treatment including rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Aim. The objective of this study was detecting of neurological pathology among first grade students.Materials and methods. We examined 2507 students (1414 male and 1093 female) in the age from 16 to18 in the process of deep medical examination. We collected neurological complains, neurostatus, analyses of medical documentation. This data was statistically handled.Results. Therefore 80% of students had neurological pathology. The most frequent cases were vegetative-vascular dystonia, vertebrogenic pathology and essential headache.Conclusions. The gained data means the very high level of neurological disease among students, which shows not only importance of rehabilitation activities, but modernization of preventive activities among adolescences.

The aim of this scientific work is detecting of neurological pathology among first grade students. We examined 2507 students (1414 male and 1093 female) in the age from 16 to 18 in the process of deep medical examination. We collected neurological complains, neurostatus, analyses of medical documentation. This data was statistically handled. Therefore 80% of students had neurological pathology. The most frequent cases were vegetative-vascular dystonia, vertebrogenic pathology and essential headache. The gained data means the very high level of neurological disease among students, which shows not only importance of rehabilitation activities, but modernization of preventive activities among adolescences.

The study of the effectiveness and safety of intermittent fasting (IF) at 185 patients aged from 25 to 75 years (mean age – 48,6 years) with arterial hypertension (AH) and headache was carried out. AH was seen as the most likely factor of cerebral discirculation and associated cephalgia. Patients volunteered to maintain a short-term dietary restriction with terms of 16 or 24 hours once in 7 days over a period of 4 weeks. During this period, 43 patients stopped participation in the study, of which 31 -at 24-hour IF and 12 -at 16-hour IF. The assessment of the influence on cephalgia was considered positive when the score of visual analog scale (VAS) was decreased by 2 or more points and / or there was a significant decrease in the duration and frequency of cephalgia attacks. In a rhythmic diet with a 16-hour food intake missing, a positive result was registered at 35% (37,25% of young patients, 40,48% – of average and 28,57% of the elderly) without a significant difference between ages. The effectiveness of a 24-hour type of IF was higher and made up about 75% in all age groups. Negative side effects of IF that would require its termination due to objective reasons (threatening changes in blood pressure, syncope states and others) were not recorded, the most common complaints were the feeling of hunger (from 50 to 76% with a difference in age), psychological tension, uncertain anxiety (on average about 32%). The authors consider that such a psychological feature -namely, the impossibility and unwillingness to endure short-term fasting was a main factor of refusal to continue the treatment regimen, and within certain limits prevents the wider use of IF method in the treatment of cephalgia. In general, the efficacy of a 24-hour IF compared with a 16-hour type was significantly higher, without severe side effects. [ABSTRACT FROM AUTHOR]

The article presents a case of idiopathic hypertrophic pachymeningitis of a 61-year-old male patient with severe cephalgia and progressive neuropathy of the oculomotor nerves. The diagnosis was confirmed by MRI with gadolinium, which revealed thickening of the dura mater with accumulation of paramagnetic in the convexital parts of the frontal and temporal regions, as well as on the base of the skull and tentorium. During the use of pulse therapy with glucocorticosteroids (GCS) the symptoms regressed, but when the therapy was stopped, there was a relapse of ptosis and oculomotor abnormalities on the other side followed by a slower effect of GCS therapy. The article also presents a brief review of current knowledge about this pathology.

Headache secondary to sinonasal disease is still overestimated in the diagnostic pathway of cephalalgia. Contrary to belief, so-called sinus headaches are fairly uncommon and seen mostly in acute sinusitis or acute exacerbations. Even though literature has written extensively about the prevalence of migraines in self-diagnosed or primary care-diagnosed sinus headache, there is only a small body of literature regarding the real prevalence of pain and headache occurring during acute and chronic sinusitis.We reviewed the current literature and clarified the differences in presentation of pain for acute and chronic sinusitis, highlighting the higher prevalence of pain in chronic rhinosinusitis without polyps versus with polyps. Furthermore, we stressed the need for a rethinking in the clinical diagnosis of sinusitis based on pain as a major symptom. [ABSTRACT FROM AUTHOR]

Aim To investigate the relationship between primary headache types and accomplished or attempted suicide in countries from all world regions. Methods Data were obtained using a questionnaire about suicide due to headache in a face-to-face interview with 203 physicians with expertise in headaches. They came from 48 countries, and from all continents. Results Primary headaches cause one suicide per 1,000,000 population each year (1% of the suicide rate due to all causes). Cluster headache and migraines account for 70-80% of them. Suicide attempts are 10 times more frequent than accomplished suicides. Cluster headache poses more risk than migraine. This risk is not often acknowledged, and is increased if there is previous psychiatric history. More than half of the physicians interviewed think it could be reduced with a more aggressive treatment of headaches. Conclusions Cluster headache and migraine are not always benign, and are the cause of the majority of suicides due to headache. [ABSTRACT FROM AUTHOR]

Neck-tongue syndrome is a rarely reported headache disorder characterized by occipital and/or upper neck pain triggered by sudden rotatory head movement and accompanied by abnormal sensation and/or posture of the ipsilateral tongue. Although onset is thought to be in childhood, most of the limited number of cases reported so far were adults. Here the authors describe 3 cases, 2 girls and 1 boy, with neck-tongue syndrome. In each child additional headache symptoms occurred, headache improved over time in all, spontaneously in 2 and coinciding with gabapentin treatment in the other. Investigations were consistently unremarkable. Review of the literature reveals a usually self-limiting disorder, with early onset and variable additional features. Awareness of neck-tongue syndrome among pediatric neurologists and other practitioners is important, to allow for timely diagnosis and informed management of an underreported headache disorder with childhood onset. [ABSTRACT FROM AUTHOR]

Cephalalgia is the 10th and the 14th most frequent symptom in women and men respectively. It has a peak prevalence at the age of 401. After the age of 65, although with less frequency than in young individuals, a new onset of cephalalgia or a change of pattern in a chronic cephalalgia brings up a diagnostic challenge due to an increased incidence of side effects from malignant diseases within this population group2. Some of the secondary headaches in elderly patients include subarachnoid or intracranial hemorrhage, ischemic stroke, pharmacological, temporal arteritis, and central nervous system (CNS) tumors or infection2. Cluster headache (CC) belong to a group called trigeminalautonomic cephalalgias (TACs). TACs are primary headaches with a common clinical phenotype consisting of unilateral trigeminal pain with ipsilateral autonomic signs, which may include lacrimation, rhinorrhea and miosis3,4. The average age of onset is usually 28-30 years of age, so special care should be taken when diagnosing it in elderly patients. Due to this exceptionality, neuroimaging studies are required to rule out secondary causes2. We discuss the case report of an elderly patient with a cephalalgia initially identified as a Cluster headache. Cephalalgia and respiratory clinical features suggest a malignant disease before the appearance of neurologic focus and the diagnosis through an imaging test. [ABSTRACT FROM AUTHOR]

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Résumé L’Algie Vasculaire de la Face (AVF) se manifeste par des accès douloureux paroxystiques fréquents et invalidants. L’intensité de la douleur est exceptionnellement sévère. Dans l’AVF, des manifestations psychiques ou comportementales sont retrouvées en cours de crise, avec une sémiologie pour le moins singulière, voire extrême. Ce travail phénoménologique veut tenter de répondre à la question : « Qu’est-ce que cela vous fait d’avoir une crise d’AVF ? » en utilisant la méthode dite d’entretien d’explicitation des vécus conscients. Trois axes phénoménologiques se différencient : (1) une altération de l’Être-au-monde attestée par une impression de restriction physique et d’enfermement insupportable, imposé, sans échappatoire ; (2) une altération de l’Être-à-soi qui va de la déformation à la dissolution ; (3) et une altération de l’Être-à-l’autre allant de la solitude impérative à la seule acceptation d’une présence sans mots. Objectives Cluster headache (CH) is a rare disease (1 to 3/1000), predominant in men (sex ratio: four men/one woman) and characterized by frequent very painful paroxystic attacks occurring sometimes eight times by day. CH is a disease without lesion and impairs the quality of life of patients. Attacks occur only on the same hemiface and can last from 15 minutes to 3 hours. The pain is particularly severe and a frequent and extreme psychiatric symptomatology is observed during the attacks. Treatments are rare and not always efficient: sumatriptan, oxygen, LSD, psilocybin. In this paper, we try to answer to the question: “What does that make you to have a cluster headache attack?” using elicitation interview developed by Vermersch. Patients and methods Ten patients have been interviewed using elicitation interview (EI) (40–50 min for one interview). All these patients (seven men's and three women's) T suffer from chronic or episodic CH, with a mean age of 43 years. The patients come from the Lariboisière hospital (Paris), and more precisely from the center of headache urgency. EI allows describing the pre-reflexive consciousness contents. The method is described in Balzani et al., and in Petitmengin et al. (see bibliography). Data analyses were performed using Interpretative phenomenological analysis (IPA). Results From the EI, we have distinguished three phenomenological axes, following Heidegger's philosophy: (1) An alteration of being-to-the-world with a strong unbearable feeling of imprisonment, and physical restriction. At the same time the patients present a stereotypical and automatic behavior with few motor schemes and escaping strategies. When pain arises, they want to leave and to go very far. Aggressive behaviors frequently occur. Sometimes, the patients are not able to perform the sumatripan injection, due to a motor inhibition. Some patients try to do autohypnosis or other methods to resist to the pain. (2) An alteration of being-to-the self, going from the corporal distortion to the body dissolution. At the onset of symptoms, the patient does the experience of physical deformation, particularly of the face, with strong vegetative symptoms. The patient is not able to control corporeal manifestations: tears, mad thinks, incoherent projects in order to stop the crisis. Some patients want to remove the part of their body where the pain is the most intense (eye, for example). There is a losing of the body limits and a loss of the time orientation. In many cases, the pain is unbearable and patients want to commit suicide. At the extreme, the sensation of self seems destroyed, and some patients evoke an experience similar than Near Death Experiences, or describe an experience of swaying in emptiness or imminent death. (3) An alteration of being-to-the-other, going from the imperative solitude to the acceptance for a presence without words. Solitude is the most experience for the patients. They cannot accept anybody. Another person is unbearable, because asking questions about the crisis. In the same time, the patient is scared of this solitude since he is not able to speak about his painful experience. In summary, the structure of the self is altered, and thinking is completely disturbed. The experience of time and space is modified and a pragmatism is a consequence of this intense pain. During the crisis, pain is central and the patient lives a kind of dissolution, near death: a self-dismantling. Conclusion The EI have allowed us to describe precisely the painful experience of subjects with a cluster headache. This experience is very rich and very intense. EI, as a phenomenological method, is a very useful method to describe more precisely the symptomatology of a disease, because it pays attention to the effective experience of the pathological flesh, as compared to the pathological body. [ABSTRACT FROM AUTHOR]

Headaches are very common in children and adolescents. Headaches occur, on average, in 53% of children and adolescents. Most headaches are classified as migraines, tension headaches, or mixed headache syndrome. Headaches may be either acute or chronic and may be either progressive or non-progressive. Many headaches in children and adolescents are amenable to lifestyle changes and relaxation techniques. Medical management in conjunction with complimentary and alternative therapies often provides the best results for headache management. [ABSTRACT FROM AUTHOR]

We present the case of a 47 years old woman submitted to an endovascular trapping of a left cavernous internal carotid artery aneurysm, in which the distal balloon was inflated, as usually done, within the cavernous segment of the internal carotid artery, different from the proximal one which was inflated inside the carotid canal due to technical problems. Consequently, a clinical picture of Raeder's paratrigeminal neuralgia took place. This is the first case report in the literature with theses characteristics. A review of the anatomic pathways and further considerations about the possible pathophysiological mechanisms involved are presented.Apresentamos o caso de uma mulher de 47 anos submetida a obliteração endovascular de um aneurisma gigante de carótida interna cavernosa à esquerda, no qual o balão distal foi inflado, tal como usual, dentro do segmento cavernoso da artéria carótida interna, diferente do proximal, o qual foi inflado dentro do canal carotídeo devido a problemas técnicos. Conseqüentemente, um quadro clínico de neuralgia paratrigeminal de Raeder se instalou. Este é o primeiro relato na literatura com estas características. Uma revisão das vias anatômicas e maiores considerações a respeito de possíveis mecanismos fisiopatológicos envolvidos são apresentados.

We present the first mnemonic in Spanish, "PPIENSENLo," for alarm criteria in secondary headaches in children in order to facilitate their identification, diagnosis, and treatment. A search was performed across different electronic databases for a mnemonics that applied to clinical alarm criteria in secondary headaches in children. None were found in English or Spanish. This tool is perhaps useful both for clinical and teaching purposes. [ABSTRACT FROM AUTHOR]