Endovascular treatment of trigeminal neuralgia with cranial autonomic symptoms due to a right-sided petrous ridge dAVF

2021 ◽  
pp. 1-7
Author(s):  
Thomas Mulcahy ◽  
Norman Ma ◽  
Kenneth Mitchell
Keyword(s):  
Trigeminal Neuralgia ◽  
Endovascular Treatment ◽  
Autonomic Symptoms ◽  
Cranial Autonomic Symptoms

scholarly journals Differential diagnosis short-lasting unilateral neuralgiform headache attacks and trigeminal neuralgia

2019 ◽  
Vol 10 (2) ◽  
pp. 60-65
Author(s):  
E. V. Parkhomenko ◽  
S. E. Nartov
Keyword(s):  
Differential Diagnosis ◽  
Trigeminal Neuralgia ◽  
Diagnostic Criteria ◽  
Conjunctival Injection ◽  
Short Term ◽  
Autonomic Symptoms ◽  
Cranial Autonomic Symptoms

The article presents diagnostic criteria, comparative characteristics of short-lasting unilateral neuralgiform headache attacks, including short-term unilateral neuralgic headaches with conjunctival injection and lacrimation (SUNCT) and short-term unilateral neuralgic headaches with cranial autonomic symptoms (SUNA), differential diagnosis with trigeminal neuralgia.

scholarly journals Clinical Features of Cluster Headache without Cranial Autonomic Symptoms: Results from a Prospective multicentre study

2020 ◽  
Author(s):  
Min Kyung Chu ◽  
Byung-Su Kim ◽  
Pil-Wook Chung ◽  
Byung-Kun Kim ◽  
Mi Ji Lee ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Clinical Features ◽  
Rating Scale ◽  
Significant Proportion ◽  
Numeric Rating Scale ◽  
Autonomic Symptoms ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Headache Intensity ◽  
Cranial Autonomic Symptoms

Abstract Background: Although cranial autonomic symptoms are typical in cluster headache, some individuals with cluster headache show no cranial autonomic symptoms during their headache attacks. Probable cluster headache is a subtype of cluster headache that fulfils all but one of the five criteria for cluster headache. This study aimed to investigate the frequency and clinical features of cluster headache and probable cluster headache without cranial autonomic symptoms in comparison to those with cranial autonomic symptoms.Methods: We analysed data from the Korea Cluster Headache Registry, a prospective multicentre registry involving data from 16 hospitals.Results: Of the 216 participants with cluster headache and 26 with probable cluster headache, 19 (8.8%) and 7 (26.9%), respectively, did not have cranial autonomic symptoms. Participants with cluster headache without cranial autonomic symptoms exhibited less severe anxiety (General Anxiety Disorder-7 score, median [interquartile range], 2.0 [1.0-6.0] vs 8.0 [3.0-12.0], p = 0.001) and depression (Patient Health Questionnaire-9 score, 3.0 [1.0-7.0] vs 7.0 [3.0-11.0], p = 0.042) than those with cranial autonomic symptoms. Other clinical features, including headache intensity, daily headache frequency, attack duration, bout duration, and location of the pain, did not differ between participants with cluster headache with and without cranial autonomic symptoms. Headache intensity was less severe in participants with probable cluster headache without cranial autonomic symptoms than in those with cranial autonomic symptoms (numeric rating scale, 8.0 [7.0-8.0] vs 9.5 [8.0-10.0], p = 0.015).Conclusions: A significant proportion of participants with cluster headache and probable cluster headache did not have cranial autonomic symptoms. Some clinical features of cluster headache and probable cluster headache differed based on the presence of cranial autonomic symptoms.

scholarly journals Rizatriptan in migraineurs with unilateral cranial autonomic symptoms: a double-blind trial

2012 ◽  
Vol 13 (5) ◽  
pp. 407-414 ◽  
Author(s):  
Piero Barbanti ◽  
Luisa Fofi ◽  
Valentina Dall’Armi ◽  
Cinzia Aurilia ◽  
Gabriella Egeo ◽  
...  
Keyword(s):  
Double Blind Trial ◽  
Double Blind ◽  
Autonomic Symptoms ◽  
Blind Trial ◽  
Cranial Autonomic Symptoms

Unilateral Cranial Autonomic Symptoms in Migraine

Cephalalgia ◽  
2002 ◽  
Vol 22 (4) ◽  
pp. 256-259 ◽  
Author(s):  
P Barbanti ◽  
G Fabbrini ◽  
M Pesare ◽  
N Vanacore ◽  
R Cerbo
Keyword(s):  
Large Scale ◽  
Nasal Congestion ◽  
Migraine Treatment ◽  
Conjunctival Injection ◽  
Autonomic Symptoms ◽  
Therapeutic Implications ◽  
Ocular Symptoms ◽  
Cranial Autonomic Symptoms ◽  
Nasal Symptoms ◽  
Autonomic Reflex

Unilateral cranial autonomic symptoms (UAs) such as lacrimation, conjunctival injection, eyelid oedema and nasal congestion, which are the hallmark of trigeminal autonomic cephalgias, may also occur in an as yet undetermined proportion of migraine patients. We studied 177 consecutive migraineurs to assess the frequency of UAs and the clinical characteristics of such patients. UAs were reported by 81 patients (45.8%), ocular symptoms alone or in combination with nasal symptoms being the most frequent. The headache was more severe ( P< 0.0002) and more strictly unilateral ( P< 0.0004) in patients who reported UAs than in those without. Thus, the presence of UAs suggests an activation of the trigeminal-autonomic reflex, probably related to an over-activation of the trigeminal afferent arm. These findings could have therapeutic implications, given the potential large-scale recruitment of peripheral neurovascular 5-HT1B/1D receptors (the target of acute migraine treatment) in such patients.

scholarly journals Phenotypic and treatment outcome data on SUNCT and SUNA, including a randomised placebo-controlled trial

Cephalalgia ◽  
2017 ◽  
Vol 38 (9) ◽  
pp. 1554-1563 ◽  
Author(s):  
Hsing-Yu Weng ◽  
Anna S Cohen ◽  
Christoph Schankin ◽  
Peter J Goadsby
Keyword(s):  
Controlled Trial ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Outcome Data ◽  
Short Term ◽  
Autonomic Symptoms ◽  
Primary Headache Disorders ◽  
Cranial Autonomic Symptoms ◽  
History Of

Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are two rare headache syndromes classified broadly as Trigeminal Autonomic Cephalalgias (TACs). Methods Here, 65 SUNCT (37 males) and 37 SUNA (18 males) patients were studied to describe their clinical manifestations and responses to treatment. Results Pain was almost always unilateral and side-locked. There were three types of attack: Single stabs, stab groups, and a saw-tooth pattern, with some patients experiencing a mixture of two types. As to cranial autonomic symptoms, SUNA patients mainly had lacrimation (41%) and ptosis (40%). Most cases of the two syndromes had attack triggers, and the most common triggers were touching, chewing, or eating for SUNCT, and chewing/eating and touching for SUNA. More than half of each group had a personal or family history of migraine that resulted in more likely photophobia, phonophobia and persistent pain between attacks. For short-term prevention, both syndromes were highly responsive to intravenous lidocaine by infusion; for long-term prevention, lamotrigine and topiramate were effective for SUNCT, and lamotrigine and gabapentin were efficacious in preventing SUNA attacks. A randomized placebo-controlled cross-over trial of topiramate in SUNCT using an N-of-1 design demonstrated it to be an effective treatment in line with clinical experience. Conclusions SUNCT and SUNA are rare primary headache disorders that are distinct and very often tractable to medical therapy.

Prevalence of cranial autonomic parasympathetic symptoms in chronic migraine: Usefulness of a new scale

Cephalalgia ◽  
2015 ◽  
Vol 36 (4) ◽  
pp. 346-350 ◽  
Author(s):  
Nuria Riesco ◽  
Angel I Pérez-Alvarez ◽  
Laura Verano ◽  
Carmen García-Cabo ◽  
Juana Martínez-Ramos ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Nasal Congestion ◽  
Primary Headaches ◽  
Conjunctival Injection ◽  
Autonomic Symptoms ◽  
Cranial Autonomic Symptoms ◽  
Eyelid Oedema ◽  
Headache Clinic ◽  
First Time ◽  
New Criteria

Background Cranial autonomic symptoms (CAS) seem to appear in around half of migraine patients. Objective Our aim was to analyse the prevalence and profile of CAS, mainly of cranial autonomic parasympathetic symptoms (CAPS), in a series of patients with chronic migraine (CM) according the new criteria for autonomic symptoms in the current IHS classification. Patients and methods We recruited consecutive CM patients attending our headache clinic. Five CPAS were surveyed: lacrimation, conjunctival injection, eyelid oedema, ear fullness and nasal congestion. They were graded as 0 (absent), 1 (present and mild) and 2 (present and conspicuous); therefore the score in this CAPS scale ranges from 0 to 10 points. As a cranial autonomic sympathetic symptom (CSAS), we also asked about the presence of ptosis. Results We interviewed 100 CM patients. Their mean age was 45 years (18–63 years); 93 were females. Eighteen had no CAPS, while 82 reported at least one CAPS. There were only six patients with scores higher than 5, the mean and median CAPS being 2.1 and 2, respectively. Prevalence of CAPS was lacrimation (49%), conjunctival injection (44%), eyelid oedema (39%), ear fullness (30%) and nasal congestion (20%). Ptosis was reported by 42. Conclusion These results, by using for the first time an easy quantitative scale, confirm that (mild) CAPS are not the exception but the rule in CM patients. The score in this CAPS scale could be of help as a further endpoint in clinical trials or to be correlated with potential biomarkers of parasympathetic activation in primary headaches.

scholarly journals Cranial autonomic symptoms in pediatric migraine are the rule, not the exception

Neurology ◽  
2013 ◽  
Vol 81 (5) ◽  
pp. 431-436 ◽  
Author(s):  
A. A. Gelfand ◽  
A. C. Reider ◽  
P. J. Goadsby
Keyword(s):  
Autonomic Symptoms ◽  
Cranial Autonomic Symptoms ◽  
Pediatric Migraine

scholarly journals Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a CarotidCavernous Fistula: Case Report

2020 ◽  
pp. 1-4
Author(s):  
Luciano Manzato ◽  
Luciano Manzato ◽  
Paulo M. Mesquita Filho ◽  
Octavio Karam ◽  
Victor E. Angeliero ◽  
...  
Keyword(s):  
Case Report ◽  
Trigeminal Neuralgia ◽  
Endovascular Treatment ◽  
World Literature ◽  
Cranial Nerves ◽  
Conjunctival Injection ◽  
Arteriovenous Fistulas ◽  
Fourth Report ◽  
The World ◽  
Dural Arteriovenous Fistulas

Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are arteriovenous connections located in the dura mater leaflets of this region. The usual presentation of a DAVF is predominantly ocular, with symptoms such as diplopia, conjunctival injection, involvement of cranial nerves III/IV/VI, exophthalmos, and chemosis. Trigeminal neuralgia caused by a cavernous DAVF is extremely rare. To the best our knowledge, this is only the fourth report in the world literature. We describe the case of a patient treated by embolization in whom the only presenting symptom of DAVF was trigeminal neuralgia. After endovascular treatment, the patient became asymptomatic.

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