Triptans in Orgasmic Headache

Orgasmic headache (headache associated with sexual activity type 2 according to the International Headache Society classification) is a sudden severe headache which occurs at orgasm. Experiences with triptan therapy are described. Two out of four patients with severe headache continuing for >2 h had a positive response to acute triptan therapy. Two out of three patients using triptans as short-term prophylaxis reported a reliable response on several occasions. Trip- tans might be a treatment option to shorten orgasmic headache attacks after the diagnosis is clear and, particularly, subarachnoid haemorrhage has been excluded. In patients who chose to predict their sexual activity, short-term prophylaxis with oral triptans 30 min before sexual activity might be a therapeutic option in those not responsive to or not tolerating indomethacin.

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Headaches and sleep problems among adults in the United States: Findings from the National Comorbidity Survey–Replication Study

Cephalalgia ◽

10.1177/0333102410390395 ◽

2011 ◽

Vol 31 (6) ◽

pp. 648-653 ◽

Cited By ~ 35

Author(s):

Tarannum Lateef ◽

Sonja Swanson ◽

Lihong Cui ◽

Karin Nelson ◽

Erin Nakamura ◽

...

Keyword(s):

Migraine With Aura ◽

Sleep Problems ◽

International Headache Society ◽

The United States ◽

Structured Interview ◽

Early Morning ◽

Severe Headache ◽

Disturbed Sleep ◽

Headache Type ◽

International Headache Society Classification

Background: Several studies have demonstrated an association between headache and disturbed sleep. None have examined this association across the headache spectrum. Our goal was to determine whether migraine and migraine with aura differ from nonmigraine headache in terms of associated insomnia complaints or severity of sleep problems. Methods: A probability sample of US adults was used. A structured interview administered by trained interviewers was used. Diagnostic criteria for migraine and migraine with aura were based on the International Headache Society classification. The presence or absence of four forms of sleep disturbance associated with an insomnia diagnosis was ascertained. Results: There was a significant association between frequent severe headache, including migraine with and without aura, and disordered sleep. Adults with headache reported more frequently difficulty initiating sleep (odds ratio [confidence interval] = 2.0 [1.6–2.5]), difficulty staying asleep (2.5 [2.1–3]), early morning awakening (2.0 [1.7–2.5]) and daytime fatigue (2.6 [2.2–3.2]) and also were more than twice as likely to report three or more of these symptoms(2.5 [2–3.1]) compared to the individuals without headache. Discussion: Adults with severe headache are at significantly higher risk of also suffering from sleep problems, when compared with the general population, regardless of specific headache type. Optimal treatment of headache must include investigation for sleep disorders and vice versa.

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Tolosa-Hunt syndrome - diagnostic problem of painful ophthalmoplegia

Vojnosanitetski pregled ◽

10.2298/vsp1207627p ◽

2012 ◽

Vol 69 (7) ◽

pp. 627-630 ◽

Cited By ~ 5

Author(s):

Jelena Paovic ◽

Predrag Paovic ◽

Ivica Bojkovic ◽

Mirjana Nagulic ◽

Vojislav Sredovic

Keyword(s):

Optic Nerve ◽

Cavernous Sinus ◽

Inflammatory Process ◽

Positive Response ◽

Case Reports ◽

International Headache Society ◽

Hunt Syndrome ◽

International Headache Society Classification ◽

Periorbital Pain

Background. Tolosa-Hunt syndrome (THS) is an uncommon disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. The disease is characterized by periorbital pain, paresis of the bulbomotor and quick response to steroid treatment. The orbital process may lead to optic nerve atrophy. According to the International Headache Society Classification of 2004, the diagnostic protocol includes magnetic resonance imaging (MRI) and biopsy. Case reports. We presented 46-year old male patient, with THS. The patient had unilateral periorbital pain, inflammatory process in the cavernous sinus, the apex of the orbit and the paranasal sinuses. Inflammatory process had spread into the fascia of the bulbomotor and performed compression to the optic nerve, causing paresis of the bulbomotor, protrusion of the eyeball and atrophy of the optic nerve. Pulse doses of corticosteroids were effective. Regarding the presented patient, diagnostic dilemmas arose from nonspecific sinusitis. The initial ophthalmological diagnosis, based on periorbital pain, drop in visual acuity and the narrow chamber angle was angular glaucoma, which resulted in a delayed diagnosis of THS and the beginning of the treatment. MRI and positive response to the treatment with corticosteroids were relevant for making the diagnosis. Conclusion. According to the International Headache Society Classification of 2004, THS is an entity that occurs rarely, its etiopathogenesis is unknown, it is manifested clinically by unilateral orbital pain associated with simple or multiple oculomotor paralyses, which resolves spontaneously but may recur. MRI orbital phlebography and biopsy are the recommended methods for making diagniosis. In our patient MRI findings and positive response to the corticosteroide treatment were relevant for making the diagnosis.

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