Impairment in episodic and chronic cluster headache

Cephalalgia ◽  
2010 ◽  
Vol 31 (6) ◽  
pp. 671-682 ◽  
Author(s):  
Tim P Jürgens ◽  
Charly Gaul ◽  
Andrea Lindwurm ◽  
Thomas Dresler ◽  
Yvonne Paelecke-Habermann ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Epidemiological Data ◽  
Chronic Cluster Headache ◽  
Co Morbidity ◽  
Headache Disability ◽  
And Function ◽  
Headache Disability Inventory ◽  
Specific Disability ◽  
One Way Anova ◽  
Multicentre Prospective Study

Despite being an excruciating headache, little is known about the burden of cluster headache (CH) regarding its various subtypes. In a multicentre, prospective study, patients with chronic CH ( n = 27), with episodic CH in the active ( n = 26) and outside the active period ( n = 22), migraine patients ( n = 24) and healthy controls ( n = 31) were included. Epidemiological data, the German version of the Headache Disability Inventory (HDI) and a screening for psychiatric complaints were applied. About 25% of chronic CH patients in our study received invalidity allowance due to CH. HDI scores (total and subscales emotion and function) indicated a severe headache-specific disability (one-way ANOVA: P < 0.01). Patients with chronic and active episodic CH were significantly more affected than patients with inactive CH and migraine. Healthy volunteers were significantly less affected than all headache patients. Symptoms suggestive of psychiatric co-morbidity were found predominantly in chronic CH: depressive symptoms (56%), signs of agoraphobia (33%) and suicidal tendencies (25%) were frequently reported. Patients with chronic and active episodic CH were severely impaired in non-economic and economic domains such as disability, working life and psychiatric complaints. Remarkably, psychiatric co-morbidity was highest in chronic CH. Thus, especially chronic CH warrants special medical and further supportive care.

TRIGEMINAL NERVE RADIOSURGICAL TREATMENT IN INTRACTABLE CHRONIC CLUSTER HEADACHE

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1252-1257 ◽  
Author(s):  
Anne Donnet ◽  
Manabu Tamura ◽  
Dominique Valade ◽  
Jean Régis
Keyword(s):  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
High Rate ◽  
Long Term Results ◽  
Complete Relief ◽  
Term Evaluation ◽  
The One

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.

Efficacy and safety of 121 injections of the greater occipital nerve in episodic and chronic cluster headache

Cephalalgia ◽  
2012 ◽  
Vol 32 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Andreas R Gantenbein ◽  
Nina J Lutz ◽  
Franz Riederer ◽  
Peter S Sándor
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Efficacy And Safety ◽  
Occipital Nerve ◽  
Greater Occipital Nerve

Outcome of trigeminal nerve section in the treatment of chronic cluster headache

Neurology ◽  
2003 ◽  
Vol 60 (8) ◽  
pp. 1360-1362 ◽  
Author(s):  
R.G. Jarrar ◽  
D.F. Black ◽  
D.W. Dodick ◽  
D.H. Davis
Keyword(s):  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
Nerve Section

Disability and psychiatric disorders in an urban community: measurement, prevalence and outcomes

1998 ◽  
Vol 28 (3) ◽  
pp. 509-517 ◽  
Author(s):  
S. S. BASSETT ◽  
G. A. CHASE ◽  
M. F. FOLSTEIN ◽  
D. A. REGIER
Keyword(s):  
Psychiatric Disorders ◽  
Service Utilization ◽  
Adult Population ◽  
Diagnostic Category ◽  
Psychiatric Evaluation ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Sampling Weights ◽  
Co Morbidity ◽  
Specific Disability

Background. The purpose of this analysis was to examine: (1) the prevalence of psychiatric disorders among disabled people, using seven different measures of disability; (2) variation in disability between and within psychiatric diagnostic categories; and (3) relationship of diagnosis and disability to health service utilization.Method. Data were drawn from Phase I and Phase II of the Eastern Baltimore Mental Health Survey, part of the Epidemiologic Catchment Area Program (ECA) conducted in 1980–1 to survey mental morbidity within the adult population. A total of 810 individuals received both a household interview and a standardized clinical psychiatric evaluation. Estimated prevalence rates were computed using appropriate survey sampling weights.Results. Prevalence of disability ranged from 2·5 to 19·5%, varying with specific disability measure. Among those classified as disabled by any of the measures examined, 56 to 92% had a psychiatric disorder and serious chronic medical conditions were present in the majority of these cases (54 to 78%). Disability was expressed differently among the various diagnostic groups. Diagnostic category and disability were significant independent predictors of medical service utilization and receipt of disability payments.Conclusions. The majority of disabled adults living in the community have diagnosable psychiatric disorders, with the majority of these individuals suffering from significant chronic medical conditions as well, thus making co-morbidity the norm.

scholarly journals Efficacy of transdermal rotigotine in chronic cluster headache: A case series

2018 ◽  
Vol 1 ◽  
pp. 251581631880969
Author(s):  
Cherubino Di Lorenzo ◽  
Lanfranco Pellesi ◽  
Gianluca Coppola ◽  
Vincenzo Parisi ◽  
Maurizio Evangelista ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Case Series ◽  
Chronic Cluster Headache ◽  
Drug Resistant ◽  
Transdermal Patch ◽  
Full Resolution ◽  
Episodic Cluster Headache ◽  
Monoaminergic System ◽  
Rotigotine Transdermal Patch ◽  
Effective Treatments

Cluster headache (CH) is one of the most severe forms of headache, but the number of effective treatments is still limited. Recently, we reported the case of a drug-resistant CH patient responsive to the rotigotine transdermal patch, which is used in the treatment of Parkinson’s disease. This report formed the basis for a case series where other drug-resistant CH patients were treated with rotigotine. Here are the results of this study. Twenty-two CH patients underwent the treatment. Eight were episodic cluster headache (ECH) patients and 14 were chronic cluster headache (CCH) patients. Of the eight ECH patients, four reported that their CH had been stopped by the treatment. Of the 14 CCH patients, 11 were considered responders to the treatment (5 experienced a full resolution of headache, and 6 had a headache reduction of at least 50% in terms of mean monthly number of attacks). Our case series confirms the previous observation that rotigotine could be helpful in the treatment of CH. It may even influence the monoaminergic system that has a key role in the pathogenesis of CH.

Vidian Neurectomy for Management of Chronic Cluster Headache

Neurosurgery ◽  
2018 ◽  
Vol 84 (5) ◽  
pp. 1059-1064 ◽  
Author(s):  
Shao-Cheng Liu ◽  
Ming-Chang Kao ◽  
Yun-Chen Huang ◽  
Wan-Fu Su
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Preliminary Evaluation ◽  
Sphenopalatine Ganglion ◽  
Attack Frequency ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Vidian Neurectomy ◽  
Headache Onset ◽  
Attack Intensity

Abstract BACKGROUND Management of chronic cluster headache (CCH) remains a challenging endeavor, and the optimal surgical approach for medically refractory CCH remains controversial. OBJECTIVE To conduct a preliminary evaluation of the efficacy and safety of vidian neurectomy (VN) in patients with medically refractory CCH. METHODS Between March 2013 and December 2015, 9 CCH patients, all of whom had failed to respond to conservative therapy, underwent VN with a precise nerve cut and maximal preservation of the sphenopalatine ganglion. Data included demographic variables, cluster headache onset and duration, mean attack frequency, mean attack intensity, and pain disability index measures pre- and through 12-mo postsurgery. RESULTS Seven of the 9 cases (77.8%) showed immediate improvement. Improvement was delayed by 1 mo in 1 patient, after which the surgical effects of pain relief were maintained throughout the follow-up period. One patient (11.1%) did not improve after surgery. One year after VN, patients’ mean attack frequency, mean attack intensity, and pain disability index decreased by 54.5%, 52.9%, and 56.4%, respectively. No patient experienced treatment-related side effects or complications. CONCLUSION VN is an effective treatment method for CCH patients. Precise Vidian nerve identification and maximal preservation of the sphenopalatine ganglion may achieve good surgical outcomes and dramatically improve quality of life among patients, without significant adverse events.

scholarly journals DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL

2014 ◽  
Vol 56 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Larissa Rodrigues Fabris ◽  
Úrsulla Vilella Andrade ◽  
Aline Ferreira Dos Santos ◽  
Ana Paula da Costa Marques ◽  
Sandra Maria do Valle Leone de Oliveira ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Age Distribution ◽  
Epidemiological Data ◽  
Infection Prevalence ◽  
Age Group ◽  
Clinical Form ◽  
Mato Grosso ◽  
Co Morbidity ◽  
Mato Grosso Do Sul ◽  
Overall Mortality

With the objective to evaluate the behavior of paracoccidioidomycosis in the last three decades, clinical and epidemiological data of 595 patients admitted to clinical services of the Federal University of Mato Grosso do Sul from 1980 to 2009 were investigated. Gender, age distribution, clinical form, comorbidity with tuberculosis or AIDS, and mortality were compared by decades of clinical admission. It was shown that during the three decades there was a decrease in women percentage, and the same manner occurred a reduction in participants in the age group of 20 to 39 years. Moreover, the acute/subacute forms have been diminished in the period. These fluctuations are closely related and can be simultaneously analyzed. Increased AIDS co-infection prevalence from the first to the second decade was also revealed, coinciding with the appearance of the retroviral epidemic and stabilizing during the third decade. No change in the tuberculosis co-infection rate was observed (overall = 6.9%). It reinforces the importance of this co-morbidity. The overall mortality rate remained steady at 6.7%, not varying significantly from one decade to another. The persistent mortality rate calls attention to the importance of this neglected disease.

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