The impact of sexual activity on idiopathic headaches: An observational study

Cephalalgia ◽  
2013 ◽  
Vol 33 (6) ◽  
pp. 384-389 ◽  
Author(s):  
Anke Hambach ◽  
Stefan Evers ◽  
Oliver Summ ◽  
Ingo W Husstedt ◽  
Achim Frese
Keyword(s):  
Observational Study ◽  
Cluster Headache ◽  
Sexual Activity ◽  
Case Reports ◽  
Primary Headache ◽  
Complete Relief ◽  
Headache Attack ◽  
Cluster Headache Attack ◽  
The Impact ◽  
Headache Patients

Background Headache associated with sexual activity is a well-known primary headache disorder. In contrast, some case reports in the literature suggest that sexual activity during a migraine or cluster headache attack might relieve the pain in at least some patients. We performed an observational study among patients of a tertiary headache clinic. Methods A questionnaire was sent to 800 unselected migraine patients and 200 unselected cluster headache patients. We asked for experience with sexual activity during a headache attack and its impact on headache intensity. The survey was strictly and completely anonymous. Results In total, 38% of the migraine patients and 48% of the patients with cluster headache responded. In migraine, 34% of the patients had experience with sexual activity during an attack; out of these patients, 60% reported an improvement of their migraine attack (70% of them reported moderate to complete relief) and 33% reported worsening. In cluster headache, 31% of the patients had experience with sexual activity during an attack; out of these patients, 37% reported an improvement of their cluster headache attack (91% of them reported moderate to complete relief) and 50% reported worsening. Some patients, in particular male migraine patients, even used sexual activity as a therapeutic tool. Conclusions The majority of patients with migraine or cluster headache do not have sexual activity during headache attacks. Our data suggest, however, that sexual activity can lead to partial or complete relief of headache in some migraine and a few cluster headache patients.

Rebound following oxygen therapy in cluster headache

Cephalalgia ◽  
2011 ◽  
Vol 31 (10) ◽  
pp. 1145-1149 ◽  
Author(s):  
Rianne PJ Geerlings ◽  
Danielle YP Haane ◽  
Peter J Koehler
Keyword(s):  
Cluster Headache ◽  
Oxygen Therapy ◽  
Rebound Effect ◽  
Case Series ◽  
Acute Attack ◽  
Complete Relief ◽  
Headache Attack ◽  
Oxygen Treatment ◽  
Cluster Headache Attack ◽  
The Individual

Background: Rapid recurrence of a new cluster headache attack following oxygen treatment was named the ‘rebound effect’ by Kudrow (1981). It has never been studied properly. To study this effect, we defined it as a more rapid than usual (for the individual patient) recurrent cluster headache attack after complete relief following oxygen therapy, or an increase in the number of attacks per 24 hours while using oxygen therapy as acute attack treatment. We reviewed the literature and searched our cluster headache study databases. Case series: In our eight patients with rebound cluster headache, the effect was experienced following 87.5% of oxygen treated attacks. Duration until the next cluster headache attack was on average 894 minutes shorter and frequency was on average 1.6 cluster headache attacks per day higher than without oxygen therapy. Conclusion: Although the 1981 trial reported a prevalence of 25%, rebound cluster headache following oxygen therapy is rarely reported nowadays. This may be due to better techniques in oxygen application, the use of higher oxygen flow rates or underreporting. The few literature data and data on our eight patients did not provide clues about the mechanism of the rebound effect. Further study, applying the proposed definition, seems useful.

Increased suicidality in patients with cluster headache

Cephalalgia ◽  
2019 ◽  
Vol 39 (10) ◽  
pp. 1249-1256 ◽  
Author(s):  
Mi Ji Lee ◽  
Soo-Jin Cho ◽  
Jeong Wook Park ◽  
Min Kyung Chu ◽  
Heui-Soo Moon ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Cluster Headache ◽  
Disease Duration ◽  
Headache Attack ◽  
Factors Associated ◽  
Cluster Headache Attack ◽  
Point Increase ◽  
Patient Health ◽  
Headache Impact ◽  
Headache Patients

Objective To investigate suicidality related to cluster headache and factors associated with increased suicidality in cluster headache patients. Methods In this multicenter study, 193 cluster headache patients were recruited between September 2016 and August 2018. Patients were asked about their suicidality during and between attacks, specifically about passive suicidal ideation, active suicidal ideation, suicide plan, and suicide attempt. Univariable and multivariable logistic regression analyses were performed to evaluate the factors associated with high ictal suicidality (sum of positive response ≥ 2). Patients were followed up when they were in the between-bouts period. Results A total of 175 cluster headache patients in the in-bout period were included in this study. Passive suicidal ideation, active suicidal ideation, suicidal planning, and suicidal attempt were reported by 111 (64.2%), 62 (35.8%), 10 (5.8%), and four (2.3%) patients during attacks; seven (4.0%), six (3.5%), five (2.9%) and two (1.2%) patients interictally; and none (0%), one (1.9%), one (1.9%), and none (0%) among patients in the between-bouts period. Factors associated with high ictal suicidality were longer disease duration, the Headache Impact Test score, and the Patient Health Question-9 score (multivariable OR = 1.90 per 10-year increase in disease duration, 95% CI = 1.18–3.05, p = 0.008; multivariable OR = 3.19 per 10-point increase in HIT-6, 95% CI = 1.73–5.87, p < 0.001; multivariable OR = 2.11 per 10-point increase in PHQ-9, 95% CI = 1.13–3.95, p = 0.020, respectively). Conclusions Cluster headache attack carries a high suicidality compared to the interictal or between-bouts state. An intensive treatment to reduce cluster headache burden may be helpful to alleviate suicide risk in cluster headache patients.

scholarly journals ‘A cry in the dark’: a qualitative exploration of living with cluster headache

2020 ◽  
pp. 204946372097669
Author(s):  
Laura Andre ◽  
Debbie Cavers
Keyword(s):  
Primary Care ◽  
Cluster Headache ◽  
Lived Experience ◽  
Social Contact ◽  
Primary Headache ◽  
Headache Disorder ◽  
Psychosocial Needs ◽  
Structured Interviews ◽  
The Impact ◽  
Headache Patients

Context: Cluster headache is a rare primary headache disorder said to be one of the most painful conditions in existence. Limited evidence demonstrates cluster headache patients have difficulties securing a diagnosis and poor access to services. There is a gap in research around psychosocial needs, meaning there are no evidence-based guidelines to inform optimal management of this patient group in primary care. Objectives: The aim of this study is to explore the perspectives of cluster headache patients in the United Kingdom in order to suggest ways their care can be improved. Methods: It is an in-depth qualitative study involving telephone interviews with 15 participants with either chronic or episodic cluster headache. Semi-structured interviews (43–58 minutes) were conducted, recorded and transcribed verbatim. Two researchers conducted thematic analysis to identify themes. Results: Participants described the impact cluster headache has on their quality of life. They also felt the legitimacy of their disorder was questioned. This situation was often exacerbated by a reported lack of awareness among General Practitioners (GPs), which negatively impacted their care in terms of diagnosis and access to treatments and specialists. They attempted to control the pain through treatments and avoiding triggers, often with detrimental consequences for their social contact and mental health. Conclusion: Findings indicate the need to improve the lived experience of cluster headache patients in two key areas: (1) raising awareness of the disorder and its impact among GPs, and (2) extending care beyond clinical treatment provision, supporting patients in self-management and addressing its psychosocial impact, with implications for the management of this group in primary care.

Studies of Platelet Monoamine Oxidase Activity during an Acute Cluster Headache Attack.

Cephalalgia ◽  
1991 ◽  
Vol 11 (11_suppl) ◽  
pp. 254-255 ◽  
Author(s):  
Aron D. Mosnaim ◽  
Shankar Huprikar ◽  
Marion E. Wolf ◽  
Frederick Freitag ◽  
Seymour Diamond
Keyword(s):  
Monoamine Oxidase ◽  
Cluster Headache ◽  
Oxidase Activity ◽  
Monoamine Oxidase Activity ◽  
Headache Attack ◽  
Cluster Headache Attack ◽  
Platelet Monoamine Oxidase

scholarly journals Phase Specific Pain Localization in Cluster Headache Patients.

2020 ◽  
Author(s):  
Philipp Schröder ◽  
Charly Gaul ◽  
Attyla Drabik ◽  
Albrecht Molsberger
Keyword(s):  
Cluster Headache ◽  
Online Survey ◽  
Anatomical Structures ◽  
Headache Attack ◽  
Location Data ◽  
Pain Location ◽  
Cluster Headache Attack ◽  
Significant Difference ◽  
Survey Results ◽  
Pain Localization

Abstract Background and Objective:Applying local treatments like neuromodulation or injections for cluster headache, requires exact knowledge of the anatomical structures and pain topography. However studies with emphasis on exact pain localization are rare although local treatments are increasingly used for patients in whom systemic pharmacotherapy is ineffective or contraindicated. Here, survey results with emphasis on exact pain location in cluster headache attacks for onset of pain, peak pain and radiation of pain, are presented. Methods: Data from 631 respondents were collected for 23 months using an online survey composed of 117 questions on pain location, epidemiology, and clinical features. 5260 datapoints on 44 pain locations were analyzed.Results: There is a periorbital concentration of pain during onset and peak phases of attacks. Pain locations outside the periorbital region were reported more frequently during radiation when compared to the onset and peak of attacks. Dorsal (occipital/nuchal) pain is more frequent during onset and radiation compared to peak: onset pain (13%) vs. peak pain (6%), p < 0,001. Pain radiation (22%) vs. peak pain (6%), p < 0,001. There is no significant difference in dorsal pain frequencies for pain radiation (22%) vs. onset (13%), p = 0,552. Furthermore, single pain spots differ significantly in frequency during the three attack phases.Conclusions: Analysis of the pain location data shows phase specific frequencies and distributions of pain location during the three stages of a cluster headache attack. Single pain spots differ significantly in frequency during the three attack phases. Dorsal pain is more frequent during onset and radiation, compared to peak. Extra-orbital pain locations are more frequent during pain radiation. These findings will help to better understand cluster headache and might help to identify further target structures for local treatments.

Primary headache and migraine in headache specialists – does personal history of doctors matter?

Cephalalgia ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 96-106 ◽  
Author(s):  
Stefan Evers ◽  
Nicole Brockmann ◽  
Oliver Summ ◽  
Ingo W Husstedt ◽  
Achim Frese
Keyword(s):  
Cluster Headache ◽  
General Practitioners ◽  
Primary Headache ◽  
Treatment Recommendations ◽  
Personal History ◽  
Self Report ◽  
Primary Headache Disorders ◽  
History Of ◽  
The Impact ◽  
Age And Sex

Objective Migraine is a common disorder affecting more than 10% of the population. The prevalence of migraine among physicians and, in particular, among headache specialists is widely unknown as is the impact of suffering from migraine on the attitudes towards migraine and on treatment recommendations of physicians. We designed a survey among headache specialists and neurologists and compared the results to general pain specialists and general practitioners. Methods A standardized interview in randomly selected samples of these four groups of physicians was performed. The interview included data on the prevalence of migraine and other primary headache disorders in the physician groups, self-report on their own treatment, attitudes towards migraine, and treatment recommendations for migraine. The prevalence rates were also compared to an age- and sex-matched German general population sample. Results The lifetime prevalence of migraine was higher in headache specialists (53.0%) than in general neurologists (43.0%), pain specialists (21.7%), general practitioners (19.3%), and in the general age- and sex-matched population (16.8%). Cluster headache prevalence was high in neurologists (1.9%) and in headache specialists (1.3%); episodic tension-type headache prevalence was significantly lower in general practitioners (19.5%). One reason, among others, was that being a migraine (or cluster headache) patient more often prompted the sufferers to become a specialist in neurology. Physicians with migraine rated the biopsychosocial concept of lower importance for migraine than did physicians without migraine. The self-treatment of migraine in physicians differs from the treatment recommendations to the patients. For example, only 36.4% of the headache specialists with migraine take triptans whereas 94.4% recommend triptans to their patients. Conclusions We conclude that being a headache specialist or a neurologist is associated with an increased migraine or cluster headache prevalence. This personal history of migraine leads to a more somatic view of migraine as a disorder and to different treatment recommendations as compared to self-treatment.

Beta-oscillations in the posterior hypothalamus are associated with spontaneous cluster headache attack

2010 ◽  
Vol 257 (10) ◽  
pp. 1743-1744 ◽  
Author(s):  
Wido Nager ◽  
Thomas F. Münte ◽  
Josep Marco-Pallares ◽  
Marcus Heldmann ◽  
Reinhard Dengler ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Posterior Hypothalamus ◽  
Beta Oscillations ◽  
Headache Attack ◽  
Cluster Headache Attack

Abnormal tyrosine metabolism in chronic cluster headache

Cephalalgia ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 148-153 ◽  
Author(s):  
Giovanni D’Andrea ◽  
Massimo Leone ◽  
Gennaro Bussone ◽  
Paola Di Fiore ◽  
Andrea Bolner ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Plasma Levels ◽  
Primary Headache ◽  
Chronic Cluster Headache ◽  
Predisposing Factor ◽  
Episodic Cluster Headache ◽  
Tyrosine Metabolism ◽  
Low Levels ◽  
And Control ◽  
Headache Patients

Objective Episodic cluster headache is characterized by abnormalities in tyrosine metabolism (i.e. elevated levels of dopamine, tyramine, octopamine and synephrine and low levels of noradrenalin in plasma and platelets.) It is unknown, however, if such biochemical anomalies are present and/or constitute a predisposing factor in chronic cluster headache. To test this hypothesis, we measured the levels of dopamine and noradrenaline together with those of elusive amines, such as tyramine, octopamine and synephrine, in plasma of chronic cluster patients and control individuals. Methods Plasma levels of dopamine, noradrenaline and trace amines, including tyramine, octopamine and synephrine, were measured in a group of 23 chronic cluster headache patients (10 chronic cluster ab initio and 13 transformed from episodic cluster), and 16 control participants. Results The plasma levels of dopamine, noradrenaline and tyramine were several times higher in chronic cluster headache patients compared with controls. The levels of octopamine and synephrine were significantly lower in plasma of these patients with respect to control individuals. Conclusions These results suggest that anomalies in tyrosine metabolism play a role in the pathogenesis of chronic cluster headache and constitute a predisposing factor for the transformation of the episodic into a chronic form of this primary headache.

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