Evaluation of interictal autonomic function during attack and remission periods in cluster headaches

Cephalalgia ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Ozlem Altiokka ◽  
Belgin Mutluay ◽  
Ayhan Koksal ◽  
Beyza Ciftci-Kavaklioglu ◽  
Musa Ozturk ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Orthostatic Hypotension ◽  
Sympathetic Skin Response ◽  
Skin Response ◽  
The Face ◽  
Skin Responses ◽  
Cluster Headaches ◽  
Drug Free ◽  
Headache Patients ◽  
Sympathetic Skin Responses

Objective To investigate which part of the autonomic system is mainly involved and assess the sensitivity of face sympathetic skin response in cluster headache. Material and methods The study sample consisted of 19 drug-free cluster headache patients (16 males, three females) and 19 healthy volunteers. Demographic features and pain characteristics were thoroughly identified. Dysautonomic symptoms were evaluated during attack and remission periods of cluster headache patients. Orthostatic hypotension, R-R interval variation and sympathetic skin responses obtained from the face and four extremities were evaluated and the sensitivity of face sympathetic skin responses was assessed in contrast to extremity sympathetic skin responses. Results All sympathetic skin responses of face and extremities could be obtained during attack and remission periods. On the symptomatic side, mean latency of face sympathetic skin responses was longer compared to the asymptomatic side and controls (p = 0.02, p = 0.004). There were no differences in latency or amplitude of extremity sympathetic skin responses between symptomatic and asymptomatic sides and controls. No significant relationship was determined between sympathetic skin responses, R-R interval variation, orthostatic hypotension and cluster headache clinical features. Conclusion Sympathetic hypoactivity of the face seems to predominate the pathophysiology of cluster headache. Face sympathetic skin responses might be more sensitive compared to extremity sympathetic skin response in demonstrating dysautonomic symptoms in cluster headache patients.

scholarly journals Electrophysiological Evaluation of Peripheral and Autonomic Involvement in Leprosy

2004 ◽  
Vol 31 (3) ◽  
pp. 357-362 ◽  
Author(s):  
Aysun Soysal ◽  
Turan Atay ◽  
Tacettin Ozu ◽  
Baki Arpaci
Keyword(s):  
Sensory Nerve ◽  
Sympathetic Skin Response ◽  
Lepromatous Leprosy ◽  
Control Group ◽  
Evaluation Standard ◽  
Standard Procedures ◽  
Skin Response ◽  
Leprosy Patients ◽  
Skin Responses ◽  
Sympathetic Skin Responses

Objective:Motor and sensory nerve conductions, F responses, sympathetic skin responses and R-R interval variations (RRIV) were studied to determine the type of peripheral neuropathy among patients with leprosy.Methods:Twenty-nine consecutive patients with leprosy (25 male, 4 female) hospitalized in the “Istanbul Leprosy Hospital'' between January - December, 1999 were included in this study. Ten patients had borderline lepromatous leprosy, and 19 had lepromatous leprosy. None of the patients studied had the tuberculoid form. The mean age was 55±12 years. The control group consisted of 30 (26 male, 4 female) healthy volunteers (mean age: 58.1±7.8 years). All subjects included in the study underwent neurological examination and electrophysiological evaluation. Standard procedures were performed for evaluating sensory and motor conduction studies. Motor studies were carried out on both left and right median, ulnar, tibial and common peroneal nerves while median, ulnar, sural and superficial peroneal nerves were examined for sensory studies. Sympathetic skin response recordings on both hands and RRIV recordings on precordial region were done in order to evaluate the autonomic involvement.Results:The lower extremity was found to be more severely affected than the upper, and sensory impairment predominated over motor. Of 58 upper limbs examined, no sympathetic skin responses was recorded in 46 (79.3%). Compared with the controls, the RRIVs of the leprosy patients were found to be reduced during both resting and deep forced hyperventilation.Conclusion:Our results indicate that leprosy causes a predominantly axonal polyneuropathy that is more severe in the lower extremities. Sensory nerve damage is accompanied by autonomic involvement.

scholarly journals Clomiphene treatment may be effective in refractory episodic and chronic cluster headache

2017 ◽  
Vol 75 (9) ◽  
pp. 620-624 ◽  
Author(s):  
Maria Eduarda Nobre ◽  
Mario Fernando Prieto Peres ◽  
Pedro Ferreira Moreira Filho ◽  
Antonio José Leal
Keyword(s):  
Complete Remission ◽  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Free Time ◽  
Chronic Patients ◽  
Conventional Medication ◽  
Episodic Cluster Headache ◽  
Cluster Headaches ◽  
Headache Patients

ABSTRACT Objective To describe the evolution of 15 patients who were treated for difficult-to-control episodic and chronic cluster headaches with clomiphene. Methods Clomiphene treatment was used for seven chronic and eight episodic cluster headache patients. The chronic patients were refractory to the medication being used, and the episodic patients, in addition to being resistant to conventional medication, had longer cluster headache periods, exceeding the average time of previous cluster cycles. Our main analysis was of the time to pain-free, complete remission, and the length of pain-free time and complete remission. Results Clomiphene was used for 45-180 days. The average time to being pain-free was 15 days and cluster remission was up to 60 days. The average time between being pain-free until cluster remission was 26 days. Conclusions Clomiphene treatment was significantly efficient. It interrupted chronicity in all patients, suggesting the capability of changing the pattern of attacks. It proved to be safe and well tolerated.

Clinical and Functional Assessment of Dysautonomia and Its Correlation in Alzheimer’s Disease

2012 ◽  
Vol 27 (8) ◽  
pp. 592-599 ◽  
Author(s):  
Beata Zakrzewska-Pniewska ◽  
Malgorzata Gawel ◽  
Elzbieta Szmidt-Salkowska ◽  
Katarzyna Kepczynska ◽  
Monika Nojszewska
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Urinary Incontinence ◽  
Orthostatic Hypotension ◽  
Functional Assessment ◽  
Sympathetic Skin Response ◽  
Test Results ◽  
Significant Difference ◽  
Skin Response ◽  
The Relationship

The aims were to assess dysautonomia in Alzheimer’s Disease (AD), clinically and electrophysiologically, using sympathetic skin response (SSR) test and R-R interval variation (RRIV) test and to analyze the relationship between symptoms of dysautonomia and SSR/RRIV results. A tota of 54 patients with AD and 37 controls were evaluated using Autonomic Symptoms Questionnaire and SSR/RRIV test. Clinical dysautonomia was observed in 66% of patients (eg, orthostatic hypotension in 34.5%, constipation in 17.2%, urinary incontinence in 13.8%). The SSR test was abnormal in 26%, but the RRIV test was abnormal in 97.7% of cases; there was significant difference in RRIV test results between AD and controls (R mean 8.05% and 14.6%, respectively). In AD, clinical dysautonomia occurs at a various degree, and the abnormal SSR and RRIV test results were not always related to the presence of clinical dysautonomia; this observation points that the tests could be used as a useful tool in the assessment of subclinical dysautonomia.

Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations

Cephalalgia ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Luo Fang ◽  
Lu Jingjing ◽  
Shen Ying ◽  
Meng Lan ◽  
Wang Tao ◽  
...  
Keyword(s):  
Side Effects ◽  
Cluster Headache ◽  
Computerized Tomography ◽  
Sphenopalatine Ganglion ◽  
Pulsed Radiofrequency ◽  
Radiofrequency Treatment ◽  
Pulsed Radiofrequency Treatment ◽  
Cluster Headaches ◽  
Headache Patients

Background Sphenopalatine ganglion percutaneous radiofrequency thermocoagulation treatment can improve the symptoms of cluster headaches to some extent. However, as an ablation treatment, radiofrequency thermocoagulation treatment also has side effects. Objective To preliminarily evaluate the efficacy and safety of a non-ablative computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion in patients with refractory cluster headaches. Methods We included and analysed 16 consecutive cluster headache patients who failed to respond to conservative therapy from the Pain Management Center at the Beijing Tiantan Hospital between April 2012 and September 2013 treated with pulsed radiofrequency treatment of sphenopalatine ganglion. Results Eleven of 13 episodic cluster headaches patients and one of three chronic cluster headaches patient were completely relieved of the headache within an average of 6.3 ± 6.0 days following the treatment. Two episodic cluster headache patients and two chronic cluster headache patients showed no pain relief following the treatment. The mean follow-up time was 17.0 ± 5.5 months. All patients enrolled in this study showed no treatment-related side effects or complications. Conclusion Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail.

Sympathetic skin responses of the face and neck evoked by electrical stimulation

2007 ◽  
Vol 134 (1-2) ◽  
pp. 85-91 ◽  
Author(s):  
Serpil Kuyucu Yildiz ◽  
Sule Aydın Turkoglu ◽  
Nebil Yildiz ◽  
Ayhan Ozturk ◽  
Fatma Tore
Keyword(s):  
Electrical Stimulation ◽  
The Face ◽  
Skin Responses ◽  
Sympathetic Skin Responses

Clinical profile of cluster headaches in Japan: Low prevalence of chronic cluster headache, and uncoupling of sense and behaviour of restlessness

Cephalalgia ◽  
2011 ◽  
Vol 31 (5) ◽  
pp. 628-633 ◽  
Author(s):  
Noboru Imai ◽  
Nobuyasu Yagi ◽  
Ryou Kuroda ◽  
Takashi Konishi ◽  
Masahiro Serizawa ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Age At Onset ◽  
Japanese Patients ◽  
Chronic Cluster Headache ◽  
Clinical Profile ◽  
Caucasian Patients ◽  
Cluster Headaches ◽  
Low Prevalence ◽  
Headache Patients

Introduction: This study examined the clinical profile of cluster headaches in Japan and the potential presence of features peculiar to Japan. Most previous studies of cluster headaches have focused on Caucasian populations. Methods: Subjects comprised 86 consecutive new cluster headache patients (68 males, 18 females; mean age, 38.4 ± 12.2 years; range, 17–73 years). Mean age at onset was 31.0 years and the ratio of males to females was 3.8:1. Results: Chronic cluster headache was observed in 3.5% of patients. More than half of patients (68.9%) reported feelings of restlessness during headache episodes and 42.9% reported restless behaviour. Patients with uncoupling of feelings of restlessness and restless behaviour forced themselves to keep still. Similar findings were reported in a Taiwanese study. Conclusion: Japanese patients in this study showed a relatively low prevalence of chronic cluster headaches, and uncoupling of a sense of restlessness and restless behaviour. These features of cluster headache may be more common in Japanese and Taiwanese patients than in Caucasian patients.

Cluster Headache: Histamine Skin Tests in the Painful Area

Cephalalgia ◽  
1985 ◽  
Vol 5 (2) ◽  
pp. 91-94 ◽  
Author(s):  
Andrzej Bogucki ◽  
Antoni Prusinski
Keyword(s):  
Cluster Headache ◽  
Local Anaesthesia ◽  
Direct Action ◽  
Contralateral Side ◽  
Skin Tests ◽  
Skin Response ◽  
Painful Area ◽  
Headache Patients

Histamine skin tests were performed in the painful area and on the opposite side in ten cluster headache patients. The studies were carried out with and without local anaesthesia. No differences between histamine skin response in the painful region compared with the contralateral side were revealed. This study concerns the part of the triple response which is the result of a direct action of histamine on the skin vasculature (mediated by both H1 and H2) histaminergic receptors, i.e. wheal and redness, and the flare, which is the result of neuro-humoral mechanisms.

Increased Prevalence of Sensing Types in Men with Cluster Headaches

2000 ◽  
Vol 87 (2) ◽  
pp. 555-558 ◽  
Author(s):  
Loretta Mueller ◽  
R. Michael Gallahger ◽  
Robert A. Steer ◽  
Carman A. Ciervo
Keyword(s):  
Cluster Headache ◽  
Myers Briggs Type Indicator ◽  
Psychosomatic Symptoms ◽  
Psychological Types ◽  
Migraine Headaches ◽  
Type Indicator ◽  
Myers Briggs ◽  
Cluster Headaches ◽  
Headache Patients

To ascertain whether the percentage of men who suffer with cluster headaches and are classified as sensing types according to Jung's theory of psychological types was comparable to the percentage (74%) of Sensing types that was found by Gallagher, et al. among women who experience migraine headaches, the Myers-Briggs Type Indicator® was administered to 25 male cluster-headache patients. There were 19 (76%) male Sensing types, and this was comparable to the percentage of Sensing types for migrainous women. The results are discussed as supporting previous contentions that Sensing types may be prone to developing psychosomatic symptoms related to stress.

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