We report a 33-year-old lady whose headache
fulfilled the criteria for HC, but the patient developed gastric side effect to indomethacin and did not respond to other pharmacological treatments; however, injecting botulinum toxin type A has led to complete resolution of all of her symptoms. We hypothesize the mechanism by which botulinum toxin type A has led to our results through reviewing recent functional neuroimaging findings used to understand the pathophysiology of different primary headache disorders “
“(Headache 2011;51:155-162) check details The indications for using steroids when performing occipital nerve blocks (ONBs) are not completely clear. We report a patient with chronic migraines who was allergic to local anesthetics, for whom ONBs using only corticosteroid proved useful. To our knowledge, this is only published case describing the effects of ONBs using only corticosteroid, without local anesthetic. “
“Objective.— To present results from the United States
(US) Cluster Headache Survey including data on cluster headache demographics, CT99021 price clinical characteristics, suicidality, diagnostic delay, triggers, and personal burden. Background.— There are few large-scale studies looking at cluster headache patients and none from the USA. This manuscript will present data from The US Cluster Headache Survey, the largest survey ever completed of cluster headache patients living in the USA. Methods.— The total survey was composed of 187 multiple-choice questions that dealt with issues related to cluster headache including demographics, clinical
characteristics, comorbid medical conditions, family history, triggers, smoking history, and personal burden. The survey was placed on a Web site from October through December 2008. Results.— A total of 1134 individuals completed the survey (816 male, 318 female). Some key highlights from the survey include the following: (1) diagnostic delay: there remains a significant diagnostic delay for cluster headache MCE patients on average 5+ years with only 21% receiving a correct diagnosis at time of initial presentation. (2) Suicidality: suicidal ideations are substantial, occurring in 55%. (3) Eye color: the predominant eye color in cluster headache patients is brown and blue, not hazel as suggested in previous descriptions. (4) Laterality: cluster headache has a right-sided predominance. (5) Attack profile: in US cluster headache sufferers, most attacks occur between early evening and early morning hours with peak time of headache onset between midnight and 3 am; the circadian periodicity for cluster headache is present but is not as predominant in the population as previously thought. (6) Triggers: beer is the most common type of alcohol trigger in US cluster headache patients; noted migraine triggers such as weather changes and smells are also very common cluster headache triggers.