Atypical primary headache responding to finger pressure: possible involvement of the vagus nerve?

Abstract

We describe a case of atypical primary headache strongly responsive to prolonged pressure in the anterior aspect of the neck. We hypothesize that, at least in this case, the trigemino-cervical system and its connections with the vagus nerve are involved.

Vagal afferent modulation of spinal trigeminal neuronal responses to dural electrical stimulation in rats

“…It has been reported that at least half of patients receiving VNS had reductions in frequency and intensity of their chronic cluster, migraine or daily headaches which were not only associated with epilepsy or depression (Sadler et al, 2002;Hord et al, 2003;Cecchini et al, 2009), but also referred to as primary disorders (Mauskop, 2005). Furthermore, a case has been described in which mechanical (prolonged finger pressure) stimulation of the cervical portion of the vagal nerve trunk was able to abort migraine attacks (Di Stani et al, 2007). Additionally, the use of VNS as an adjunctive therapy allowed decreasing the numbers and dosages of prophylactic anticephalgic drugs received by the patients (Hord et al, 2003;Mauskop, 2005).…”