Chronic Paroxysmal Hemicrania, Hemicrania Continua and Sunct Syndrome in Association with Other Pathologies: A Review

Abstract

We present a review of 22 cases of headache mimicking chronic paroxysmal hemicrania (CPH) (17 female and five male; F : M ratio 3.4), nine cases mimicking hemicrania continua (HC) (seven female and two male) and seven cases mimicking SUNCT syndrome (five male and two female) found in association with other pathologies published from 1980 up to the present. All case reports were discussed with respect to diagnostic criteria proposed by International Headache Society (IHS) for CPH, by Goadsby and Lipton for HC and SUNCT, and evaluated to identify a possible causal relationship between the pathology and the onset of headache. The aim of the present review was to evaluate if the presence of associated lesions and their location could help elucidate the pathogenesis of trigeminal autonomic cephalalgias (TACs).

Headache attributed to unruptured saccular aneurysm, mimicking hemicrania continua

“…This has been reported for other rare primary headache syndromes associated with autonomic features [13]. Thus, intensive paraclinical evaluation may be considered for any unusual onesided headache with recent onset and autonomic features, particularly when one or two of the diagnostic criteria for any primary headache syndrome are doubtful.…”

“…In a recent report, a case of symptomatic HC associated with internal carotid artery dissection was described [12]. To distinguish the headache that is causally related with pathology from other headaches that are only coincidentally associated with it, Trucco and colleagues recently proposed specific criteria, including close temporal relationship between the associated disease and the onset of pain, side concordance, remission after surgical or aetiological therapy and prolonged post-treatment follow-up [13]. Our patient accomplishes the criteria of side concordance (both headache and the aneurysm The consistent mild orbito-temporal pain with exacerbations accompanied with autonomic features in our patient was clearly mimicking the phenotype of HC [14].…”

SUNCT: a new case with some unusual features

“…A case of SUNCT from transformation of trigeminal neuralgia has been described [15] and in another patient SUNCT disappeared after decompression of the trigeminal nerve [16] and PSH is often associated with migraine and cluster headache [2] and not with other trigeminal autonomic cephalalgias (TACs). To the best of my knowledge the association between PSH and SUNCT has not been described.…”

Trigeminal autonomic cephalgias

“…При травме глазницы может разви-ваться посттравматический SUNCT-синдром [57]. В ред-ких случаях SUNCT-синдром связан с ВИЧ-инфекцией и несовершенным остеогенезом [58]. Среди пациентов с опухолью гипофиза в 5% случаев отмечается SUNCT-синдром [59].…”