Cutaneous allodynia and migraine: Another view

Dahlöf, Carl

doi:10.1007/s11916-006-0051-x

Cited by 7 publications

(4 citation statements)

References 82 publications

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“…• Dahlöf [27] proposed that impaired gastrointestinal absorption, not allodynia, explains triptan nonresponse in late migraine treatment, but his hypothesis does not explain the fi ndings of Burstein and colleagues [24], as most nonresponders in their study received subcutaneous sumatriptan.…”

Section: Allodynia In Chronic (Transformed) Migrainementioning

confidence: 99%

Allodynia as a complication of migraine: Background and management

Young

2008

Curr Treat Options Neurol

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Allodynia is a normal part of the untreated migraine attack in most people with episodic migraine and is prevalent in chronic migraine. The extent to which allo-dynia contributes to the pain and disability of migraine attacks is unclear, as is its clinical importance. The presence of allodynia correlates with the severity and other features of migraine, including aura, migraine-associated symptoms, and motor symptoms. The development of allodynia is associated with resistance to triptan treatment. It is uncertain whether this treatment resistance is due to the accompanying increase in headache severity or whether the development of allo-dynia is the fundamental biologic event causing the new treatment-refractory state. Animal models support the relationship to allodynia. Intravenous ketorolac may be effective at treating migraine with allodynia several hours after the development of the throbbing pain, but prior treatment with opioid analgesics may confer treatment resistance. Occipital nerve blocks rapidly treat migraine pain and allodynia. Uncontrolled studies have successfully used dihydroergotamine to treat episodic and chronic migraine with allodynia.

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Section: Allodynia In Chronic (Transformed) Migrainementioning

confidence: 99%

Allodynia as a complication of migraine: Background and management

Young

2008

Curr Treat Options Neurol

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“…A clinic-based study of patients with chronic migraine has shown that these patients exhibit CA not only during acute headaches, but also in between headache exacerbations [8]. It has been suggested that the presence of CA is associated with decreased response to treatment with the 5-HT 1B/1D agonists, known as triptans [6], although this notion has been debated [10].…”

Section: Introductionmentioning

confidence: 99%

Allodynia in Cluster Headache

Ashkenazi

2010

Curr Pain Headache Rep

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Cutaneous allodynia (CA), the perception of pain when a non-noxious stimulus is applied to normal skin, has been described in various pain syndromes. The pathophysiology of CA in headache is thought to be related to central sensitization of brainstem, and possibly thalamic, neurons. The recognition of CA in cluster headache (CH) is recent, and available data are scant. Some studies suggest the occurrence of CA in a significant proportion of CH patients. However, one study that examined sensory thresholds in CH failed to confirm this. CA in CH is characterized by rapid onset and termination, suggesting different mechanisms compared with CA in migraine. CA in CH is common in trigeminal areas but may spread to cervical dermatomes and beyond. The relations between the type of CH (episodic vs chronic) and CA are unknown. Further studies are needed to determine the mechanism of CA in CH, and its clinical implications.

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“…Allodynia in migraine is the clinical correlate of central sensitization of neurons in the trigeminal nucleus caudalis [9] . The identification of allodynia in migraine may have therapeutic implications [10], although this notion has been debated [11]. …”

Section: Introductionmentioning

confidence: 99%

Dynamic mechanical (brush) allodynia in cluster headache: a prevalence study in a tertiary headache clinic

2009

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Cutaneous allodynia (CA) has been described in migraine and has been related to treatment failure. There are little data about the incidence of CA in other primary headache syndromes such as cluster headache (CH). The objectives of this study are to evaluate the prevalence of dynamic mechanical (brush) allodynia (BA) in CH patients attending a tertiary headache clinic, and to assess its relation to disease characteristics. Adult patients with episodic or chronic CH were recruited. We obtained demographic data and data on disease characteristics through a structured questionnaire, and tested the patients for brush allodynia BA by applying a 4 × 4 gauze pad over the V1, C2/C3 and C8 skin areas bilaterally. The prevalence of allodynia in the entire study population and in the different sub-groups was calculated. We also examined the association between CA and demographic parameters, and its association with disease characteristics. Forty-one patients were recruited (22 men, 19 women; mean age 44.9 years). Twenty-two had chronic CH (CCH) and 19 had episodic CH (ECH). Mean disease duration was 14.1 years (12.3 the CCH group and 15.7 in the ECH group). Overall, 20 (49%) patients were allodynic. There was no statistically significant association between the presence of allodynia and age, gender, diagnosis (episodic vs. chronic CH), disease duration or disease severity. In conclusion, BA was common in this CH patient sample. The therapeutic implications of the presence of BA in CH need to be further studied.

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Cutaneous allodynia and migraine: Another view

Cited by 7 publications

References 82 publications

Allodynia as a complication of migraine: Background and management

Allodynia as a complication of migraine: Background and management

Allodynia in Cluster Headache

Dynamic mechanical (brush) allodynia in cluster headache: a prevalence study in a tertiary headache clinic

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