Nocturnal headache associated with melatonin deficiency due to a pineal gland cyst

Karadaş, Ömer; İpekdal, İlker H.; Ulaş, Ümit Hıdır; Odabaşı, Zeki

doi:10.1016/j.jocn.2011.05.022

Cited by 10 publications

(3 citation statements)

References 12 publications

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“…Three patients had strictly unilateral headaches. In a man with pulsatile headache and a pineal cyst with a low nocturnal concentration of melatonin, the supplementation abolished the headaches, suggesting some role of melatonin in the headache mechanism (123).…”

Section: Pineal Gland Abnormalities and Headache Disorders: Pineal Cymentioning

confidence: 99%

Current understanding of pineal gland structure and function in headache

et al. 2019

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Purpose The pineal gland plays an important role in biological rhythms, circadian and circannual variations, which are key aspects in several headache disorders. Overview Melatonin, the main pineal secreting hormone, has been extensively studied in primary and secondary headache disorders. Altered melatonin secretion occurs in many headache syndromes. Experimental data show pineal gland and melatonin both interfere in headache animal models, decreasing trigeminal activation. Melatonin has been shown to regulate CGRP and control its release. Discussion Melatonin has been used successfully as a treatment for migraine, cluster headaches and other headaches. There is a rationale for including the pineal gland as a relevant brain structure in the mechanisms of headache pathophysiology, and melatonin as a treatment option in primary headache.

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Section: Pineal Gland Abnormalities and Headache Disorders: Pineal Cymentioning

confidence: 99%

Current understanding of pineal gland structure and function in headache

et al. 2019

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“…His condition was largely compatible with a diagnosis of hypnic headache; however, the presence of bilateral conjunctival hyperemia during the attacks made that diagnosis doubtful. He was started on 10 mg melatonin at bedtime and became headache free thereafter . Dodick reported a case of hypnic headache in which complete pain resolution was achieved after treatment with 6 mg melatonin at bedtime …”

mentioning

confidence: 99%

“…He was started on 10 mg melatonin at bedtime and became headache free thereafter. 3 Dodick reported a case of hypnic headache in which complete pain resolution was achieved after treatment with 6 mg melatonin at bedtime. 4 Although melatonin promotes sleep by acting on melatonin MT1 and MT2 receptors in the suprachiasmatic nucleus, orally administered melatonin is not effective for the treatment of insomnia.…”

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confidence: 99%

A Case of Unilateral Hypnic Headache: Rapid Response to Ramelteon, a Selective Melatonin MT1/MT2 Receptor Agonist

Arai

2015

Headache

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Hypnic headache is a rare primary headache disorder diagnosed in approximately 0.1% of all patients with headaches assessed at tertiary headache clinics. It is characterized by recurrent headaches occurring exclusively during sleep and almost always at the same time. Women are affected more than men, and the onset is usually after 50 years of age. Controlled trials have not yet been conducted for the treatment of hypnic headaches because of the rarity of the disorder. Therefore, treatment recommendations are based primarily on case reports and small case studies. Administration of lithium salt has been reported to be effective in the prevention of hypnic headaches; however, it is often intolerable, particularly in the elderly. Several other drugs, such as caffeine, indomethacin, verapamil, flunarizine, gabapentin, and topiramate, have also been reported as being effective.Here, we report a case fulfilling the diagnostic criteria for hypnic headache, as defined in the third edition of the International Classification of Headache Disorders (ICHD-3) beta version. 1 Our patient showed a rapid and excellent response to ramelteon, a selective melatonin MT1/MT2 receptor agonist. 2 An 81-year-old woman visited our outpatient clinic with a 5-year history of headache attacks that woke her up at night. The attacks occurred at least twice a week and always at 2 a.m., approximately 3 hours after falling asleep. The headaches were pulsatile, located in the left temporo-occipital region, and of moderate-to-severe intensity. The patient did not notice any accompanying autonomic symptoms such as lacrimation or rhinorrhea and no symptoms of photophobia, phonophobia, or restlessness. Although some attacks were associated with nausea, there was no vomiting.The headaches lasted for less than 1 hour and resolved spontaneously. The patient reported falling asleep after the cessation of the headache and only 1 attack occurred per night. Indomethacin or loxoprofen did not ameliorate the headaches. There were no instances of headaches during the day. The patient's medical history was unremarkable, apart from mild arterial hypertension, for which she was taking 2.5 mg amlodipine besylate. She was of medium build. Neurological examination, brain magnetic resonance imaging, brain magnetic resonance angiography, and routine blood tests were all unre-

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Non-tumorous Lesions of the Pineal Gland

Májovský

2020

Pineal Neurosurgery

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Nocturnal headache associated with melatonin deficiency due to a pineal gland cyst

Cited by 10 publications

References 12 publications

Current understanding of pineal gland structure and function in headache

Current understanding of pineal gland structure and function in headache

A Case of Unilateral Hypnic Headache: Rapid Response to Ramelteon, a Selective Melatonin MT1/MT2 Receptor Agonist

Non-tumorous Lesions of the Pineal Gland

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