Prevalence of Trigeminal Autonomic Symptoms in Migraine: A Population-Based Study

Obermann, Mark; Yoon, Min‐Suk; Dommes, P; Kuznetsova, Jelena; Maschke, Matthias; Weimar, Christian; Limmroth, Volker; Hc, Diener; Katsarava, Zaza

doi:10.1111/j.1468-2982.2007.01316.x

Cited by 129 publications

(136 citation statements)

References 11 publications

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“…The very different temporal patterns and duration of attacks in migraine and CH are key factors on distinguishing between these two conditions, as it is true that other features of these headaches can overlap. These overlapping features include the development of aura (known to occur in up to 20% of CH cases) [14], the pain intensity (2/3 of migraine patients also have severe pain), the existence of cranial autonomic symptoms (at least one of these symptoms is known to occur in about half of migraine patients) [15,16,17,18,19,20,21,22] or the presence of associated ‘migraine' features in CH attacks (in a large German cohort CH attacks associated photo/phonofobia in 61% and nausea and vomiting in 28% of cases) [13]. The IHS criteria of ‘strictly unilateral pain' may also cause confusion as switching attack sides has been reported in at least 10% of CH cases [23] and also in up to 10% of cases migraine attacks are strictly unilateral for years [24].…”

Section: Discussionmentioning

confidence: 99%

Errors in Recognition and Management are Still Frequent in Patients with Cluster Headache

et al. 2014

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Objectives: To analyze the trajectory to diagnosis and information provided in a series of cluster headache (CH) patients from five headache clinics. Methods: CH patients were asked to fill in an ad hoc questionnaire. Results: Seventy-five patients (mean age 41.5 years, 67 males) completed the questionnaire. Patients had visited during an average of 4.9 years a mean of 4.6 physicians who had obtained 2.5 neuroimaging procedures per patient before getting a diagnosis of CH. Sixty-three (84%) had received no diagnosis (21 cases; 28%), while 43 (57%) had been given an average of 2.1 alternative diagnoses. Migraine, trigeminal neuralgia and sinusitis were the most frequent mistakes. After diagnosis, 55% had subjectively received poor/very poor information on CH. Ninety-five percent had poor or incorrect information about the nature of the disease, or acute (70%) and preventive (61%) treatments. Etiology (90%), management options (36%) and potential adverse events of medications (29%) were their main information demands. Conclusions: Although CH is an invalidating and clinically clear-cut disorder suffered by around 1/1,000 people, it is still frequently unrecognized and/or mistaken for other disorders, which calls for a better knowledge and education in the diagnosis of the main primary headaches.

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Section: Discussionmentioning

confidence: 99%

Errors in Recognition and Management are Still Frequent in Patients with Cluster Headache

et al. 2014

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“…similarly, referred facial pain with cranial autonomic symptoms, frequently experienced by migraineurs 10 , can explain the "sinus headache" diagnosis. It is well established that trigeminal stimulation leads to cranial autonomic activation with symptoms such as tearing, conjunctival injection and nasal congestion 11 .…”

Section: Migraine Often Mimics Other Headache Disordersmentioning

confidence: 99%

Migraine in the triptan era: progresses achieved, lessons learned and future developments

Bigal

Krymchantowski²,

2009

Arq. Neuro-Psiquiatr.

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-Triptans, serotonin 5-HT 1B/1D receptor agonists, more than revolutionizing the treatment of migraine, stimulated also ground breaking research that provided insights into the anatomy, physiology, and molecular pharmacology of migraine. This knowledge, in turn, is stimulating research on new mechanisms of action for the treatment of migraine. Accordingly, it is opportune to critically review the main advances in migraine science that happened in the triptan era. Herein we first review and conceptualize some of the progresses achieved in migraine science during the triptan era. We then review the class of the triptans -mechanism of action and clinical evidence. We close by briefly discussing the class of CGRP receptor antagonists, which is currently being developed for the acute treatment of migraine.Key WoRDs: migraine, triptans, CGRP antagonists, emerging drugs.Migrânea na era dos triptanos: progressos alcançados, lições aprendidas e desenvolvimentos futuros resumo -os triptanos, agonistas serotoninérgicos 5-HT 1B/1D , revolucionaram o tratamento da migrânea promovendo pesquisas que evidenciaram aspectos da anatomia, fisiologia e farmacologia molecular deste tipo prevalente de cefaléia primária. esse conhecimento, por sua vez vem estimulando ainda mais a descoberta de novos mecanismos de ação para drogas anti-migranosas. Assim, é oportuno rever de forma crítica, os maiores avanços na ciência das cefaléias ocorridos durante a era dos triptanos. Inicialmente reveremos e conceituaremos alguns dos progressos obtidos nesta fase seguido de uma revisão profunda dos mecanismos de ação e evidências clínicas para o uso desta classe de fármacos. Finalmente, discutiremos a nova classe dos antagonistas dos receptores do peptideo geneticamente relacionado à calcitonina (CGRP) atualmente em desenvolvimento. Migraine is a chronic neurological disorder characterized by episodic attacks of headache and associated symptoms 1 . Attempts to alleviate the suffering caused by migraine span millennia and encompass treatments as primitive as trepanation of the skull, to increasingly specific medications that act on receptor subtypes implicated in the pathophysiology of migraine 2 . Triptans, serotonin 5-HT 1B/1D receptor agonists, more than revolutionizing the treatment of migraine, stimulated also ground breaking research that provided insights into the anatomy, physiology, and molecular pharmacology of migraine 3 . This knowledge, in turn, is stimulating research on new mechanisms of action for the treatment of migraine. Accordingly, it is opportune to critically review the main advances in migraine science that happened in the triptan era. To do so, we divided this views and reviews in two main components. We first review and conceptualize some of the progresses achieved in migraine science during the triptan era. We focus on selective themes, and for each, we briefly discuss the established concept (status quo), as well as the evolving knowledge on the area. We then review the class of the triptans -mechanism of action an...

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“…In addition to the diagnostic criteria specified by the International Headache Society (1), migraine can be associated with cranial autonomic symptoms (CAS) of lacrimation, conjunctival injection, eyelid edema, nasal congestion, and forehead/facial sweating (3,4) in 27% to 73% of cases depending on criteria and study design (3)(4)(5)(6). This correlation is not limited to adults but also includes migraineurs under the age of 18 years, with a recent study showing 62% of children and adolescents complaining of migraine-associated CAS (7).…”

Section: Introductionmentioning

confidence: 99%

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

2013

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Objective: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation. Background: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation has gained increasing interest within recent years, as current treatment strategies often fail to provide adequate relief from this debilitating headache.Common migraine symptoms include lacrimation, nasal congestion, and conjunctival injection, all parasympathetic manifestations. In addition, studies have suggested that parasympathetic activity may also contribute to the pain of migraineurs.The SPG is the largest extracranial parasympathetic ganglion of the head, innervating the meninges, lacrimal gland, nasal mucosa, and conjunctiva, all structures involved in migraine with cephalic autonomic symptoms. Conclusion: We propose two possible mechanisms of action: 1) interrupting the post-ganglionic parasympathetic outflow to inhibit the pain and cephalic autonomic symptoms, and 2) modulating the sensory processing in the trigeminal nucleus caudalis. To further explore SPG stimulation in migraineurs as regards therapeutic potential and mode of action, randomized clinical trials are warranted.

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Prevalence of Trigeminal Autonomic Symptoms in Migraine: A Population-Based Study

Cited by 129 publications

References 11 publications

Errors in Recognition and Management are Still Frequent in Patients with Cluster Headache

Errors in Recognition and Management are Still Frequent in Patients with Cluster Headache

Migraine in the triptan era: progresses achieved, lessons learned and future developments

Sphenopalatine ganglion neuromodulation in migraine: What is the rationale?

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