The first report of cluster headache in identical twins

Couturier, E. G. M.; Hering, R.; Steiner, Timothy J.

doi:10.1212/wnl.41.5.761

Cited by 63 publications

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“…A striking aspect is the difference in the clinical presentation between the twins. Variations in the manifestations of cluster headache in twins have been described in previous reports [8][9][10][11], as well as in other disorders occurring in monozygous twins. These variations have been attributed to the timing of twinning, to antenatal environmental fac- tors and to several genetic mechanisms, such as DNA mutation, epigenetic modification (promoter region methylation), or changes in number and morphology of chromosomes at a karyotype level.…”

Section: Discussionmentioning

confidence: 65%

“…Their clinical features did not differ from those previously described in the literature. Smoking is a common finding in cluster headache patients [8,9] and the partial response to enalapril is anecdotal and may mirror that which has been reported for angiotensin converting enzyme inhibitors for migraine [13]. Patient #2's transient remission after a religious conversion may reflect a psychosomatic influence on the behavior of headaches.…”

Section: Discussionmentioning

confidence: 77%

“…Previous reports on identical twins with cluster headache were based on phenotype similarity [7][8][9][10] or on a comparison of blood groups [8,10], HLA haplotypes [8][9][10][11], and DNA markers [11].…”

Section: Discussionmentioning

confidence: 99%

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Report of cluster headache in a pair of monozygous twins

et al. 2004

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A pair of identical twins with cluster headache is described. Monozygosity was confirmed by the identification of 14 DNA markers. In spite of harboring the same genes, the clinical picture presented by the twins was not exactly the same. Cluster headache is probably the best known trigeminal-autonomic cephalalgia, but several questions regarding its pathophysiology remain to be answered. The cases described herein reinforce the role of genetic aspects in its etiology.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 77%

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Report of cluster headache in a pair of monozygous twins

et al. 2004

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“…However, a family history of cluster headache is reported in 2%-7% of patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Furthermore, the condition was described in both members of five pairs of monozygotic twins [16][17][18] and in three generations of a single family [19][20][21]. A Danish study [15] on cluster headache patients attending neurological clinics in Arhus, east-central Jutland, and Copenhaghen County, found that 7% (25 of 366) of patients had a family history of cluster headache, with 25 first-degree relatives and six second-degree relatives affected.…”

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A study of Italian families with cluster headache

Leone¹,

Russell

Rigamonti³

et al. 2000

J Headache Pain

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IntroductionCluster headache is an uncommon, highly debilitating primary headache, characterized by brief, severe, unilateral headaches, accompanied by homolateral eye reddening, lacrimation, rhinorrhea, ptosis, etc. [1]. These attacks occur in cluster periods lasting weeks or months. The etiology and pathogenesis of this headache have not been clearly established. Until fairly recently, the disease was considered to be sporadic. However, a family history of cluster headache is reported in 2%-7% of patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Furthermore, the condition was described in both members of five pairs of monozygotic twins [16][17][18] and in three generations of a single family [19][20][21]. A Danish study [15] on cluster headache patients attending neurological clinics in Arhus, east-central Jutland, and Copenhaghen County, found that 7% (25 of 366) of patients had a family history of cluster headache, with 25 first-degree relatives and six second-degree relatives affected. The relative risk for the illness was 14-and 2-times greater, respectively, in first-and second-degree relatives of patients with cluster headache than in the general population. These findings constitute strong prima facie evidence that cluster headache has a heritable component in at least a fraction of patients. We designed a study to uncover evidence that genetic factors play a role in the genesis of cluster headache in an Italian population of cluster headache patients. To this aim, we assessed the relative risk of cluster headache in first-and second-degree relatives of cluster headache patients attending our headache center in Milan. Materials and methodsWe studied 191 patients (118 males, 73 females, average age 45.9 years) attending the Headache Center of the C. Besta National Neurological Institute, Milan. All patients (probands) were of J Headache Pain (2000) 1:S165-S167 © Springer-Verlag 2000 A study of Italian families with cluster headache

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“…It is usually not considered a familial disorder, 2 though such cases have been reported. [2][3][4][5][6] A positive family history of CH is encountered in approximately 3% of sufferers, 7 the overwhelming majority being males.…”

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Cluster Headache in Two Sisters. Pupillary Response to Phenylephrine and Tyramine

1996

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Two sisters with cluster headache were studied with respect to the pupillary responses to instillation into the conjunctival sac of a single drop of a 1% solution of phenylephrine and a 2% solution of tyramine. The changes in pupillary diameters were documented by photographic pupillometry prior to and at 15, 30, 60, and 90 minutes after the instillations.Of the two sisters, one (case A) was examined during a symptom-free interval, when she had been free from cluster headache attacks for 2 1/2 years. When the cluster headaches recurred, retesting was performed. The other sister (case B) had been free from cluster headaches for 9 years, when she was examined.The findings indicate hypofunction within the postganglionic sympathetic nerve fibers during a cluster headache period. The hypofunction is bilateral, and thus, can not be a consequence of the unilateral cluster headache attacks. During remissions, tyramine induces a marked mydriasis, particularly on the symptomatic side, tentatively indicating an excessive release of stored monoamines.Key words: cluster headache, pupil, phenylephrine, tyramine, sympathetic dysfunction Abbreviations: CH cluster headache (Headache 1996;36:448-451 ) The pathophysiology of cluster headache (CH) is unknown. Its prevalence is low, estimated at about 70 per 100000, 1 with a marked male preponderance. It is usually not considered a familial disorder, 2 though such cases have been reported. 2-6 A positive family history of CH is encountered in approximately 3% of sufferers, 7 the overwhelming majority being males.We recently had the opportunity to examine two sisters who had suffered from typical episodic CH fulfilling the diagnostic criteria of the International Headache Society (IHS). 8 One of the sisters gave a history of more or less regularly recurrent CH periods for more than 20 years. The other had been free from CH attacks for the previous 9 years. As a cephalic sympathetic dysfunction has been implicated in the pathophysiology of CH, 9-13 the two sisters were studied with respect to the pupillary responses to conjunctival instillation of phenylephrine and tyramine. CASE HISTORIESCase A.-A 43-year-old woman sought medical advice because of recurrent periods of left-sided headache, localized around the eye. She had suffered from such a headache for more than 20 years. The periods were said to last for about 4 weeks and occurred annually, or at least every second year. The attacks had a duration of about 1 to 2 hours and used to occur particularly during nighttime. The headache was very intense and of a nonpulsating type. On rare occasions, she felt nauseated and vomited. During an attack, her left eye was red and tearing, and her ipsilateral nostril exhibited rhinorrhea, without being blocked.Between the headache periods, she was free from neurological symptoms. Her somatic and neurological examinations were normal. In particular, there was no anisocoria, nor any other manifestation of a partial Horner's syndrome. She had a gratifying response to prophylactic pizotifen (San...

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The first report of cluster headache in identical twins

Cited by 63 publications

References 0 publications

Report of cluster headache in a pair of monozygous twins

Report of cluster headache in a pair of monozygous twins

A study of Italian families with cluster headache

Cluster Headache in Two Sisters. Pupillary Response to Phenylephrine and Tyramine

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