Unusual Headache Syndromes

Abstract

Recognizing some unusual headaches, either primary or secondary, may be a challenge for many non-headache specialist physicians. It is important to study them because the correct diagnosis may result in specific treatments that may improve the quality of life of these patients, and this can even be life saving.

Exploding head syndrome: Six new cases and review of the literature

“…There is one case of a patient with EHS and primary stabbing headache relieved by nifedipine (11). The report gives reason to the speculation that EHS might arise from a transient calcium channel dysfunction, similar to episodic ataxia and familial hemiplegic migraine, that results from a mutation in the CACNA1A gene (11,20). A positive family history was reported in four EHS patients (4,15) but all other reports do not support significant genetic predisposition.…”

Red ear syndrome – Case report and review of literature

“…No associated pathology was detected in the other two of his patients [1]. Since then about 90 cases of RES have been published about 60% of the cases are in women and 40% are in men [2,3]. We present a case report of 11-year old girls whose symptoms of idiopathic RES preceded migraine without aura and the signs of redness of the ear occurred in clusters.…”

Can Temporal Course of Pain Determine Patient Response to Specific Medication in Nummular Headache?

“…The pain typically associated with NH is of a pressure‐like or stabbing quality and of mild‐to‐moderate intensity . Most cases of NH are usually localized to the right parietal region (53.7%), although cases of left‐sided frontal (11.7%), temporal (13.0%), and occipital (19.6%) headaches have been documented .…”

“…Most cases of NH are usually localized to the right parietal region (53.7%), although cases of left‐sided frontal (11.7%), temporal (13.0%), and occipital (19.6%) headaches have been documented . The pain does not radiate or change shape/size and is typically unifocal – although cases of bifocal and even multifocal headaches have been reported 4‐6. On exam, patients may demonstrate touch‐evoked paresthesias or even thinness of the skin in the painful area …”