Chronic Cluster Headache with an Atypical Presentation and Treatment Response
The management of cluster headache (CH) may be challenging. We report a 50-year-old male with recurrent attacks of dull and severe unilateral periorbital pain, lasting 30–45 minutes, twice a day, exclusively during sleep, and accompanied by ipsilateral rhinorrhea and lacrimation. The pain switched s...
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2016-01-01
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Series: | Case Reports in Neurological Medicine |
Online Access: | http://dx.doi.org/10.1155/2016/5230127 |
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doaj-a0973023ff234cc6b15e54040eb0c6772020-11-24T22:20:44ZengHindawi LimitedCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/52301275230127Chronic Cluster Headache with an Atypical Presentation and Treatment ResponseTelma Santos0Hugo Morais1Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, PortugalNeurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, PortugalThe management of cluster headache (CH) may be challenging. We report a 50-year-old male with recurrent attacks of dull and severe unilateral periorbital pain, lasting 30–45 minutes, twice a day, exclusively during sleep, and accompanied by ipsilateral rhinorrhea and lacrimation. The pain switched sides within every attack. CH treatment was initiated but the patient maintained recurrence rates compatible with chronic CH, even after increasing verapamil to 460 mg/day. Afterwards we decided to add lithium (800 mg/day). With this treatment the severity and recurrence of CH substantially decreased, despite the patient’s autonomous decision to take lithium only during the acute phase of the cluster. The exclusively alternating location and the excellent response to short cycles of lithium represent two unique features of CH.http://dx.doi.org/10.1155/2016/5230127 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Telma Santos Hugo Morais |
spellingShingle |
Telma Santos Hugo Morais Chronic Cluster Headache with an Atypical Presentation and Treatment Response Case Reports in Neurological Medicine |
author_facet |
Telma Santos Hugo Morais |
author_sort |
Telma Santos |
title |
Chronic Cluster Headache with an Atypical Presentation and Treatment Response |
title_short |
Chronic Cluster Headache with an Atypical Presentation and Treatment Response |
title_full |
Chronic Cluster Headache with an Atypical Presentation and Treatment Response |
title_fullStr |
Chronic Cluster Headache with an Atypical Presentation and Treatment Response |
title_full_unstemmed |
Chronic Cluster Headache with an Atypical Presentation and Treatment Response |
title_sort |
chronic cluster headache with an atypical presentation and treatment response |
publisher |
Hindawi Limited |
series |
Case Reports in Neurological Medicine |
issn |
2090-6668 2090-6676 |
publishDate |
2016-01-01 |
description |
The management of cluster headache (CH) may be challenging. We report a 50-year-old male with recurrent attacks of dull and severe unilateral periorbital pain, lasting 30–45 minutes, twice a day, exclusively during sleep, and accompanied by ipsilateral rhinorrhea and lacrimation. The pain switched sides within every attack. CH treatment was initiated but the patient maintained recurrence rates compatible with chronic CH, even after increasing verapamil to 460 mg/day. Afterwards we decided to add lithium (800 mg/day). With this treatment the severity and recurrence of CH substantially decreased, despite the patient’s autonomous decision to take lithium only during the acute phase of the cluster. The exclusively alternating location and the excellent response to short cycles of lithium represent two unique features of CH. |
url |
http://dx.doi.org/10.1155/2016/5230127 |
work_keys_str_mv |
AT telmasantos chronicclusterheadachewithanatypicalpresentationandtreatmentresponse AT hugomorais chronicclusterheadachewithanatypicalpresentationandtreatmentresponse |
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