ABSTRACT
La hemicránea paroxística es un cuadro de cefalea primaria, agrupada dentro de las Cefaleas Trigémino Autonómicas(CTAs), junto con la cefalea cluster y el SUNCT, caracterizada por la presencia de dolor unilateral en la distribución somática del nervio trigeminal y asociada a características autonómicas craneofaciales ipsilaterales. A pesar de sus elementos comunes, de forma individual, difieren con respecto a su duración, frecuencia y la respuesta a indometacina. Se presenta un caso de hemicránea paroxística de localización primaria dentomaxilar, sus características comunes y particulares respecto de las demás CTAs, y la necesidad del diagnóstico diferencial con cuadros dolorosos provenientes de estructuras estomatognáticas.
Paroxysmal hemialgia is a primary cephalea of the AutonomousTrigeminus Cephaleas type (ATCs) along with cluster cephalea and SUNCT characterized by the presence of unilateral pain in the somatic distribution of the trigeminal nerve associated to autonomous craniofacial ipsilateral characteristics. Despite the common elements, individually they differ with respect to the length, frequency and response to indomethacin. We present a primary location dento maxilar paroxysmal hemialgia case, its common and particular characteristics with respect to all other ATCs and the need to a differential diagnose with pain coming from stomatognathic structures.
Subject(s)
Humans , Adult , Female , Facial Pain/diagnosis , Facial Pain/drug therapy , Paroxysmal Hemicrania/diagnosis , Paroxysmal Hemicrania/drug therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Indomethacin/therapeutic use , Trigeminal Autonomic CephalalgiasABSTRACT
A number of patients attending a psychiatry out patient department present with headache and cranial autonomic symptoms (CAS) which include cluster headache (CH), shortlasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) or cranial autonomic features (SUNA) and paroxismal hemicrania (PH). The present case reports describe two cases of SUNCT which showed response to lamotrigine. In a day-today practice SUNCT should be kept in mind as effective therapy is available.
Subject(s)
Adult , Cluster Headache/drug therapy , Female , Headache/drug therapy , Humans , Male , Paroxysmal Hemicrania/drug therapy , SUNCT Syndrome/drug therapy , Triazines/analogs & derivatives , Triazines/therapeutic useABSTRACT
AIM OF THE STUDY: To report a case of unilateral headache with two possibilities of diagnosis. METHOD: Case report. RESULTS: Patient with unilateral, intense, stabbing periocular headache with conjuntival injection and tearing. Although the duration of attacks was typical of SUNCT, there was complete remission of the pain with indomethacin, suggesting that this was a case of chronic paroxysmal hemicrania with unusually short attack duration. CONCLUSION: Therapeutic trials of indomethacin on younger patients presenting clinical diagnosis of SUNCT could be tried on a more regular basis.
MOTIVO DO ESTUDO: Relatar um caso de cefaléia unilateral com duas possibilidades diagnósticas. MÉTODOS: Relato de caso. RESULTADOS: Paciente com cefaléia unilateral, intensa, em pontadas em região periocular, com congestão conjuntival e lacrimejamento. Embora a duração das crises fosse típica de SUNCT, houve remissão completa da dor com indometacina, sugerindo que se trate de um caso de hemicramia paroxística crônica com crises de duração atipicamente muito curta. CONCLUSÃO: Testes terapêuticos com indometacina em pacientes mais jovens com diagnóstico clínico de SUNCT poderiam ser tentados de forma mais regular.