ABSTRACT
OBJECTIVE: The objective of this review is to describe auditory hallucinations (paracusias) associated with migraine attacks to yield insights into their clinical significance and pathogenesis. BACKGROUND: Isolated observations have documented rare associations of migraine with auditory hallucinations. Unlike visual, somatosensory, language, motor, and brainstem symptoms, paracusias with acute headache attacks are not a recognized aura symptom by the International Headache Society, and no systematic review has addressed this association. METHODS: We retrospectively studied patients experiencing paracusias associated with migraine at our center and in the literature. RESULTS: We encountered 12 patients (our center = 5, literature = 7), 58% were female, and 75% had typical migraine aura. Hallucinations most commonly featured voices (58%), 75% experienced them during headache, and the duration was most often <1 hour (67%). No patients described visual aura evolving to paracusias. Most patients (50%) had either a current or previous psychiatric disorder, most commonly depression (67%). The course of headache and paracusias were universally congruent, including improvement with headache prophylaxis (58%). CONCLUSION: Paracusias uncommonly co-occur with migraine and usually feature human voices. Their timing and high prevalence in patients with depression may suggest that paracusias are not necessarily a form of migraine aura, though could be a migraine trait symptom. Alternative mechanisms include perfusion changes in primary auditory cortex, serotonin-related ictal perceptual changes, or a release phenomenon in the setting of phonophobia with avoidance of a noisy environment.
Subject(s)
Hallucinations/diagnosis , Hallucinations/epidemiology , Migraine Disorders/diagnosis , Migraine Disorders/epidemiology , Adolescent , Adult , Female , Humans , Male , Middle Aged , Migraine with Aura/diagnosis , Migraine with Aura/epidemiology , Retrospective Studies , Young AdultABSTRACT
Headache, a common and disabling symptom in Behçet's syndrome, may be associated with a variety of neurologic syndromes and ocular inflammation, or may present as an isolated feature. Our objective is to describe the various neurologic and ocular syndromes of Behçet's syndrome of which headache is a symptom, and to review the features of isolated headaches in Behçet's. We also report results of a study of headache in Behçet's syndrome patients who are followed at NYU Hospital for Joint Diseases, the first study of its kind in North American patients, and the first to document prevalence of both episodic and chronic daily headache in Behçet's.
Subject(s)
Behcet Syndrome/physiopathology , Headache Disorders, Primary/physiopathology , Headache Disorders/physiopathology , Inflammation/physiopathology , Optic Neuritis/physiopathology , Uveitis/physiopathology , Behcet Syndrome/complications , Headache Disorders/classification , Headache Disorders/etiology , Headache Disorders, Primary/classification , Headache Disorders, Primary/etiology , Humans , Inflammation/complications , Optic Neuritis/etiology , Uveitis/etiologySubject(s)
Tension-Type Headache/diagnosis , Chronic Disease , Diagnosis, Differential , Headache Disorders, Primary/diagnosis , Headache Disorders, Primary/physiopathology , Headache Disorders, Secondary/diagnosis , Headache Disorders, Secondary/physiopathology , Humans , Tension-Type Headache/classification , Tension-Type Headache/physiopathologyABSTRACT
Tension-type headache (TTH) is the most prevalent type of headache across all age groups worldwide. TTH is common, disabling, and associated with medical and psychiatric comorbidities. This review will focus on the epidemiologies of episodic and chronic TTH in various age groups, factors associated with progression and remission, comorbidities, and the burden of TTH.
Subject(s)
Tension-Type Headache/epidemiology , Adolescent , Adult , Age Distribution , Aged , Child , Comorbidity , Female , Humans , Male , Middle Aged , Prevalence , Tension-Type Headache/diagnosis , Young AdultABSTRACT
New daily-persistent headache (NDPH) and chronic tension-type headache (CTTH) are two forms of primary chronic daily headache of long duration that often are similar in their headache manifestations. NDPH distinguishes itself from CTTH and the other forms of chronic daily headache by its continuous head pain from onset. However, despite formalized criteria that specify NDPH must resemble the acute onset of a headache identical to that of CTTH, NDPH commonly has migraine features. Here, we review the available literature on NDPH and compare its clinical features, epidemiology, prognosis, inciting factors, and treatment to CTTH.
Subject(s)
Headache/diagnosis , Headache/epidemiology , Tension-Type Headache/diagnosis , Tension-Type Headache/epidemiology , Headache/physiopathology , Humans , Prognosis , Tension-Type Headache/physiopathologySubject(s)
Menstruation Disturbances/physiopathology , Migraine Disorders/physiopathology , Postmenopause/physiology , Amines/therapeutic use , Cyclohexanecarboxylic Acids/therapeutic use , Cyclohexanols/therapeutic use , Female , Fructose/analogs & derivatives , Fructose/therapeutic use , Gabapentin , Gonadal Steroid Hormones/blood , Herbal Medicine/methods , Hot Flashes/drug therapy , Hot Flashes/physiopathology , Humans , Menstrual Cycle/drug effects , Menstrual Cycle/physiology , Menstruation Disturbances/metabolism , Middle Aged , Migraine Disorders/drug therapy , Migraine Disorders/metabolism , Topiramate , Venlafaxine Hydrochloride , gamma-Aminobutyric Acid/therapeutic useABSTRACT
Tension-type headache (TTH) is the most common type of headache in the general population, including individuals over the age of 65 years. Although the prevalence of migraine decreases markedly with age, TTH has a greater tendency to persist later in life. Less commonly, TTH can present for the first time after the age of 50 years. As the elderly population continues to grow, more patients will be presenting to physicians with headache. Special considerations in this population include the higher prevalence of secondary causes and multiple medical comorbidities. This article presents an update on the epidemiology and prognosis of TTH in the elderly.
