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A A Pract 2018 Dec 11. Epub 2018 Dec 11.

From the Department of Anesthesiology, Northwestern University, Chicago, Illinois.

Cluster headaches are characterized by unilateral sudden onset of intense, brief, sharp pain along the side of the face around the eye. Patients often can have symptoms that are resistant to medications, nerve blocks, and surgical treatments. There is increasing evidence of anatomical and functional connections between the trigeminal and occipital nerves. Read More

Am J Manag Care 2018 Dec;24(24 Suppl):S507-S516

electroCore, Inc, Basking Ridge, NJ. Email:

GammaCore was cleared by the FDA for the acute treatment of episodic migraine and episodic cluster headache and has 5 Conformité Européenne marks. Data indicate that gammaCore treatment is both safe and effective as an acute treatment for migraine. Current reimbursement policies need to be updated based on the growing body of evidence to reflect the established status of gammaCore that is no longer experimental. Read More

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Oct;43(10):1137-1144

Department of Health and Social Behavior Science, West China School of Public Health, Sichuan University, Chengdu 610041, China.

Objective: To determine the impact of Cysticercus cellulose (C. cellulose) infection on mental health among school-aged children in Tibetan agricultural areas of Sichuan Province.
 Methods: In October 2015, all primary schools located in Tibetan agricultural areas in Yajiang, Ruoergai, and Muli county of Sichuan Province were selected as the research sites. Read More

Neurosurgery 2018 Dec 10. Epub 2018 Dec 10.

School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.

Background: Management of chronic cluster headache (CCH) remains a challenging endeavor, and the optimal surgical approach for medically refractory CCH remains controversial.

Objective: To conduct a preliminary evaluation of the efficacy and safety of vidian neurectomy (VN) in patients with medically refractory CCH.

Methods: Between March 2013 and December 2015, 9 CCH patients, all of whom had failed to respond to conservative therapy, underwent VN with a precise nerve cut and maximal preservation of the sphenopalatine ganglion. Read More

Pain Med 2018 Dec 7. Epub 2018 Dec 7.

Neurology Department, University Clinical Hospital Lozano Blesa, Instituto Aragonés de Ciencias de la Salud, Grupo de Estudio de Trastornos del Movimiento y Cefaleas (GIIS070), Zaragoza, Spain; Neurology Department, University Clinical Hospital Lozano Blesa, Zaragoza, Spain.

Background. : Cluster headache is one of the most disabling of all headache conditions. Although some studies have investigated the psychological profile of patients with cluster headache, research on its impact on cognitive function in patients with episodic cluster headache outside the cluster bout is scant. Read More

PLoS One 2018 11;13(12):e0208810. Epub 2018 Dec 11.

Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.

Background: Dengue is one of the most important vector-bore infectious diseases in China because of its drastic increase in incidence, geographic extension and profound influence on China's economy. This study aims to retrospectively uncover the epidemiological profile of dengue in Zhejiang, one of the most developed provinces in China, and to find the problem existing in dengue control and prevention.

Methodology: Descriptive analyses on the dengue incidence and associated factors were performed. Read More

Semin Neurol 2018 Dec 6;38(6):603-607. Epub 2018 Dec 6.

Department of Neurology, Boston University School of Medicine, Boston, Massachusetts.

The trigeminal autonomic cephalalgias are a group of distinct primary headache disorders that share common characteristics of strict unilateral headache often accompanied by unilateral cranial autonomic features. Cluster headache is the most well-known example, but other than neurologists, practitioners often have limited familiarity with these disorders and treatment options. Delays in diagnosis are typical and treatment options remain suboptimal, associated with limited scientific research into these brain disorders. Read More

Can J Neurol Sci 2018 Dec 4:1-9. Epub 2018 Dec 4.

Ophtalmology Department,Centre Hospitalier de l'Université de Montréal,Montreal, Quebec,Canada.

The most common symptom of post-concussive syndrome (PCS) is post-traumatic headache (PTH) accompanied by photophobia. Post-traumatic headache is currently categorized as a secondary headache disorder with a clinical phenotype described by its main features and resembling one of the primary headache disorders: tension, migraine, migraine-like cluster. Although PTH is often treated with medication used for primary headache disorders, the underlying mechanism for PTH has yet to be elucidated. Read More

J Headache Pain 2018 Nov 29;19(1):117. Epub 2018 Nov 29.

Charite Universitatsmedizin Berlin, Berlin, Germany.

Background: The three primary headaches, tension-type headache, migraine and cluster headache, occur in both genders, but all seem to have a sex-specific prevalence. These gender differences suggest that both male and female sex hormones could have an influence on the course of primary headaches. This review aims to summarise the most relevant and recent literature on this topic. Read More

J Headache Pain 2018 Nov 28;19(1):116. Epub 2018 Nov 28.

Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs Gate, NO-7489, Trondheim, Norway.

Background: Headache disorders are an important global public-health problem, but under-diagnosed, undertreated and under-prioritized. Deficiencies in health care for headache, present everywhere, are likely to be greater in poorly-resourced countries. This study reports on health-care utilization for headache in Nepal, a low-income country with high headache burden. Read More

JMM Case Rep 2018 Oct 23;5(10):e005168. Epub 2018 Oct 23.

Department Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.

Introduction: Cryptococcosis in immunocompetent adults is a rare disease in Europe, mostly induced by members of the species complex. The diagnosis can be challenging due to its rarity, unspecific symptoms and long symptomless latency.

Case Presentation: A 49-year-old woman with a three weeks history of headache was admitted to the hospital due to discrete ataxia and impaired vision. Read More

J Headache Pain 2018 Nov 23;19(1):114. Epub 2018 Nov 23.

University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, ST4 6QG, UK.

Background: Evidence supports the use of non-invasive vagus nerve stimulation (nVNS; gammaCore®) as a promising therapeutic option for patients with cluster headache (CH). We conducted this audit of real-world data from patients with CH, the majority of whom were treatment refractory, to explore early UK clinical experience with nVNS used acutely, preventively, or both.

Methods: We retrospectively analysed data from 30 patients with CH (29 chronic, 1 episodic) who submitted individual funding requests for nVNS to the National Health Service. Read More

Cephalalgia 2018 Nov 23:333102418815506. Epub 2018 Nov 23.

1 Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Denmark.

Background And Aim: Cluster headache attacks exhibit a nocturnal predilection, but little is known of long-term sleep and circadian rhythm. The aim was to compare actigraphy measures, firstly in episodic cluster headache patients in bout and in remission and, secondly, to compare each disease phase with controls.

Methods: Episodic cluster headache patients (ICHD III-beta), from the Danish Headache Center and healthy, age- and sex-matched controls participated. Read More

J Pain Symptom Manage 2018 Nov 19. Epub 2018 Nov 19.

NYU Rory Meyers College of Nursing, New York City, New York, USA. Electronic address:

Context: There exists a research interest shift from separate symptoms to symptom clusters among people living with HIV (PLWH), which may provide a better understanding of symptom management in HIV/AIDS care. However, the symptom clusters among Chinese PLWH is still unknown.

Objectives: The aim of our study is to identify symptom clusters and to examine demographic and health related factors associated with these symptom clusters among PLWH prescribing antiretroviral therapy (ART) in China. Read More

Funct Neurol 2018 Jul/Sept;33(3):167-168

J Headache Pain 2018 Nov 15;19(1):109. Epub 2018 Nov 15.

Department of Neurology and Algology, Gazi University Faculty of Medicine, Besevler, 06510, Ankara, Turkey.

Cognitive dysfunction has recently gained attention as a significant problem among migraine sufferers. All of the clinical studies show poor cognitive performance during migraine attacks, though, the interictal data are conflicting. Migraineurs show impaired cognitive function interictally in most of the clinic-based studies. Read More

J Headache Pain 2018 Nov 12;19(1):106. Epub 2018 Nov 12.

Department of Neurology, Semmelweis University, Balassa u. 6, Budapest, 1083, Hungary.

Background: Despite its high prevalence, migraine remains underdiagnosed and undertreated. ID-Migraine is a short, self-administrated questionnaire, originally developed in English by Lipton et al. and later validated in several languages. Read More

Front Neurol 2018 26;9:908. Epub 2018 Oct 26.

Department of Neurology, Uijeongbu St.Mary's Hospital, Uijeongbu, South Korea.

Epidemiological data of probable cluster headaches (CH) are scarce in the relevant literature. Here, we sought to assess the prevalence and clinical characteristics of probable CH in comparison with definite CH. Data used in this study were obtained from the Korean Cluster Headache Registry (KCHR), a prospective, cross-sectional, multicenter headache registry that collected data from consecutive patients diagnosed with CH. Read More

Drugs 2018 Nov;78(17):1829-1834

Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

Fremanezumab-vfrm (hereafter referred to as fremanezumab) [AJOVY™] is a fully humanized monoclonal antibody (IgG2Δa) developed by Teva Pharmaceuticals to selectively target calcitonin gene-related peptide (a vasodilatory neuropeptide involved in the pathophysiology of migraine). Its use has been associated with significant reductions in migraine frequency, the requirement for acute headache medication use and headache-related disability compared with placebo in multinational, phase III studies, and in September 2018 fremanezumab was approved by the US FDA for the preventive treatment of migraine in adults. A regulatory assessment for fremanezumab as a preventive treatment of migraine in adults is underway in the EU. Read More

Headache 2018 Nov;58 Suppl 3:276-290

Geisel School of Medicine at Dartmouth, Hanover, NH, USA.

Objective: To briefly update and correct the available data on anti-calcitonin gene-related peptide (CGRP) therapies for headache since the American Headache Society 60th Scientific Meeting, San Francisco, June 2018.

Background: CGRP is a target for primary headache therapies.

Methods: The author briefly reviews the new data and publications on gepants and anti-CGRP and anti-CGRP receptor monoclonal antibodies since the writing of his previous review in May 2018, with an emphasis on data provided at the American Headache Society 60th Scientific Meeting, San Francisco, June 2018. Read More

J Headache Pain 2018 Nov 1;19(1):100. Epub 2018 Nov 1.

Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65, Stockholm, Sweden.

Background: Cluster headache is a severe headache disorder with unknown aetiology. The pathophysiology and symptoms present certain common features with migraine. Specifically, activation of the trigeminal vascular system seems to be involved in both disorders, which is hypothesized to result in neurogenic inflammation and vasodilation of the cerebral vessels. Read More

Drugs 2018 Nov;78(16):1769-1775

Springer, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.

Galcanezumab-gnlm (Emgality™; Eli Lilly and Company), hereafter galcanezumab, is a humanized monoclonal antibody against the calcitonin gene-related peptide (CGRP) ligand. A potent vasodilator, CGRP is implicated in nociceptive transmission and migraine pathogenesis. In September 2018, the US FDA approved galcanezumab as a once-monthly subcutaneous injection for the preventive treatment of migraine in adults. Read More

J Oral Facial Pain Headache 2018 Fall;32(4):e49-e52

Cluster headache (CH) is a rare trigeminal autonomic cephalalgia. Although its pathophysiology is not entirely understood, the hypothalamus and trigeminal nociceptive and autonomic pathways seem to play a key role in its pathology. In the majority of cases, CH begins at a young age and affects mainly men. Read More

Mol Pain 2018 Oct 16:1744806918810297. Epub 2018 Oct 16.

University of California, San Diego, School of Medicine.

The occurrence of debilitating chronic persistent (24/7) headache after mild traumatic brain injury (MTBI) represents a central neuropathic pain state. Previous studies suggest that this chronic headache (HA) state can be attributed to altered supraspinal modulatory functional connectivity in both resting and evoked pain states. Abnormalities in the myelin sheaths along the supraspinal Superior Longitudinal Fasciculus (SLF) and Anterior Thalamic Radiation (ATR) are frequently associated with alteration in pain modulation related to functional connectivity deficit with the prefrontal cortex. Read More

World Neurosurg 2018 Oct 11. Epub 2018 Oct 11.

Department of Neurosurgery, University Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Background: In the literature, there are only short series of radiofrequency of the sphenopalatine ganglion (SPG) to treat chronic refractory cluster headache (CCHr) with variable results. Furthermore, there is no consensus on which methodology to use: radiofrequency ablation (RFA) or pulsed radiofrequency (PRF).

Methods: We conducted a prospective analysis of 37 patients with CCHr who underwent RFA or PRF of the SPG in our center between 2004 and 2015. Read More

Neurol Sci 2018 Oct 10. Epub 2018 Oct 10.

Hull York Medical School, University of Hull, Hull, UK.

Introduction: Patients with cluster headache (CH), the most common trigeminal autonomic cephalalgia, often face delayed diagnosis, misdiagnosis and mismanagement.

Objectives: To identify, appraise and synthesise clinical studies on the delays in diagnosis and misdiagnosis of CH in order to determine its causes and help the management of this condition.

Methods: The systematic review was prepared, conducted and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis. Read More

J Headache Pain 2018 Oct 10;19(1):94. Epub 2018 Oct 10.

Department of Neurology, Zuyderland Medical Center Heerlen, PO Box 4446, 6401, CX, Heerlen, The Netherlands.

Background: Cluster headache attacks can, in many patients, be successfully treated with oxygen via a non-rebreather mask. In previous studies oxygen at flow rates of both 7 L/min and 12 L/min was shown to be effective. The aim of this study was to compare the effect of 100% oxygen at different flow rates for the treatment of cluster headache attacks. Read More

Neuromodulation 2018 Oct 10. Epub 2018 Oct 10.

Department of Neurosurgery, Stanford University, Stanford, CA, USA.

Objectives: Cluster headaches are a set of episodic and chronic pain syndromes that are sources of significant morbidity for patients. The standard of care for cluster headaches remains medication therapy, however a minority of patients will remain refractory to treatment despite changes to dosage and therapeutic combinations. In these patients, functional neuromodulation using Deep Brain Stimulation (DBS) presents the opportunity to alleviate the significant pain that is experienced by targeting the neurophysiological substrates that mediate pain. Read More

Eur J Neurol 2018 Oct 9. Epub 2018 Oct 9.

Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, Glostrup.

Background And Purpose: Cluster headache (CH) is characterized by severe, unilateral attacks of pain and a high nocturnal attack burden. It remains unknown whether perturbations of sleep are solely present during the CH bout. Therefore, we aimed to investigate differences in sleep between the bout and remission period in patients with episodic CH and, secondly, to compare patients in the two phases with controls. Read More

Acta Neurol Scand 2019 Jan 29;139(1):4-17. Epub 2018 Oct 29.

Danish Headache Center, Rigshospital-Glostrup, Glostrup, Denmark.

Small subsets of patients who fail to respond to pharmacological treatment may benefit from alternative treatment methods. In the last decade, neurostimulation is being explored as a potential treatment option for the patients with chronic, severely disabling refractory primary headaches. To alleviate pain, specific nerves and brain areas have been stimulated, and various methods have been explored: deep brain stimulation, occipital nerve stimulation, and sphenopalatine ganglion stimulation are among the more invasive ones, whereas transcranial magnetic stimulation and supraorbital nerve stimulation are noninvasive. Read More

Cephalalgia 2018 Oct 5:333102418804160. Epub 2018 Oct 5.

1 Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.

Introduction Many patients with cluster headache report use of illicit drugs. We systematically assessed the use of illicit drugs and their effects in a well-defined Dutch cluster headache population. Methods In this cross-sectional explorative study, 756 people with cluster headache received a questionnaire on lifetime use and perceived effects of illicit drugs. Read More

Clin Med (Lond) 2018 Oct;18(5):422-427

St George's Hospital, London, UK

Headache is common. Up to 5% of attendances to emergency departments and acute medical units are due to headache. Headache is classified as either primary (eg migraine, cluster headache) or secondary to another cause (eg meningitis, subarachnoid haemorrhage). Read More

Neuromodulation 2018 Sep 30. Epub 2018 Sep 30.

Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany.

Introduction: Sphenopalatine ganglion stimulation (SPG-S) is an invasive form of neuromodulation by which a neurostimulator is implanted into the pterygopalatine fossa to treat refractory chronic cluster headache. The implant is MRI conditional, up to 3 T, however there is no clinical data on the shape, size, and location of the artifact produced by the implant.

Materials And Methods: Records of patients with SPG-S were analyzed for postoperative cranial MRI scans. Read More

Headache 2018 Nov 22;58 Suppl 3:238-275. Epub 2018 Sep 22.

Professor of Neurology, Geisel School of Medicine at Dartmouth, Hanover, NH.

Objective - To briefly describe the history of and available data on anti-calcitonin gene-related peptide (CGRP) therapies for headache. Background - CGRP was proposed as a target for primary headache therapies. Translational research involved moving from delineating the relationships between CGRP and primary headaches and the clinical development of anti-CGRP treatments. Read More

J Headache Pain 2018 Sep 21;19(1):89. Epub 2018 Sep 21.

Department of Neurogeriatric Medicine, Headache Medical Center Linz, Ordensklinikum Linz Barmherzige Schwestern, Seilerstaette 4, 4010, Linz, Austria.

Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both migraine and cluster headache. While exact mechanisms behind both disorders remain to be fully understood, the trigeminovascular system represents one possible common pathophysiological pathway and network of both disorders. Read More

Headache 2018 Nov 17;58(10):1568-1578. Epub 2018 Sep 17.

Department of Neurology, Yale School of Medicine, New Haven, CT, USA.

Objective: In this secondary analysis of the Clusterbusters Medication Use survey, the use, effectiveness, and tolerability of inhaled oxygen were investigated and compared with injectable sumatriptan. We also sought to understand the predictors of medication response.

Background: Inhaled oxygen is a mainstay abortive intervention in cluster headache but is not approved by the Food and Drug Administration (FDA). Read More

Headache 2018 Nov 14;58(10):1519-1529. Epub 2018 Sep 14.

Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.

Objectives: To investigate long-term outcomes in per-protocol chronic cluster headache patients (n = 7), 18 and 24 months after participation in "Pilot study of sphenopalatine injection of onabotulinumtoxinA for the treatment of intractable chronic cluster headache."

Methods: Data were collected prospectively through headache diaries, HIT-6, and open questionnaire forms at 18 and 24 months after the first treatment. Patients had access to repeated injections when needed. Read More

J Pain Res 2018 27;11:1613-1625. Epub 2018 Aug 27.

Department of Psychiatry, Rheinische Friedrich-Wilhelms University, Bonn, Germany,

Objectives: Cervical noninvasive vagus nerve stimulation (nVNS) emerged as an adjunctive neuromodulation approach for primary headache disorders with limited responsiveness to pharmacologic and behavioral treatment. This narrative review evaluates the safety and efficacy of invasive and noninvasive peripheral nerve stimulation of the cervical branch of the vagal nerve (afferent properties) for primary headache disorders (episodic/chronic migraine [EM/CM] and cluster headache [ECH/CCH]) and provides a brief summary of the preclinical data on the possible mechanism of action of cervical vagus nerve stimulation (VNS) and trigemino-nociceptive head pain transmission.

Materials And Methods: A systematic search of published data was performed in PubMed for randomized controlled trials (RCTs) and prospective cohort clinical studies assessing the efficacy/safety and cost-effectiveness of cervical VNS in primary headache disorders and related preclinical studies. Read More

Chin Med J (Engl) 2018 Sep;131(18):2158-2163

Department of Neurology, Chinese People's Liberation Army General Hospital, Beijing 100853, China.

Background: Histopathology identified the anatomical and molecular abnormalities of brainstem nuclei in migraine patients. However, the exact whole brainstem structural changes in vivo have not yet been identified in medication-overuse headache (MOH) transformed from migraine. The aim of this study was to investigate the regional volume changes over the whole brainstem in the MOH patients using voxel-based morphometry (VBM) in vivo. Read More

Dent Clin North Am 2018 Oct 14;62(4):611-628. Epub 2018 Aug 14.

Tufts University School of Dental Medicine, 1 Kneeland Street, Suite 601, Boston, MA 02111, USA.

The primary headaches are composed of multiple entities that cause episodic and chronic head pain in the absence of an underlying pathologic process, disease, or traumatic injury. The most common of these are migraine, tension-type headache, and the trigeminal autonomic cephalalgias. This article reviews the clinical presentation, pathophysiology, and treatment of each to help in differential diagnosis. Read More

Headache 2018 Oct 3;58(9):1472-1474. Epub 2018 Sep 3.

IRCCS Institute of Neurological Sciences of Bologna, UOC Clinica Neurologica, Bologna, Italy.

J Headache Pain 2018 Sep 3;19(1):78. Epub 2018 Sep 3.

Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Keun Jae Bong-gil 7, Hwaseong, Gyeonggi-do, 18450, South Korea.

Background: Cluster headaches (CH) are recurrent severe headaches, which impose a major burden on the life of patients. We investigated the impact of CH on employment status and job burden.

Methods: The study was a sub-study of the Korean Cluster Headache Registry. Read More

Singapore Med J 2018 08;59(8):399-406

Department of Family Medicine, National University Health System, Singapore.

Headaches are common in primary care. For safe assessment and management of the patient with headache, a focused history and physical examination are important to identify secondary headache, and find out whether an immediate referral to the emergency department or a non-emergent referral to the neurologist is warranted. The majority of patients with primary headache may be safely managed in the outpatient setting. Read More

Kurume Med J 2018 Aug 30. Epub 2018 Aug 30.

Seattle Science Foundation.

Pterygopalatine ganglion block (sphenopalatine ganglion block) is a well-known procedure for treating cluster headache and for relieving cancer pain. In this review, the history and anatomy of the pterygopalatine ganglion are discussed, and images, including computed tomography and endoscopy, are presented to improve understanding of the clinical anatomy of the ganglion regarding the block procedure. Read More

J Manag Care Spec Pharm 2018 Sep;24(9):921-928

1 Eli Lilly and Company, Indianapolis, Indiana.

Background: Cluster headache (CH) is a rare trigeminal cephalalgia that is associated with extremely painful unilateral headache attacks and autonomic symptoms. Attacks may be episodic or chronic and associated with substantial suffering due to excruciating pain and limited treatment options. Frequent cluster headaches cause substantial burden for patients, resulting in reduced productivity caused by disability, as well as direct costs in some European countries. Read More

Eat Weight Disord 2018 Aug 28. Epub 2018 Aug 28.

Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Hezar Jarib Ave, Azadi Squre, Isfahan, 73461-81746, Iran.

Purpose: Few studies have assessed the relationship between meal skipping with subjective health complaints in children and adolescents. The aim of our study was to determine the association between meal skipping and subjective health complaints in this population.

Methods: A total of 14,400 students aged 7-18 years were selected using multistage stratified cluster sampling method from 30 provinces of Iran. Read More

Headache 2018 Aug 24. Epub 2018 Aug 24.

Mayo Clinic Florida, Jacksonville, FL, USA.

Objective: To determine the efficacy of high-volume anesthetic suboccipital nerve blocks (HVSON) for chronic cluster headache (CCH) and to define consistency of response over long-term use.

Background: There are studies showing efficacy of greater occipital and suboccipital nerve block injections for CCH and also their possible use as a preventive treatment modality. There are scant data about the long-term efficacy of repetitive greater occipital and suboccipital nerve injections in CCH. Read More

Nat Rev Neurol 2018 Nov;14(11):636-637

Department of Neurology, The Foundation of the Carlo Besta Neurological Institute, IRCCS, Milan, Italy.

J Headache Pain 2018 Aug 20;19(1):72. Epub 2018 Aug 20.

Headache Research Unit, University Department of Neurology CHR, CHU de Liège, Boulevard du 12ème de Ligne 1, 4000, Liège, Belgium.

Background: Percutaneous occipital nerve stimulation (ONS) is effective in refractory chronic cluster headache (rCCH) patients. Responders to ONS differ from non-responders by greater glucose metabolism in subgenual anterior cingulate cortex (sgACC). We reasoned that transcranial direct current stimulation (tDCS), a non-invasive approach, might be able to activate this area and thus improve rCCH patients. Read More

J Neurol 2018 Aug 17. Epub 2018 Aug 17.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

Cluster headache (CH) is characterized by attacks of severe, strictly unilateral pain that is orbital, supraorbital, temporal, or any combination of these, lasts 15-180 min, and occurs from once every other day to eight times a day. The pain is associated with ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis and/or eyelid edema, and/or with restlessness or agitation. The understanding of the pathophysiological mechanisms behind CH is far from complete, but CH is considered to be a neurovascular and chronobiologic headache disorder, with a pivotal role played by the central brain mechanisms. Read More