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Effective management of ice pick pains, SUNCT, and episodic and chronic paroxysmal hemicrania

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Abstract

Idiopathic stabbing headaches, the SUNCT syndrome, and the paroxysmal hemicranias are a group of primary headache disorders that are characterized by brief, short-lived attacks of head pain, which recur multiple times throughout the day. These syndromes are much less prevelant than other types of primary headaches such as migraine and tension-type headaches but are significantly more disabling. Recognition of these uncommon disorders is important because their management differs from standard headache therapies.

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References and Recommended Reading

  1. Pareja JA, Ruiz J, Deisla C, et al.: Idiopathic stabbing headache (jabs and jolts syndrome). Cephalalgia 1996, 16:93–96.

    Article  PubMed  CAS  Google Scholar 

  2. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Headache Classification Committee of the International Headache Society [no authors listed]. Cephalalgia 1988, 8(suppl 7):1-96.

  3. Lansche RK: Ophthalmodynia periodica. Headache 1964, 4:247–249.

    Article  PubMed  CAS  Google Scholar 

  4. Mathew NT: Indomethacin responsive headache syndromes. Headache 1981, 21:147–150.

    Article  PubMed  CAS  Google Scholar 

  5. Sjaastad O, Apfelbaum R, Caskey W, et al.: Chronic paroxysmal hemicrania (CPH): the clinical manifestations a review. Uppsala J Med Sci 1980, 31:27–33.

    CAS  Google Scholar 

  6. Sands GH, Newman L, Lipton R: Cough, exertional, and other headaches. In Medical Clinics of North America, vol 74. Edited by Diamond S. Philadelphia: W.B. Saunders; 1991:733–747. A comprehensive review of headaches of short duration.

    Google Scholar 

  7. Rassmussen BK: Epidemiology of headache. Cephalalgia 1995, 15:45–68.

    Google Scholar 

  8. Raskin NH, Schwartz RK: Icepick-like pain. Neurology 1980, 30:203–205.

    PubMed  CAS  Google Scholar 

  9. Drummond PD, Lance JW: Neurovascular disturbances in headache patients. Clin Exp Neurol 1984, 20:93–99.

    PubMed  CAS  Google Scholar 

  10. Lance JW, Anthony M: Migrainous neuralgia or cluster headache? J Neurol Sci 1971, 13:401–414.

    Article  PubMed  CAS  Google Scholar 

  11. Ekbom K: Some observations on pain in cluster headache. Headache 1975, 14:219–225.

    Article  PubMed  CAS  Google Scholar 

  12. Sjaastad O: Cluster Headache Syndrome. London: W.B. Saunders; 1992.

    Google Scholar 

  13. Newman LC, Lipton RB, Solomon S: Hemicrania continua: ten new cases and a review of the literature. Neurology 1992, 44:2111–2114.

    Google Scholar 

  14. Goadsby PJ, Lipton RB: A review of paroxysmal hemicranias, SUNCT syndrome and other short-lasting headaches with autonomic feature, including new cases. Brain 1997, 120:193–209. The most up-to-date review of these headache disorders.

    Article  PubMed  Google Scholar 

  15. Mascellino AM, Lay CL, Newman LC: Stabbing headache as the presenting manifestation of intracerebral meningioma: a report of two cases. Headache 2001, in press.

  16. Medina JL, Diamond S: Cluster headache variant: spectrum of a new headache syndrome. Arch Neurol 1981, 38:705–709.

    PubMed  CAS  Google Scholar 

  17. Sjaastad O, Russell D, Horven I, Bunaes U: Multiple neuralgiform unilateral headache attacks associated with conjunctival injection and appearing in clusters. A nosological problem. Proceedings of the Scandinavian Migraine Society. 1978:31.

  18. Sjaastad O, Saunte C, Salvesen R, et al.: Short-lasting unilateral neuralgiform headache attacks with conjunctival injection, tearing, sweating, and rhinorrhea. Cephalalgia 1989, 9:147–156.

    Article  PubMed  CAS  Google Scholar 

  19. Pareja JA, Sjaastad O: SUNCT syndrome in the female. Headache 1994, 34:217–220.

    Article  PubMed  CAS  Google Scholar 

  20. Bouhassira D, Attal N, Esteve M, Chauvin M: ‘SUNCT’ syndrome. A case of transformation from trigeminal neuralgia? Cephalalgia 1994, 14:168–170.

    Article  PubMed  CAS  Google Scholar 

  21. Pareja JA, Sjaastad O: SUNCT syndrome. A clinical review. Headache 1997, 37:195–202. Overview of the SUNCT syndrome.

    Article  PubMed  CAS  Google Scholar 

  22. Benoliel R, Sharav Y: SUNCT syndrome: case report and literature review. Oral Surg Oral Med Oral Path Oral Radiol Endod 1998, 85:158–161.

    Article  CAS  Google Scholar 

  23. Raimondi E, Gardella L: SUNCT syndrome. Two cases in Argentina. Headache 1998, 38:369–371.

    Article  PubMed  CAS  Google Scholar 

  24. May A, Bahra A, Buchel C, et al.: Functional magnetic resonance imaging in spontaneous attacks of SUNCT: short-lasting neuralgiform headache with conjunctival injection and tearing. Ann Neurol 1999, 46:791–794.

    Article  PubMed  CAS  Google Scholar 

  25. Pareja JA, Shen JM, Kruszewski P, et al.: SUNCT syndrome: Duration, frequency, and temporal distribution of attacks. Headache 1996, 36:161–165.

    Article  PubMed  CAS  Google Scholar 

  26. Pareja JA, Joubert J, Sjaastad O: SUNCT syndrome. Atypical temporal patterns. Headache 1996, 36:108–110.

    Article  PubMed  CAS  Google Scholar 

  27. Pareja JA, Caballero V, Sjaastad O: SUNCT syndrome. Statuslike pattern. Headache 1996, 36:622–624.

    Article  PubMed  CAS  Google Scholar 

  28. Pareja JA, Pareja J, Palomo T, et al.: SUNCT syndrome: repetitive and overlapping attacks. Headache 1994, 34:114–116.

    Article  PubMed  CAS  Google Scholar 

  29. Becser N, Berky M: SUNCT syndrome: a Hungarian case. Headache 1995, 35:158–160.

    Article  PubMed  CAS  Google Scholar 

  30. Hannerz J, Greitz D, Hansson P, Ericson K: SUNCT may be another manifestation of orbital venous vasculitis. Headache 1992, 32:384–389.

    Article  PubMed  CAS  Google Scholar 

  31. Bussone G, Leone M, Dalla Volta G, et al.: Short-lasting unilateral neuralgiform headache attacks with tearing and conjunctival injection: the first ‘symptomatic’ case? Cephalalgia 1991, 11:123–127.

    Article  PubMed  CAS  Google Scholar 

  32. De Benedittis G: SUNCT syndrome associated with cavernous angioma of the brain stem. Cephalalgia 1996, 16:503–506.

    Article  PubMed  Google Scholar 

  33. Morales F, Mostacero E, Marta J, Sanchez S: Vascular malformation of the cerebellopontine angle associated with ‘SUNCT’ syndrome. Cephalalgia 1994, 14:301–302.

    Article  PubMed  CAS  Google Scholar 

  34. Kruszewski P: Shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome): V. Orbital phlebography. Cephalalgia 1992, 12:387–389.

    Article  PubMed  CAS  Google Scholar 

  35. Sjaastad O, Kruszewski P, Fostad K, et al.: SUNCT syndrome: VII. Ocular and related variables. Headache 1992, 32:489–495.

    Article  PubMed  CAS  Google Scholar 

  36. Zhao JM, Sjaastad O: SUNCT syndrome: VIII. Pupillary reaction and corneal sensitivity. Funct Neurol 1993, 8:409–414.

    PubMed  CAS  Google Scholar 

  37. Kruszewski P, White LR, Shen JM, et al.: Respiratory studies in SUNCT syndrome. Headache 1995, 35:344–388.

    Article  PubMed  CAS  Google Scholar 

  38. Shen JM, Johnsen HJ: SUNCT syndrome: estimation of cerebral blood flow velocity with transcranial Doppler ultrasonography. Headache 1994, 34:25–31.

    Article  PubMed  CAS  Google Scholar 

  39. Poughias L, Aasly J: SUNCT syndrome: cerebral SPECT images during attacks. Headache 1995, 35:143–145.

    Article  PubMed  CAS  Google Scholar 

  40. Pareja JA, Kruszewski P, Sjaastad O: SUNCT syndrome: trials of drugs and anesthetic blockades. Headache 1995, 35:138–142.

    Article  PubMed  CAS  Google Scholar 

  41. Ghose RR: SUNCT syndrome. Med J Aust 1995, 162:667–668.

    PubMed  CAS  Google Scholar 

  42. D’Andrea G, Granella F, Cadaldini M: Possible usefulness of lamotrigine in the treatment of SUNCT syndrome. Neurology 1999, 22:1609.

    Google Scholar 

  43. Sjaastad O, Dale I: Evidence for a new (?), treatable headache entity. Headache 1974, 14:105–108.

    Article  PubMed  CAS  Google Scholar 

  44. Sjaastad O, Dale I: A new (?) clinical headache entity "chronic paroxysmal hemicrania" 2. Acta Neurol Scand 1976, 54:140–159.

    PubMed  CAS  Google Scholar 

  45. Russell D: Chronic paroxysmal hemicrania: severity, duration and time of occurrence of attacks. Cephalalgia 1984, 4:53–56.

    Article  PubMed  CAS  Google Scholar 

  46. Antonaci F, Sjaastad O: Chronic paroxysmal hemicrania (CPH): a review of the clinical manifestations. Headache 1989, 29:648–656. A comprehensive review of CPH.

    Article  PubMed  CAS  Google Scholar 

  47. Sjaastad O, Shen JM: Cluster headache. Our current concepts. Acta Neurol 1991, 13:500–505.

    CAS  Google Scholar 

  48. Spierings EL: Episodic and chronic paroxysmal hemicrania. Clin J Pain 1992, 8:44–48.

    Article  PubMed  CAS  Google Scholar 

  49. Gearney DP: Indomethacin-responsive episodic cluster headache. J Neurol Neurosurg Psychiatry 1983, 46:860–861.

    Google Scholar 

  50. Bogucki A, Niewodniczy A: Case report: chronic cluster with unusual high frequency of attacks: differential diagnosis with CPH. Headache 1984, 24:150–151.

    Article  PubMed  CAS  Google Scholar 

  51. Kudrow L, Esperanca P, Vijayan N: Episodic paroxysmal hemicrania? Cephalalgia 1987, 7:197–201.

    Article  PubMed  CAS  Google Scholar 

  52. Blau JN, Engel H: Episodic paroxysmal hemicrania: a further case and review of the literature. J Neurol Neurosurg Psychiatry 1990, 53:343–344.

    Article  PubMed  CAS  Google Scholar 

  53. Antonaci F: Chronic paroxysmal hemicrania and hemicrania continua: orbital phlebography and MRI studies. Headache 1994, 34:32–34.

    Article  PubMed  CAS  Google Scholar 

  54. Cummings WJK: Episodic paroxysmal hemicrania. J Neurol Neurosurg Psychiatry 1991, 54:666.

    Google Scholar 

  55. Newman LC, Gordon ML, Lipton RB, et al.: Episodic paroxysmal hemicrania: two new cases and a literature review. Neurology 1992, 42:964–966.

    PubMed  CAS  Google Scholar 

  56. Spierings EL: The chronic paroxysmal hemicrania concept expanded. Headache 1998, 28:597–598.

    Article  Google Scholar 

  57. Newman LC, Lipton RB, Solomon S: Episodic paroxysmal hemicrania: 3 new cases and a review of the literature. Headache 1993, 33:195–197. Case reports and review of EPH.

    Article  PubMed  CAS  Google Scholar 

  58. Dodick DW: Extratrigeminal episodic paroxysmal hemicrania. Further clinical evidence of functionally relevant brain stem connections. Headache 1998, 38:794–798.

    Article  PubMed  CAS  Google Scholar 

  59. Newman LC, Lipton RB: Paroxysmal hemicranias. In Headache. Blue Books of Practical Neurology, 17. Edited by Goadsby PJ, Silberstein SD. Boston: Butterworth-Heinemann; 1997:43–250.

    Google Scholar 

  60. Rapoport AM, Sheftell FD, Baskin SM: Chronic paroxysmal hemicrania: case report of the second known definite occurrence in a male. Cephalalgia 1981, 1:67–69.

    Article  PubMed  CAS  Google Scholar 

  61. Petty RG, Rose FC: Chronic paroxysmal hemicrania: first reported British case. BMJ 1983, 286:438.

    PubMed  CAS  Google Scholar 

  62. Haggag KJ, Russell D: Chronic paroxysmal hemicrania. In The Headaches. Edited by Olesen J et al. New York: Raven Press; 1993:601–608.

    Google Scholar 

  63. Joubert J, Powell D, Djikowski J: Chronic paroxysmal hemicrania in a South African Black. A case report. Cephalalgia 1987, 7:193–196.

    Article  PubMed  CAS  Google Scholar 

  64. Joubert J: Cluster headaches in black patients. A report of 7 cases. S Afr Med J 1988, 73:552–554.

    PubMed  CAS  Google Scholar 

  65. Kudrow DB, Kudrow L: Successful aspirin prophylaxis in a child with chronic paroxysmal hemicrania. Headache 1989, 29:280–281.

    Article  PubMed  CAS  Google Scholar 

  66. Broeske D, Lenn NJ, Cantos E: Chronic paroxysmal hemicrania in a young child: possible relation to ipsilateral occipital infarction. J Child Neurol 1993, 8:235–236.

    PubMed  CAS  Google Scholar 

  67. Pollmann W, Pfaffenrath V: Chronic paroxysmal hemicrania: the first possible bilateral case. Cephalalgia 1986, 6:55–57.

    Article  PubMed  CAS  Google Scholar 

  68. Sjaastad O: Chronic paroxysmal hemicrania (CPH). In Handbook of Clinical Neurology, vol 48. Edited by Vinken PJ et al. Amsterdam: Elsevier Science; 1986:257–266.

    Google Scholar 

  69. Delcanho RE, Graff-Radford SB: Chronic paroxysmal hemicrania presenting as a toothache. J Orofac Pain 1993, 7:300–306.

    PubMed  CAS  Google Scholar 

  70. Boes CJ, Swanson JW, Dodick DW: Chronic paroxysmal hemicrania presenting as otalgia with a sensation of external acoustic meatus obstruction: two cases and a pathophysiologic hypothesis. Headache 1998, 38:787–791.

    Article  PubMed  CAS  Google Scholar 

  71. Stein HJ, Rogodo AZ: Headache rounds. Chronic paroxysmal hemicrania: 2 new patients. Headache 1980, 20:72–76.

    Article  PubMed  CAS  Google Scholar 

  72. Bogucki A, Szymanska R, Braciak W: Chronic paroxysmal hemicrania: lack of a pre-chronic stage. Cephalalgia 1984, 4:187–189.

    Article  PubMed  CAS  Google Scholar 

  73. Kayed K, Godtilibsen OB, Sjaastad O: Chronic paroxysmal hemicrania. 4. "REM sleep locked" nocturnal headache attacks. Sleep 1978, 1:91–95.

    PubMed  CAS  Google Scholar 

  74. Sjaastad O, Saunte C, Graham JR: Chronic paroxysmal hemicrania. VII. Mechanical precipitation of attacks. New cases and localization of trigger points. Cephalalgia 1984, 4:113–118.

    Article  PubMed  CAS  Google Scholar 

  75. Sjaastad O, Russell D, Saunte C, Horven I: Chronic paroxysmal hemicrania. 6. Precipitation of attacks. Further studies on the precipitation mechanism. Cephalalgia 1982, 2:211–214.

    Article  PubMed  CAS  Google Scholar 

  76. Drummond PD: Thermographic and pupillary asymmetry in chronic paroxysmal hemicrania. A case study. Cephalalgia 1985, 5:133–136.

    Article  PubMed  CAS  Google Scholar 

  77. Sjaastad O, Saunte C, Russell D, et al.: Cluster headache. The sweating pattern during spontaneous attacks. Cephalalgia 1981, 1:233–244.

    Article  PubMed  CAS  Google Scholar 

  78. Sjaastad O, Aasly J, Fredriksen T, et al.: Chronic paroxysmal hemicrania. 10. On the autonomic involvement. Cephalalgia 1986, 6:113–124.

    Article  PubMed  CAS  Google Scholar 

  79. de Souza Caralho S, Salvesen R, Sand T, et al.: Chronic paroxysmal hemicrania. XIII. The pupillometric pattern. Cephalalgia 1988, 8:219–226.

    Article  Google Scholar 

  80. Sjaastad O: Cluster headache and its variants. Headache 1988, 28:667–668.

    Article  PubMed  CAS  Google Scholar 

  81. Medina JL: Organic headaches mimicking chronic paroxysmal hemicrania. Headache 1992, 32:73–74.

    Article  PubMed  CAS  Google Scholar 

  82. Newman LC, Herskovitz S, Lipton RB, Solomon S: Chronic paroxysmal headache: two cases with cerebrovascular disease. Headache 1992, 32:75–76.

    Article  PubMed  CAS  Google Scholar 

  83. Delreux V, Kevers L, Callewaert A: Hemicranie paroxysitique inaugurant un syndrome de Pancoast. Rev Neurol 1989, 145:151–152.

    PubMed  CAS  Google Scholar 

  84. Vijayan N: Symptomatic chronic paroxysmal hemicrania. Cephalalgia 1992, 12:111–113.

    Article  PubMed  CAS  Google Scholar 

  85. Gawel MJ, Rothbart P: Chronic paroxysmal hemicrania which appears to arise from either third ventricle pathology or internal carotid artery pathology. Cephalalgia 1992, 12:327.

    Article  PubMed  CAS  Google Scholar 

  86. Sjaastad O, Stovner LJ, Stolt- Nielsen A, et al.: CPH and hemicrania continua: requirements of high indomethacin dosages-an ominous sign? Headache 1995, 35:363–367.

    Article  PubMed  CAS  Google Scholar 

  87. Hannerz J, Jogestrand T: Intracranial hypertension and sumatriptan efficacy on a case of chronic paroxysmal hemicrania which became bilateral. (The mechanism of indomethacin in CPH). Headache 1993, 33:320–323.

    Article  PubMed  CAS  Google Scholar 

  88. Macmillan JC, Nukada H: Chronic paroxysmal hemicrania. NZ Med J 1989, 102:251–252.

    CAS  Google Scholar 

  89. Pareja J, Pareja J: Chronic paroxysmal hemicrania coexisting with migraine. Differential response to pharmacological treatment. Headache 1992, 32:77–78.

    Article  PubMed  CAS  Google Scholar 

  90. Jotkowitz S: Chronic paroxysmal hemicrania and cluster. Ann Neurol 1978, 4:389.

    Article  PubMed  CAS  Google Scholar 

  91. Pearce SHS, Cox JGC, Pearce JMS: Chronic paroxysmal hemicrania, episodic cluster headache and classic migraine in one patient. J Neurol Neurosurg Psychiatry 1987, 50:1699–1700.

    PubMed  CAS  Google Scholar 

  92. Tehindrazanarivelo AD, Visy JM, Bousser MG: Ipsilateral cluster headache and chronic paroxysmal hemicrania: two case reports. Cephalalgia 1992, 12:318–320.

    Article  PubMed  CAS  Google Scholar 

  93. Centonze V, Bassi A, Causarano V, et al.: Simultaneous occurrence of ipsilateral cluster headache and chronic paroxysmal hemicrania: a case report. Headache 2000, 40:54–56.

    Article  PubMed  CAS  Google Scholar 

  94. Hannerz J: Trigeminal neuralgia with chronic paroxysmal hemicrania: the CPH-tic syndrome. Cephalalgia 1993, 13:361–364.

    Article  PubMed  CAS  Google Scholar 

  95. Caminero AB, Pareja JA, Dobato JL: Chronic paroxysmal hemicrania-tic syndrome. Cephalalgia 1998, 18:159–161.

    Article  PubMed  CAS  Google Scholar 

  96. Zukerman E, Peres MFP, Kaup AO, et al.: Chronic paroxysmal hemicrania-tic syndrome. Neurology 2000, 54:1524–1526.

    PubMed  CAS  Google Scholar 

  97. Antonaci F, Sandrini G, Danilov A, Sand T: Neurophysiological studies in chronic paroxysmal hemicrania and hemicrania continua. Headache 1994, 34:479–483.

    Article  PubMed  CAS  Google Scholar 

  98. Horven J, Russell D, Sjaastad O: Ocular blood flow changes in cluster headache and chronic paroxysmal hemicrania. Headache 1989, 29:373–376.

    Article  PubMed  CAS  Google Scholar 

  99. Saunte C: Chronic paroxysmal hemicrania: salivation, tearing and nasal secretion. Cephalalgia 1984, 4:25–32.

    Article  PubMed  CAS  Google Scholar 

  100. Russell D, Storstein L: Chronic paroxysmal hemicrania: heart rate changes and ECG rhythm disturbances. A computerized analysis of 24h ambulatory ECG recordings. Cephalalgia 1984, 4:135–144.

    Article  PubMed  CAS  Google Scholar 

  101. Mongini F, Caselli C, Macri V, Tetti C: Thermographic findings in cranio-facial pain. Headache 1990, 30:497–504.

    Article  PubMed  CAS  Google Scholar 

  102. Shen JM: Transcranial Doppler sonography in chronic paroxysmal hemicrania. Headache 1993, 33:493–496.

    Article  PubMed  CAS  Google Scholar 

  103. Micieli G, Cavallini A, Facchinetti F, et al.: Chronic paroxysmal hemicrania: a chronobiological study (case report). Cephalalgia 1989, 9:281–286.

    Article  PubMed  CAS  Google Scholar 

  104. Goadsby PJ, Edvinsson L: Neuropeptide changes in a case of chronic paroxysmal hemicrania-evidence trigeminoparasympathetic activation. Cephalalgia 1996, 16:448–450.

    Article  PubMed  CAS  Google Scholar 

  105. Sjaastad O, Antonaci F: Chronic paroxysmal hemicrania: a case report. Long-lasting remission in the chronic stage. Cephalalgia 1987, 7:203–205.

    Article  PubMed  CAS  Google Scholar 

  106. Coria F, Claveria LE, Jimenez-Jimenez FJ, de Seijas EV: Episodic paroxysmal hemicrania responsive to calcium channel blockers. J Neurol Neurosurg Psychiatry 1992, 55:166.

    PubMed  CAS  Google Scholar 

  107. Shabbir N, McAbee G: Adolescent chronic paroxysmal hemicrania responsive to verapamil monotherapy. Headache 1994, 34:209–210.

    Article  PubMed  CAS  Google Scholar 

  108. Hannerz J, Ericson K, Bergstrand G: Chronic paroxysmal hemicrania: orbital phlebography and steroid treatment. A case report. Cephalalgia 1987, 7:189–192.

    Article  PubMed  CAS  Google Scholar 

  109. Sjaastad O, Antonaci F: A piroxicam derivative partially effective in chronic paroxysmal hemicrania and hemicrania continua. Headache 1995, 35:549–550.

    Article  PubMed  CAS  Google Scholar 

  110. Warner JS, Wanul AW, McLean MJ: Acetazolamide for the treatment of chronic paroxysmal hemicrania. Headache 1994, 34:597–599.

    Article  PubMed  CAS  Google Scholar 

  111. Dahlof C: Subcutaneous sumatriptan does not abort attacks of chronic paroxysmal hemicrania (CPH). Headache 1990, 33:201–202.

    Article  Google Scholar 

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  1. St. Luke’s Roosevelt Hospital Center, The Headache Institute, 1000 Tenth Avenue at 58th Street, 10019, New York, NY, USA

    Lawrence C. Newman MD

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Newman, L.C. Effective management of ice pick pains, SUNCT, and episodic and chronic paroxysmal hemicrania. Current Science Inc 5, 292–299 (2001). https://doi.org/10.1007/s11916-001-0046-6

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