- Meeting abstract
- Open access
- Published:
EHMTI-0009. A particular case of cluster headache
The Journal of Headache and Pain volume 15, Article number: C60 (2014)
Introduction
Cluster headache represents a severe, strictly unillateral retroorbital short lasting headache, accompanied by permanent parasimpathetic autonomic features; attacks occur regularly for one week to one year, separated by pain- free periods that last at least one month.
Aims
We present a case of cluster headache as the presenting symptom leading, in the end, to the diagnosis of Multiple Sclerosis(MS) with a demyelinating lesion in the left trigeminal nucleus and tract.
Methods
We reviewed the case retrospectively, including the clinical, laboratory and radiological data.
Results
Our patient, female, aged 31 years, was admitted to our hospital with attacks of headache of short duration 10-20 minutes, that occur 4-5 times a day, usually during sleeping, accompanied by rhinorrhea, eyelid edem, ptosis, miosis and conjunctival injection. The pain is so excruciating that the patient describes it as "suicide headache", followed by an incomplete abolition of the pain after 50-100 mg Sumatriptane per day, 600 mg Magnesium daily and Capsaicin cream. Cerebrospinal fluid revealed mildly elevated protein. Magnetic resonance imaging showed a non-hancing, non restricting lesion within the pontine portion of the left trigeminal nucleus and tract.There were also numerous periventricular and callosal white T2 hyperintensities consistent with demyelination. The diagnosis of MS was confirmed by additional lesions in the cervical spinal cord, presence of oligoclonal bands, intrathecal Ig G synthesis.
Conclusion
The case suggests that in patients with any primary headache, especially young population, neuroimaging is often useful in order to exclude structural lesions.
No conflict of interest.
Author information
Authors and Affiliations
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
About this article
Cite this article
Tertan, D., Tertan, O. EHMTI-0009. A particular case of cluster headache. J Headache Pain 15 (Suppl 1), C60 (2014). https://doi.org/10.1186/1129-2377-15-S1-C60
Published:
DOI: https://doi.org/10.1186/1129-2377-15-S1-C60