Cluster Headache

Cluster headache (CH), paroxysmal hemicrania (PH), and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome) are primary headaches grouped together as trigeminal autonomic cephalalgias (TACs). All are characterized by short-lived unilateral head pain attacks associated with oculofacial autonomic phenomena. Neuroimaging studies have demonstrated that the posterior hypothalamus is activated during attacks, implicating hypothalamic hyperactivity in TAC pathophysiology and suggesting stimulation of the ipsilateral posterior hypothalamus as a means of preventing intractable CH. After almost 10 years of experience, hypothalamic stimulation has proved successful in preventing pain attacks in approximately 60% of the 58 documented chronic drug-resistant CH patients implanted at various centers. Positive results have also been reported in drug-resistant SUNCT and PH. Microrecording studies on hypothalamic neurons are increasingly being performed and promise to make it possible to more precisely identify the target site. The implantation procedure has generally proved safe, although it carries a small risk of brain hemorrhage. Long-term stimulation is proving to be safe: studies on patients under continuous hypothalamic stimulation have identified nonsymptomatic impairment of orthostatic adaptation as the only noteworthy change. Studies on pain threshold in chronically stimulated patients show increased threshold for cold pain in the distribution of the first trigeminal branch ipsilateral to stimulation. When the stimulator is switched off, changes in sensory and pain thresholds do not occur immediately, indicating that long-term hypothalamic stimulation is necessary to produce sensory and nociceptive changes, as also indicated by clinical experience that CH attacks are brought under control only after weeks of stimulation. Infection, transient loss of consciousness, and micturition syncope have been reported, but treatment interruption usually is not required.

Cluster headaches are a primary headache disorder characterized by intense unilateral head pain, localized in the supraorbital or suborbital regions. Cluster headache attacks have a very rapid onset (~5 minutes) and generally last from 30 to 90 minutes. The pain of cluster headaches is frequently debilitating, and some patients have been driven to suicide as a means to escape their suffering.

Front-line medications to treat cluster headaches are limited. At present, there are no pharmaceuticals developed specifically to treat cluster headache symptoms. Medical practitioners rely on off-label application of existing medications (including verapamil, topiramate, lithium, and a host of triptans, the most common being sumatriptan) with varying degrees of success.

The lack of reliable medical options, coupled with the excruciating pain of cluster headaches, has led patients to research and develop their own methods of treating their symptoms. In recent years, a number of “alternative” treatments have been adopted by patients seeking more relief than what is available from mainstream medicine.

In early 2014, a small-scale trial was conducted by two cluster headache patients using the novel tryptamine N,N-diallyl-5 methoxytryptamine (hereafter referred to by its common name 5-MeO-DALT) as a preventive treatment for cluster headaches (Post, 2014). The results of this trial demonstrated that 5-MeO-DALT could be extremely effective in preventing cluster headache attacks, meriting further research.

In July of 2015, the information from this study was released to the cluster headache patient community. Many cluster headache patients, especially those already comfortable with self-medication and alternative treatments, began using 5-MeO-DALT as their primary prophylactic treatment. Once the population of patients using 5-MeO-DALT had grown to a significant number, anecdotal evidence suggested that positive results were being obtained, and this survey was implemented in January of 2015 to collect data from this patient group.

Inflammation Mastery, 4th Edition is printed in beautiful full-color and is loaded with images, diagrams, photos, and colorful emphasis. Thousands of citations are provided in the footnotes for easy access. See PDF document for table of contents, samples, and index.

Availability: http://www.amazon.com/dp/1522951008/
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Purpose and audience: This book is written to provide essential information to doctors and patients dealing with chronic pain generally, migraine and fibromyalgia specifically. The information is also relevant for cluster headache, myofascial pain syndrome, and complex regional pain syndrome. With hundreds of citations to the biomedical research literature, this book provides unique insights into the causes of and solutions for migraine and fibromyalgia as prototypic pain disorders chiefly characterised by central sensitization, glial activation, and mitochondrial dysfunction. Clinicians and patients alike will gain insights that are immediately applicable for the treatment of these conditions. Importantly, the focus of Dr Vasquez’s Functional Inflammology Protocol is to skillfully address—in a structured manner—the underlying causes of pain and inflammation, not simply to alleviate pain/inflammation via drug dependency. This book details the pathophysiology and essential treatment components; additional explanations and updates are provided via video lectures and tutorials.
About this book: This book is an excerpt from Chapter 5 of Dr Vasquez’s most recent 1,200-page textbook, Inflammation Mastery, 4th Edition (2016). The information in this book has been developed over many years starting from Dr Vasquez’s teaching notes in Orthopedics and Rheumatology in 2000 and 2001, then in Integrative Orthopedics (2004, 2012), Musculoskeletal Pain: Expanded Clinical Strategies (Institute for Functional Medicine, 2008), Functional Medicine Rheumatology (2014), and Human Microbiome and Dysbiosis in Clinical Disease (2015).

... Des algies oculaires chroniques, plus rares, proches de la migraine ou de l'algie vasculaire peuvent être liées à des glaucomes chroniques ... Le syndrome de Tolosa-Hunt (ICHD code 13.16) [1] associe une douleur rétro-orbitaire intense, continue, unilatérale et une paralysie de ...

Approximately 8 million people worldwide are afflicted with possibly the most excruciating condition known to medicine: cluster headaches. Patients endure immense suffering, and many commit suicide to escape the pain. Current medical options are inadequate. Fortunately there is now clear evidence that psilocybin and chemically related substances are effective for many patients in preventing and aborting attacks. However, their legal status in most countries makes it difficult for patients to access them. Governments can dramatically improve the quality of life for many of their citizens, with little or no additional cost or risk, by removing the legal barriers to cluster headache patients accessing psilocybin and related compounds for therapeutic purposes.

Background: Treatment resistant cluster headache and migraine patients are exploring alternative treatments online. The aim of this study was to improve comprehension regarding the use of non-established or alternative pharmacological treatments used by sufferers of cluster headaches and migraines. Methods: A qualitative thematic analysis of the users' own accounts presented in online forum discussions were conducted. The forum boards https://shroomery.org/, http://bluelight.org, and https://clusterbusters.org/ met the inclusion criteria and were used for the study.

Episodic brain disorders (EBD) form an intriguing group of neurological diseases in which at least some of the symptoms occur in attacks. The hypothalamus integrates many brain functions, including endocrine and autonomic control, and governs various body rhythms. It seems a likely site in which the initiation of attacks of EBD can be modulated. Indeed, the hypothalamus has a crucial role in EBD such as narcolepsy and cluster headache. The same may be true for migraine and depression. Here we summarise the evidence supporting an important role for the hypothalamus in the initiation of disease episodes in various EBD. Study of the various pathophysiological concepts of EBD within the context of the hypothalamus may prove a fruitful example of cross-fertilisation between various research areas.

This paper considers a heterogeneous network of energy constrained sensors deployed over a region. Each Normal sensor node in a network is systematically gathering and transmitting sensed data to the cluster-head, and then cluster head sending data to a base station (via intermediate cluster- heads). This paper focuses on reducing the energy consumption and hence improving lifetime of wireless sensor Networks. Clustering sensor node is an effective topology for the energy constrained networks. So energy saving algorithm has been developed in which clusters are formed considering a subset of high energy nodes as a cluster-head and another subset of powerful nodes is ask to go to sleep. When Cluster heads deplete their energy another subset of nodes becomes active and acts as a cluster head. Proposed approach is implemented in MATLAB, Simulation results shows that it can prolong the network lifetime than LEACH protocol, and achieves better performance than the existing clustering algorithms such as LEACH.

Cluster headache (CH) is a well characterized primary headache disorder. Nevertheless, symptomatic CH has been reported in association with various underlying diseases. Symptomatic cluster headache related to ocular pathologies have been rarely described. We report a case consequent to a surgical operation for cataract.

To evaluate structural changes in the retina and correlate those with visual function measurements in patients with Parkinson disease (PD). A cross-sectional comparative study of 20 patients with PD and 20 age-matched healthy controls was conducted. Visual acuity, color vision, contrast sensitivity, visual fields, pattern visual-evoked response (VER), and multifocal electroretinogram were recorded to determine functional change, whereas structural changes were evaluated with retinal nerve fiber layer (RNFL) thickness, macular thickness, macular volume, and ganglion cell-inner plexiform layer complex (GCL-IPL) thickness using spectral domain ocular coherence tomography (SD-OCT). PD patients ranged from Stage 1-3, with median Stage 2 (Hoehn and Yahr Classification) with mean Unified Parkinson Disease Rating Scale III score of 19 ± 10.42, and average disease duration of 5.8 ± 2.78 years. Visual acuity, color vision, and visual fields were unaffected but contrast sensitivity was signifi...

In this paper, we introduce and discuss an approach that will be used to secure the DSDV routing protocol in an ad-hoc network. Due to mobility and absence of infrastructure, nodes are more vulnerable to several malicious attacks. The secure routing is essential to transmit packets from source to the destination. Our approach consists to model and manage fidelity concept in an ad-hoc clustering architecture. Clustering makes it possible to group the mobile nodes and to send data simultaneously to the each group. Our security model thus aims to integrate mechanisms against black hole attacks, forcing cooperation between nodes and detecting failing behaviors. The nodes present in the clusters will work more efficiently and the message passing within the nodes will also get more authenticated from the cluster heads. The simulation of our proposed algorithm is carried out using NS2 network simulator by evaluating some network performances such as average delay, throughput of communication and packets loss.

This study evaluates osmophobia (defined as an unpleasant perception, during a headache attack, of odours that are non-aversive or even pleasurable outside the attacks) in connection with the diagnosis of primary headaches. We recruited 775 patients from our Headache Centre (566 females, 209 males; age 38+/-12 years), of whom 477 were migraineurs without aura (MO), 92 with aura (MA), 135 had episodic tension-type headache (ETTH), 44 episodic cluster headache (ECH), 2 chronic paroxysmal hemicrania (CPH) and 25 other primary headaches (OPHs: 12 primary stabbing headaches, 2 primary cough headaches, 3 primary exertional headaches, 2 primary headaches associated with sexual activity, 3 hypnic headaches, 2 primary thunderclap headaches and 1 hemicrania continua). Among them, 43% with MO (205/477), 39% with MA (36/92), and 7% with CH (3/44) reported osmophobia during the attacks; none of the 135 ETTH and 25 OPH patients suffered this symptom. We conclude that osmophobia is a very specific...