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The trigemino-cervical reflex in tension-type headache
1Department of Neurology, 'F. Tappeiner' Hospital, Merano (BZ), Italy. raffaele.nardone@asbmeran-o.it
European Journal of Neurology
|May 20, 2003
Summary
Chronic tension-type headache (CTTH) patients show abnormal trigeminal system responses, unlike episodic TTH patients. This suggests CTTH pathophysiology involves trigeminal nerve dysfunction, offering diagnostic insights.
Area of Science:
- Neurology
- Neuroscience
- Pain Research
Background:
- Tension-type headache (TTH) pathophysiology, particularly central mechanisms and trigeminal system involvement, requires further investigation.
- The trigemino-cervical reflex, a brainstem reflex, can be measured via sternocleidomastoid muscle responses to trigeminal nerve stimulation.
Purpose of the Study:
- To investigate the pathophysiology of TTH, focusing on central mechanisms and trigeminal system involvement.
- To assess the trigemino-cervical reflex in healthy subjects and patients with episodic TTH (ETTH) and chronic TTH (CTTH).
Main Methods:
- Studied the trigemino-cervical reflex in 15 healthy subjects, 15 ETTH patients, and 15 CTTH patients outside of pain episodes.
- Measured short latency responses in the sternocleidomastoid muscle following infraorbital nerve stimulation.
Main Results:
- Abnormal trigemino-cervical reflex responses (size or latency) were observed in 13 out of 15 CTTH patients.
- Only one ETTH patient exhibited an abnormal trigemino-cervical reflex response.
- These findings suggest significant trigeminal system involvement in CTTH pathophysiology.
Conclusions:
- The trigemino-cervical reflex is a sensitive indicator of trigeminal brainstem neuron involvement in TTH.
- Abnormalities in this reflex are primarily associated with chronic TTH, not episodic TTH.
- Assessment of the trigemino-cervical reflex may offer valuable diagnostic and prognostic information for TTH patients.