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Dynamic mechanical (brush) allodynia in cluster headache
Avi Ashkenazi1, William B Young
1Jefferson Headache Center, Department of Neurology, Jefferson University Hospital, Philadelphia, PA 19107-5092, USA.
Headache
|November 18, 2004
Summary
Dynamic mechanical allodynia (brush allodynia) was observed in 40% of cluster headache patients, suggesting a link to disease chronicity and duration. This finding supports neuronal sensitization as a factor in cluster headache.
Area of Science:
- Neurology
- Pain Medicine
- Headache Disorders
Background:
- Cutaneous allodynia, a phenomenon linked to trigeminal nucleus caudalis sensitization, is well-documented in migraine.
- This sensory disturbance has not been previously investigated in cluster headache (CH) patients.
Purpose of the Study:
- To investigate the presence and characteristics of dynamic mechanical allodynia (brush allodynia) in individuals diagnosed with cluster headache.
- To explore potential correlations between allodynia and CH subtypes (episodic vs. chronic) or disease duration.
Main Methods:
- A cohort of adult patients with episodic or chronic cluster headache underwent allodynia testing.
- Brush allodynia was assessed using repetitive stroking with a gauze pad on trigeminal and cervical dermatomes, with severity rated on a visual analog scale (VAS).
- Demographic data, CH characteristics, and headache-related factors were collected via questionnaire.
Main Results:
- Four out of ten (40%) cluster headache patients exhibited brush allodynia.
- The prevalence was higher in chronic CH (2/3) compared to episodic CH (2/7).
- Patients with allodynia had a longer median disease duration (22 years) than those without (12 years).
Conclusions:
- This study provides the first evidence of cutaneous allodynia in cluster headache.
- The occurrence of brush allodynia in CH appears associated with disease type and duration.
- Findings suggest that time-dependent neuronal sensitization may contribute to allodynia in cluster headache.