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Related Experiment Videos

Tearing without pain after trigeminal root section for cluster headache.

Helen Lin1, David W Dodick

  • 1The Mayo Clinic, Scottsdale, AZ 85259, USA.

Neurology
|November 23, 2005
PubMed
Summary

Cluster headache (CH) symptoms can occur independently of pain, suggesting a central origin. This indicates that the trigeminovascular network may not be essential for expressing these neurological symptoms.

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Area of Science:

  • Neurology
  • Pain Medicine
  • Headache Disorders

Background:

  • Cranial autonomic symptoms (CAS) in cluster headache (CH) are typically linked to severe ophthalmic pain.
  • The exact pathophysiology of CH and its associated symptoms remains incompletely understood.

Purpose of the Study:

  • To investigate the relationship between CAS, pain, and trigeminal nerve activation in CH patients.
  • To explore the central versus peripheral mechanisms underlying CH symptom generation.

Main Methods:

  • Surgical transection of the trigeminal nerve root was performed in five CH patients.
  • Observation of CAS and pain occurrence in patients post-surgery and in a control group of five CH patients with typical headaches.

Main Results:

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  • Five patients who underwent trigeminal nerve root transection continued to experience periodic CAS, but without pain.
  • Five patients continued to experience typical cluster headaches with pain.

Conclusions:

  • Cluster headache (CH) appears to be generated by a central pacemaker.
  • Pain associated with CH may not require activation of the peripheral trigeminovascular network.
  • Cranial autonomic symptoms (CAS) can manifest independently of pain in CH, supporting a central origin.