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Chronic paroxysmal hemicrania-tic syndrome
A B Caminero1, J A Pareja, J L Dobato
1Unidad de Neurología, Hospital Ntra. Sra. de Sonsoles, Avila, Spain.
Cephalalgia : an International Journal of Headache
|May 22, 1998
Summary
This study details a rare case of coexisting chronic paroxysmal hemicrania (CPH) and trigeminal neuralgia in one patient, forming a CPH-tic syndrome. The pain occurred in the same facial area, suggesting shared pathogenic mechanisms.
Area of Science:
- Neurology
- Pain Medicine
- Headache Disorders
Background:
- Chronic paroxysmal hemicrania (CPH) and trigeminal neuralgia (TN) are distinct primary headache disorders.
- CPH is characterized by severe, unilateral orbital, supraorbital, or temporal pain attacks lasting 2–30 minutes.
- TN typically presents as sudden, severe, electric shock-like pain in the trigeminal nerve distribution.
Observation:
- A female patient presented with a unique combination of CPH and TN.
- Both pain syndromes manifested in the same orbital region, involving the first branch of the trigeminal nerve.
- The CPH and TN symptoms appeared synchronously, years after initial isolated TN attacks in the second and third trigeminal divisions.
Findings:
- The coexistence of CPH and TN in the same patient is termed CPH-tic syndrome.
- The synchronous onset in the V1 distribution suggests a potential shared underlying pathophysiology.
- This case challenges traditional distinctions between CPH and TN, particularly regarding symptom location.
Implications:
- Understanding the CPH-tic syndrome may offer insights into the pathogenesis of both CPH and TN.
- The findings could influence diagnostic criteria and treatment strategies for complex headache presentations.
- Further research is warranted to explore the neurobiological underpinnings and pharmacological responses in such coexisting conditions.