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   Author  Topic: What triggers the trigeminal-autonomic reflex?  (Read 1825 times)
Stoic
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What triggers the trigeminal-autonomic reflex?
« on: Jan 12th, 2008, 10:17am »
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I just joined this site yesterday after getting a diagnosis of cluster headaches from my neurologist. From others on this site as well as other reading, I'm getting a rapid-fire education about clusterheads like us.
 
Whatever the underlying cause for these headaches, I gather that something triggers the trigeminal-autonomic reflex, which leads to the nasal swelling, eye tearing, headache pain, etc.
 
Obviously, even one drink of alcohol can serve as such a trigger. But while I drank heavily when I was much younger, I've been a teetotaler for more than three years.
 
What other kinds of conditions seem to lead to the emergence of this kind of reflex?
 
Bob
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #1 on: Jan 12th, 2008, 10:44am »
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On left: "headache links" --> cluster news --> exore the 3 items there.
 
Stories about the discovery of how the hypothalamus is the generator of CH--but the exact trigger mechanism has yet to be identified.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #2 on: Jan 12th, 2008, 11:42am »
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Sorry, I can't find the "headache links" to the left. Perhaps we're looking at different web browsers.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #3 on: Jan 12th, 2008, 12:22pm »
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hi, Bob.  Go up to the address box in theupper left corner of the screen, click and go to the end of that email address, then back space out  to ".com" (http://www.clusterheadaches.com), then hit enter, go to the bottom of the page, and hit ENTER.  it should give you a different screen with helpful items on the left.  Or click on (http://www.clusterheadaches.com/wwwboard/index.html)
 
Charlotte
« Last Edit: Jan 12th, 2008, 12:36pm by Charlotte » IP Logged
Stoic
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #4 on: Jan 12th, 2008, 12:46pm »
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Thanks, Charlotte. I've got it.
 
Bob
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #5 on: Jan 12th, 2008, 1:07pm »
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Alcohol, petroleum, and other chemicals like perfumes, some cleaning products seem to be especially good triggers. These all have aryl hydrocarbons.  But this is only when a person is in-cycle or susceptible - most episodics can drink alcohol out of cycle without triggering.  
 
Heat also seems to be a common trigger.
 
Salt seems to be a trigger for some - the ions seem to play a role as people with clusters handle calcium, sodium, and other ions differently. And magnesium helps turn down the headaches in some people (as does lithium - a prescription only mineral ion).  
 
Many people have listed MSG as a trigger - glutamate hits the NMDA neurotransmitter sites and makes those nerves fire more rapidly.  
 
Nitroglycerin (heart medicine) - definitely. This is used to provoke attacks in some studies ... it messes up the nitric oxide levels and can trigger.  Nitrates and nitrites in meat - some people say they are susceptible to these.  
 
Allergies - maybe. And antihistamines or histamine desensitization help some people.  
 
Serotonin - a big one in terms of stopping the pain (triptans and mushrooms affect different serotonin components).  Not sure of anything serotonin related that triggers, though.  
 
Flickering light has been reported to be a trigger for some, or bright light.  
 
There are probably others - people are different.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #6 on: Jan 13th, 2008, 8:05am »
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That article by Dr. Goadsby says he can identify CH by a new scanning technique and looking for excessive growth of grey cells.  I presume this can not be seen in a MRI?  Too bad this is not a test anyone can get.
 
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #7 on: Jan 17th, 2008, 4:24pm »
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I was also very intrigued by the findings of the Doctor. It seems that there is an issue of gray matter in the hypothalamus that is different in us then in the "normal" guy.  
 
http://news.bbc.co.uk/2/hi/health/380497.stm
http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s42434.htm
 
Voxel is a workstation of sorts in the way a PET scan has a workstation. I have thought about finding a hospital with one but don't know what I would do with the information once I had it. It won't make the CH's go away.  
And if they could remove the extra gray matter does it fix the problem? Or does it come back after another cycle? Is is the cause or is it a result of the issue?
I wonder if anyone on the site has contact Dr. Goadsby or if he has been asked to attend any of the meetings?  
 
I feel like Joe vs the Volcano - I have a brain cloud  
 
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #8 on: Jan 18th, 2008, 7:53pm »
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Stoic,
 
Be careful to separate the terms "cause" and "trigger."  As someone pointed out above, there are many common triggers for clusterheads, like alcohol and smoke, but that is only after you already have the disease, and if that's a trigger for you then only when you're in cycle or susceptible.
 
What "causes" the disease is a different story altogether, and there have been very few studies to give any definitive answer.  The grey matter study showed excessive grey matter in the hypothalmus, the first physiological sign, but not what caused that overgrowth.  Genetic studies have linked it in some people to the same genetic predisposition for migraines.  As for other things trying to link CH to behavioral causes, like heavy drinking, studies go both ways and follow-up studies haven't backed up the findings.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #9 on: Jan 18th, 2008, 8:29pm »
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Some of the triggers like beer or Chinese food my bring a hit on more rapidly, but there is really no avoiding these things.  When in cycle, a trip to a noisy smoky bar will usually result in a hit within the hour.  But I also find myself generally intolerant of noisy smoky bars even out-of-cycle.  
 
But I usually learn pretty quickly to avoid the heavier triggers, and just deal with the triggers like sleep, awake, light, dark, air,etc.
 
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #10 on: Jan 18th, 2008, 10:43pm »
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Crappy (I hate to address you as that :0),
 
Both those things you said are true.  I also tried to post today a recent article from June 2007 which seems to be lending credence to the head injury theory for SOME (not all--but the writers seem to believe it plays a role in many with CH if I am not mistaken from the jist of the article)  with CH--trying to address doubt that some have had that CH may "seemingly manifest" (my words) for the first time many many years after the head injury.  I had trouble getting the link to work--I will try again b/c I think it was a good article.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #11 on: Jan 18th, 2008, 11:10pm »
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Here is the link. I also posted it in the other thread.  
 
http://www.scielo.br/scielo.php?pid=S0004-282X2007000200033&script=s ci_arttext
 
I had a serious brain injury about 25 years before my first cluster headache.  
 
Have read other studies that people with serious head injuries are more susceptible to depression and schizophrenia later in life - sometimes decades later.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #12 on: Jan 23rd, 2008, 2:15pm »
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on Jan 23rd, 2008, 2:09pm, JEG_43MD wrote:

 
Two Excedrin Migraine, a cup of coffee, or Ibuprofen 800 and the lay in bed in the dark for 20 minutes. That should help.

Yeah that works for everybody, we've all known that forever.  We just take all these other meds for the cool side-effects.   Roll Eyes
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #13 on: Jan 23rd, 2008, 2:20pm »
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Two Excedrin Migraine, a cup of coffee, or Ibuprofen 800 and the lay in bed in the dark for 20 minutes. That should help.
 
What ???????
anyone with clusters would know that you just cant lay in a room in the dark,
there not migraines dude, there fucking cluster headaches, they make you wanna cave your head in lots of moving around, you cant stay still even when im sitting down im still rocking back and forth in pain,
I still ask you the question...
Are you sure you got clusters? because you sound like you drink tooo much from all your other posts,
why dont you take a back seat for a bit, untill your more knowledged, or is it your kick to piss off everyone on this site, maybe thats it and im just feeding your buzz, with this reply.
i dont think you advise is any good and i wont be taking any of it.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #14 on: Jan 23rd, 2008, 2:26pm »
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This guy dosnt listen dont feed his buzz i think he;s pretty fuckin sick
there are real people here suffering and your not helping
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #15 on: Jan 23rd, 2008, 2:40pm »
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on Jan 23rd, 2008, 2:09pm, JEG_43MD wrote:

 
Most experts attribute this phenomenon to some sort of autonomic instability and that migh even be the trigger.
 
They are wrong. The nerves and tissue that cause the tearing, nasal problems, etc. is simply caused by the spread of inflamation caused by the headache.  
 
Two Excedrin Migraine, a cup of coffee, or Ibuprofen 800 and the lay in bed in the dark for 20 minutes. That should help.

 
I don't know who you are, or who you think you are, but you are filled with an amazing quantity of shit.
 
Pretty obvious that this is another troll.
 
 
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #16 on: Jan 23rd, 2008, 2:48pm »
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JEG--
 
Why and how did you decide that inflammation rather than autonomic response causes tearing, etc.?  The role of inflammation in CH is still uncertain.  Researchers do seem fairly sure that autonomic response causes the tearing, etc.  Just wondering why you have made this deduction...
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #17 on: Jan 23rd, 2008, 5:36pm »
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  JEG:
 
    Are you an idiot? Or do you just play one on TV?
 smokin
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #18 on: Jan 24th, 2008, 7:37pm »
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on Jan 18th, 2008, 11:10pm, monty wrote:
I had a serious brain injury about 25 years before my first cluster headache.  
 
Have read other studies that people with serious head injuries are more susceptible to depression and schizophrenia later in life - sometimes decades later.

 
Ditto.. I got rear ended on the highway 16 years before my clusters started. I was stopped in a S10 work truck on 169 and 394 when a full size Bronco hit me at 45-50 Mph.
 
My head broke out the back window and topper window also. Then my chin hit the steering wheel and my head broke the windshield. It sent me into 8 more cars.
 
I got a ruptured disk C6-C7 and 17% nerve disability in my arms. I was never knocked out but couldn’t walk very well for a few days.
 
I’ve given up on figuring out why. I sure wish I could get the neurologist to connect the horse to the buggy but I’m sure he only knows how to drive golf carts and BMW’s. laugh
 
Rolo..
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #19 on: Jan 24th, 2008, 8:27pm »
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on Jan 23rd, 2008, 2:48pm, starlight wrote:
JEG--
 
Why and how did you decide that inflammation rather than autonomic response causes tearing, etc.?  The role of inflammation in CH is still uncertain.  Researchers do seem fairly sure that autonomic response causes the tearing, etc.  Just wondering why you have made this deduction...

 
There is an inflammatory process here that is escaping Dx by normal active phase blood markers. (ex. CRP)
 
I deduced that the tearing and nasal problems were due to inflamation based upon what meds make those symptoms stop and that on my body, when I get a CH, my Occipital nerve becomes inflamed and the inflamation travels along the nerve toward my temple as the headache progresses. Kind of like water filling up a fire hose. As the nerve becomes inflamed, what its responsible for may be triggered. Regardless of all this junk...the tearing and the nasal clogging is a side affect of the headache. It has nothing to do with the real cause and the real pain. I read a IHS paper on the hypothesis of this autonomic instability and the resarch into it and I just wanted to scream!!! Focus on the headache..Focus on the headache...not the side effects. But what do I know...
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #20 on: Jan 24th, 2008, 8:51pm »
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on Jan 24th, 2008, 8:27pm, JEG_43MD wrote:
I deduced that...

 
Oh.  That made a nice ending right there.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #21 on: Jan 24th, 2008, 8:57pm »
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on Jan 24th, 2008, 8:27pm, JEG_43MD wrote:

 
There is an .

 
Should have stopped right there
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #22 on: Jan 24th, 2008, 9:02pm »
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Quote:

 
There is an .  
 
 
 
Should have stopped right there  
 
 

 
Should of stoped way before that.
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Re: What triggers the trigeminal-autonomic reflex?
« Reply #23 on: Jan 25th, 2008, 3:10am »
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on Jan 24th, 2008, 8:27pm, JEG_43MD wrote:

 
There is an inflammatory process here that is escaping Dx by normal active phase blood markers. (ex. CRP)
 
I deduced that the tearing and nasal problems were due to inflamation based upon what meds make those symptoms stop and that on my body, when I get a CH, my Occipital nerve becomes inflamed and the inflamation travels along the nerve toward my temple as the headache progresses. Kind of like water filling up a fire hose. As the nerve becomes inflamed, what its responsible for may be triggered. Regardless of all this junk...the tearing and the nasal clogging is a side affect of the headache. It has nothing to do with the real cause and the real pain. I read a IHS paper on the hypothesis of this autonomic instability and the resarch into it and I just wanted to scream!!! Focus on the headache..Focus on the headache...not the side effects. But what do I know...

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Ah! The foreigners put on such airs
Wearing the tangerine suits
And their harlequin eyes.
The pain they inspire
Draws in harmonica melodies
And the feathers of birds
Which flame up at their touch.
It all comes to light in the sheer
Debonair.
(Ellen)
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