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Question : Trigeminal or Occipital ? (Read 1019 times)
Joshua
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Question : Trigeminal or Occipital ?
Sep 14th, 2009 at 10:46am
 
Which nerve is cluster headache specific?  Is it one of them, both of them?  Is it the hypothalamus? 

Just looking for some better knowledge here.  A lot of the articles online conflict between histamine headache theory and other theories. 

Thanks,
Joshua
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Bob Johnson
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Re: Question : Trigeminal or Occipital ?
Reply #1 - Sep 14th, 2009 at 11:29am
 
Suggest you start with this aritcle. Coherent, organized, presents currenting thinking.
=======

Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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Joshua
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Re: Question : Trigeminal or Occipital ?
Reply #2 - Sep 14th, 2009 at 11:35am
 
Thanks Bob.
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MattyAA
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Re: Question : Trigeminal or Occipital ?
Reply #3 - Sep 14th, 2009 at 1:47pm
 
It is quite tricky because I think all nerves are somehow connected through the skull, pain behind eyes and temple would mean it is trigeminal nerve, but then Occipital Nerve Stimulation affects the headaches too, meaning it has connection not only through brain with other peripherial nerves I think?
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MJ
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Re: Question : Trigeminal or Occipital ?
Reply #4 - Sep 15th, 2009 at 1:27am
 
trigeminal is the primary nerve
occipital is affected secondary in some

hypothalamus is thought to be involved.
Its not certain wether this is reactionary or causative.
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MJ
 
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