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Posted by Ted ( on December 01, 1999 at 02:25:00:

Premonitory Symptoms May Occur in Cluster Headache Patients

WESTPORT, Nov 30 (Reuters Health) - Patients with cluster headache may experience nonpainful, premonitory symptoms several days to several weeks in advance of an attack.

"The recognition of the importance of such symptoms paves the way to the institution of an early prophylactic program and to the possibility of further research geared towards a better understanding of the etiopathogenesis of this primary headache," Dr. Elsa Raimondi, of Universidad Nacional de Rosario, in Argentina, suggests in the September issue of Headache.

Dr. Raimondi describes the premonitory phenomena in four patients with cluster headache.

The first patient reported symptoms characteristic of both central and peripheral dysfunction, including a heightened state of anxiety, "eye discomfort" and a feeling of having "something inside my head." Patient 2 reported eye discomfort, which was aggravated by reading or noise. The third patient experienced paresthesias in the left temple, beginning a week before the headaches; and the last patient reported right hemicranial discomfort.

In the four patients, these symptoms preceded headache onset by several days to 2 weeks, according to the report.

"These cases clearly show that changes occur in the nervous system that anticipate the autonomic and painful manifestations," Dr. Raimondi says in the journal. The cases also leave open the debate about the genesis of cluster headache, indicating that in some patients there may be a central origin and in others a peripheral origin, "...with a common final pathway via in the autonomic-trigeminal reflex."

Headache 1999;39:565-566.

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