Drug-resistant epicrania fugax: Responding to onabotulinumtoxinA.
Francisco José Alberola-AmoresJorge Moral-RubioPublished in: Headache (2023)
Epicrania fugax (EF) is a primary headache consisting of brief paroxysms of pain, lasting 1-10 s, that move through different nerve territories of one hemicranium with a linear or zigzag trajectory, although there are some clinical variants. Preventive therapy with anti-seizure medication such as gabapentin and lamotrigine are most commonly used in patients presenting with frequent and non-remitting attacks. In some cases, greater occipital nerve blockades are used for short- or long-term relief. Here, we report two patients with a paroxysmal EF-type pain who meet the criteria for EF of the International Classification of Headache Disorders, 3rd edition, with clear triggers and autonomic ocular signs and who failed multiple preventive treatments, but had a sustained response to onabotulinumtoxinA.
Keyphrases
- drug resistant
- neuropathic pain
- chronic pain
- multidrug resistant
- pain management
- acinetobacter baumannii
- multiple sclerosis
- peripheral nerve
- deep learning
- machine learning
- heart rate
- heart rate variability
- emergency department
- stem cells
- copy number
- disease activity
- cystic fibrosis
- pseudomonas aeruginosa
- postoperative pain
- adverse drug