Login / Signup

Chronic Cluster Headache Update and East-West Comparisons: Focusing on Clinical Features, Pathophysiology, and Management.

Chia-Lin TsaiGuan-Yu LinSheng-Kai WuFu-Chi YangShuu-Jiun Wang
Published in: Current pain and headache reports (2020)
Chronic CH in Eastern populations was relatively rare, compared to that in Western populations. Lacrimation and/or conjunctival injection is the most frequently reported cranial autonomic symptom, and visual aura is predominant in chronic CH patients. Neuroimaging evidence in both ethnic groups suggests that CH pathophysiology involves the hypothalamus and pain-modulatory areas, with dynamic alternations between CH episodes. Recent evidence indicates that midbrain dopaminergic systems may participate in CH chronicity. Noteworthy advances have emerged in neuromodulatory therapies for chronic CH, but treatment with calcitonin gene-related peptide (CGRP) monoclonal antibodies has been unsuccessful. Recent evidence shows divergence of chronic CH between Eastern and Western populations. Neuromodulatory therapies but not CGRP inhibition is effective in this intractable patient group.
Keyphrases
  • room temperature
  • chronic pain
  • end stage renal disease
  • newly diagnosed
  • case report
  • drug induced
  • dna methylation
  • pain management
  • prognostic factors
  • copy number
  • ionic liquid
  • spinal cord injury
  • patient reported