Current pain and headache reports
-
Curr Pain Headache Rep · Apr 2006
ReviewChronic widespread pain and psychiatric disorders in veterans of the first Gulf War.
More than 10% of the 700,000 American troops who served during the first Gulf War (GW) are receiving treatment for a constellation of diffuse and frequently poorly defined medical and psychiatric symptoms that have been designated the GW syndrome by both clinicians and the popular media. The current clinical consensus is that the symptoms reported in GW veterans are the sequela of combat and other stressful events that have been identified in the veterans of other wars and armed conflicts. ⋯ Research has confirmed a close bimodal relationship between chronic pain and psychiatric symptoms. Investigators are now exploring the efficacy of treatment approaches that address the close relationship between chronic pain and mental illness in this challenging patient population.
-
Post-traumatic cluster headache (CH) is a very rare occurrence. Only one such case has been verified in the literature thus far. ⋯ Head trauma may damage extra- or intracranial peripheral or central nervous structures, hence predisposing to the future development of CH. However, there also is the possibility that previous head injuries may be more frequent among CH patients because of their lifestyle, which may leave them more exposed to the risk of traumatic events.
-
Although cluster headache (CH) has been the focus of a great deal of research, it also has been the focus of a great deal of speculations that have been repeated commonly as fact. The authors conducted a thorough review of the literature and an informal poll of several noted headache experts to investigate the truth behind common myths and hypotheses regarding CH. They then present an overview of some of these more common hypotheses, observations, and myths, and offer a brief review of the existing evidence supporting or negating the theories. These include gender, genetics, suicidality, homicidality, physical appearance, personality, and psychologic features of the patient with CH.
-
Cluster headache has been defined by the International Headache Society (IHS) as one of the primary headaches. A primary headache is a headache that has no other known cause, such as infection or trauma. ⋯ The IHS has described cluster headache as "attacks of severe, strictly unilateral pain that is orbital, supraorbital, temporal or in any combination of these sites, lasting 15 to 180 minutes." In the author's practice, as a dentist treating orofacial pain, patients with cluster headache have dental or midfacial complaints as a primary presentation. This paper introduces such presentations based on interviews with cluster headache patients, with the main purpose of having midfacial complaints considered as an important presentation to be added to the IHS diagnostic criteria for cluster headache.
-
Serotonin (5-hydroxtryptamine, 5-HT) is an important molecule in pain processing and modulation. Whether 5-HT has an analgesic or hyperalgesic action depends on the cell type and type of receptor it acts on. ⋯ Furthermore, genetic alterations in the 5-HT system may influence the susceptibility to migraine. In the central nervous system, 5-HT is involved in descending inhibition, but facilitatory serotonergic pathways may be functionally more important.