Arquivos de neuro-psiquiatria
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We report the cases of two women who presented a clinical condition compatible with the SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing) syndrome. Both presented normal clinical and neurological examination and MRI compatible with microangiopathy. The first one related headache attacks for three years, occurring several times a day when she masticated or yawned. ⋯ The second one related she had daily headaches for six months that occurred from 20 to 40 times per day. At the first visit to the ambulatory, she related she was using carbamazepine (600 mg per day) and chlorpromazine (15 mg per day) having a partial response. Administration of gabapentin (1200 mg per day) led to complete resolution of the pain attacks, but the patient continue to have episodes of conjunctival injection.
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Epilepsy is the most common neurological disorder and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. The cause of SUDEP is still unknown, however, the most commonly suggested mechanisms are cardiac abnormalities. Based on this, in this review the relationship between SUDEP and cardiac abnormalities has been emphasized.
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Case Reports
Oligosymptomatic and giant basilar artery dolichoectasia discovered after a stroke: case report.
The most frequently diagnosed complication of vertebrobasilar dolichoectasia (VBD) is the compression of structures adjacent to the vertebral and basilar arteries. A giant VBD with only slight compressive symptoms is unusual. In this setting, the diagnosis of VBD may be casually revealed after the occurrence of a posterior circulation stroke, another potential complication. ⋯ Diagnosis was made only after the occurrence of a stroke. Despite of the good functional recovery after stroke, the presence of significant atherosclerotic changes and the large BA diameter may indicate a poor outcome. However, after one year, she remains oligosymptomatic.
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To evaluate a sample of patients with atypical facial pain (AFP) in comparison to patients with symptomatic facial pain (SFP). ⋯ AFP patients had more: a) traumatic events previously to pain onset, and b) emotions as a triggering factor for pain. These data support the need of trained health professionals in multidisciplinary groups for the accurate diagnosis and treatment of these patients.
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Case Reports
Cluster headache attacks in a woman previously struck by lightning: pathophysiology of the latent period.
Cases of patients who developed cluster headache-like symptoms after different putative causes have been reported, indicating a direct relationship between brain lesion and this particular type of headache. Long term, delayed, neurological sequelae after lightning have also been described. ⋯ We hypothesize that a relationship between the lightning and the cluster headache-like episodes observed in our patient. This case study may have helped throw some light into the still unknown pathophysiology of this particular type of primary headache.