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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After analysing personal results and the data in the literature concerning the therapeutic effects of Lithium salts in cluster headache, the Authors discuss some of the pathogenetic problems related to this particular form of idiopathic headache. The results obtained seem very favourable however the therapeutic efficiency of Lithium salts, also observed in neuralgic-vasomotor syndromes (Charlin, Sluder) and in some forms of chronic headache, seems to indicate a relatively unspecific mechanism of action. The Authors suggest therefore an intervention in the stabilization of the membrane at the CNS level, with increasing efficiency of "antinociceptive" system.
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PMID:[Lithium salts in the treatment of cluster headache]. 37 52

A study of 46 patients has shown that Clonazepam is an effective drug in preventing attacks of pain in essential trigeminal and glossopharyngeal neuralgia and in Sluder's syndrome. The therapeutic action of the drug is less evident in different types of migraine, among which only the combined headache presents good results to the treatment. The effective dose of this drug is generally not greater than 3 mg/die and does not give rise to side effects in long-term prescription.
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PMID:[Clonazepam in painful syndromes of the head]. 45 5

Upper and lower limb pain associated to attacks of migraine or cluster headache has been mentioned by many authors since the early descriptions of Liveing, Gowers and Jeliffe. The symptom was also described by Sluder as part of the syndrome of "sphenopalatine ganglion neuralgia." Several authors in the 1920's and 1930's including Cushing and Harris reported cases currently classifiable as migraine or cluster headache with limb pain, but did not accept the mechanisms for pain proposed by Sluder. The scarcity of more recent reports suggests that many patients with migrainous limb pain may be assumed to have other causes for this pain.
Headache 1990 Feb
PMID:Migrainous limb pain. A historical note. 218 68

According to new findings, Sluder's neuralgia, cluster headache and sympathetic neuralgia in the face are likely to be of vascular origin from the branches of the external carotid artery. These vessels receive multiple innervation: sympathetic (constricting), parasympathetic (vasodilator) and through C-fibre liberating substance P. In addition enkephalins, known to act as antagonists to substance P, have been found in the vessels of the external and the internal carotid artery. The equilibrium between sympathetic and parasympathetic fibres, between C-fibres and local enkephalins may be disturbed by various mechanisms. An excess of the sympathetic or parasympathetic activity may not only cause changes of vascular tone but also induce the liberation of substance P. In general, the atypical facial neuralgias are self-limiting or may present with an intermittent course. In chronic and drug-resistant cases surgical interventions can be helpful. The trigeminal nerve is the first target, as all C-fibres from the head, including the vessels, reach the trigeminal nerve. Of less importance for surgical intervention is the pterygopalatine ganglion, which is not only parasympathetic, but contains also sympathetic and C-fibres from the mucosa of nose and orbit.
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PMID:[So-called atypical facial neuralgias]. 247 89

This disorder has failed to achieve the status of general recognition among the cephalic neuralgias. Whether its orphanage derives from narrow-minded expulsion from the neurological domain of cephalic neuralgias to the ENT-field, or can be attributed to its rarity (though this did not keep glossopharyngeal neuralgia from rightfully assuming its place among equals), or to the hazy outlines of the disorder, remains a question more readily posed than answered. Yet, if it shares with Sluder's sphenopalatine neuralgia an uncertain clinical identity, there are a sufficient number of observable clinical data from which to conclude the reality of this neuralgia. A review of pertinent reports should enable the reader to make up his own mind.
Cephalalgia 1983 Dec
PMID:Superior laryngeal neuralgia. 664 Jun 57

In 1908 Sluder described a symptom complex consisting of neuralgic, motor, sensory and gustatory manifestations that he attributed to the sphenopalatine ganglion. He stated that treatment directed at the ganglion successfully alleviated these symptoms. Over the last 90 years several reports have described patients as having sphenopalatine neuralgia and have directed treatment at the ganglion. The symptoms described and the criteria for patient selection in these studies has often been varied and deviated from Sluder's description. In reports claiming cures with treatment directed at the ganglion the duration of post-treatment follow-up has been short. This article discusses Sluder's description and attempts to analyse its features in the light of current understanding of the different mechanisms and categories of facial pain. It is proposed that the condition described by Sluder is a neurovascular headache that most closely resembles cluster headache in its aetiology and clinical manifestations. We propose that the term Sluder's neuralgia should be discarded as there are serious flaws in its original description and many authors have misused the term leading to persistent confusion about it.
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PMID:What is Sluder's neuralgia? 1281 50

The objective was to formulate distinctive criteria to substantiate our opinion that Sluder's neuralgia and cluster headache are two different clinical entities. A systematic review was carried out of all available, original literature on Sluder's neuralgia. Pain characteristics, periodicity and associated signs and symptoms were studied and listed according to frequency of appearance. Eleven articles on Sluder's neuralgia were evaluated. Several differences between Sluder's neuralgia and cluster headache became evident. Based on described symptoms, new criteria for Sluder's neuralgia could be formulated. Sluder's neuralgia and cluster headache could possibly be regarded as two different headache syndromes, and Sluder's neuralgia could be a trigeminal autonomic cephalalgia.
Cephalalgia 2010 Mar
PMID:Sluder's neuralgia: a trigeminal autonomic cephalalgia? 1961 98

In 1988, diagnostic criteria for headaches were drawn up by the International Headache Society (IHS) and is divided into headaches, cranial neuralgias and facial pain. The 2(nd) edition of the International Classification of Headache Disorders (ICHD) was produced in 2004, and still provides a dynamic and useful instrument for clinical practice. We have examined the current IHC, which comprises 14 groups. The first four cover primary headaches, with "benign paroxysmal vertigo of childhood" being the forms of migraine of interest to otolaryngologists; groups 5 to 12 classify "secondary headaches"; group 11 is formed of "headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures"; group 13, consisting of "cranial neuralgias and central causes of facial pain" is also of relevance to otolaryngology. Neither the current classification system nor the original one has a satisfactory collocation for migraineassociated vertigo. Another critical point of the classification concerns cranio-facial pain syndromes such as Sluder's neuralgia, previously included in the 1988 classification among cluster headaches, and now included in the section on "cranial neuralgias and central causes of facial pain", even though Sluder's neuralgia has not been adequately validated. As we have highlighted in our studies, there are considerable similarities between Sluder's syndrome and cluster headaches. The main features distinguishing the two are the trend to cluster over time, found only in cluster headaches, and the distribution of pain, with greater nasal manifestations in the case of Sluder's syndrome. We believe that it is better and clearer, particularly on the basis of our clinical experience and published studies, to include this nosological entity, which is clearly distinct from an otolaryngological point of view, as a variant of cluster headache. We agree with experts in the field of headaches, such as Olesen and Nappi who contributed to previous classifications, on the need for a revised classification, particularly with regards to secondary headaches. According to the current Committee on headaches, the updated version of the classification, presently under study, is due to be published soon; it is our hope that this revised version will take into account some of the above considerations.
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PMID:Headaches of otolaryngological interest: current status while awaiting revision of classification. Practical considerations and expectations. 2276 67

The interest for the sphenopalatine ganglion (SPG) in neurovascular headaches dates back to 1908 when Sluder presented his work on the role of the SPG in 'nasal headaches', which are now part of the trigeminal autonomic cephalalgias and cluster headache (ICHD-III-beta). Since then various interventions with blocking or lesional properties have targeted the SPG (transnasal injection of lidocaine and other agents, alcohol or steroid injections, radiofrequency lesions, or even ganglionectomy); success rates vary, but benefit is usually transient. Here we briefly review some anatomophysiological characteristics of the SPG and hypotheses about its pathophysiological role in neurovascular headaches before describing recent therapeutic results obtained with electrical stimulation of the SPG. Based on results of a prospective randomized controlled study, SPG stimulation appears to be an effective treatment option for patients with chronic cluster headaches; efficacy data indicate that acute electrical stimulation of the SPG provides significant attack pain relief and in many cases pain freedom compared to sham stimulation. Moreover, in some patients SPG stimulation has been associated with a significant and clinically meaningful reduction in cluster headache attack frequency; this preventive effect of SPG stimulation warrants further investigation. For migraine attacks, the outcome of a proof-of-concept study using a temporary electrode implanted in the pterygopalatine fossa was less encouraging; however, an ongoing multicenter trial is evaluating the efficacy of long-term SPG stimulation against sham stimulation for acute and preventive treatment in patients with frequent migraine.
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PMID:Sphenopalatine Ganglion Stimulation in Neurovascular Headaches. 2639 72

The sphenopalatine ganglion (SPG) has been assumed to be involved in the genesis of several types of facial pain, including Sluder's neuralgia, trigeminal neuralgia, persistent idiopathic facial pain, cluster headache, and atypical facial pain. The gold standard treatments for SPG-related pain are percutaneous procedures performed with the aid of fluoroscopy or CT. In this technical note the authors present, for the first time, an SPG approach using the aid of a neuronavigator.
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PMID:Neuronavigated percutaneous approach to the sphenopalatine ganglion. 2710 40


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