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

Three groups of patients were studied: Group A consisted of 12 patients with cluster headache that was treated with lithium carbonate. Group B consisted of six patients with cluster headache that was managed with other drugs. Group C consisted of five patients with muscle contraction headache who received lithium. Serum lithium levels, platelet count, platelet serotonin levels, and platelet-rich plasma histamine levels were determined before and during therapy. The frequency of the headache and levels of serotonin and histamine tended to follow a parallel course in groups A and B: as the headache frequency dropped, serotonin and histamine levels fell. The stable period was characterized by little change in serotonin and histamine levels. Recurrences of headaches were accompanied by a return of serotonin and histamine to pretreatment levels. The course of cluster headache is related to changes in serotonin and histamine levels. Lithium, by modifying the headache course, changes serotonin and histamine levels.
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PMID:Lithium carbonate therapy for cluster headache. Changes in number of platelets, and serotonin and histamine levels. 741 56

Prophylactic use of Lithium salts in patient suffering from cluster headaches has been evaluated looking at the mean number of headache attacks in one critical period and the mean weekly duration of the period itself. These two elements have been compared to those observed on other drugs treatments. Plasma Lithium monitoring has been performed weekly during the trial. Authors discuss the results reported and the hypothetic basis of them.
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PMID:[Lithium therapy in Horton's neuralgia: preliminary results]. 744 25

The majority of cases of central diabetes insipidus are still pathogenetically unclear (idiopathic). Atherosclerotic cholesterol emboli might be partly responsible for some of these idiopathic cases. A 54-year-old woman with known aortic valve stenosis and a history of a transitory ischemic attack presented with sudden-onset polyuria and polydipsia of up to eight l/d, which had started acutely with headaches. She had been treated with lithium for 3 years because of cyclothymic depression. Plasma sodium was in the upper normal range (142-148 mmol/l). Hypertonic saline infusion during lithium therapy revealed a normal threshold of thirst and resetting of vasopressin secretion (osmotic threshold > 300 mosmol/l), whereas vasopressin reserve was normal. Lithium withdrawal led to an even greater delay of vasopressin release upon hypertonic saline infusion (> 310 mosmol/l). Pituitary function tests revealed a normal anterior pituitary function. MR imaging of the hypothalamo-hypophyseal region showed a normal hypothalamic region and a highly intensive neurohypophyseal signal in the T1-weighted image. The patient responded well to desmopressin. We suggest that in this rare case clinical symptoms as well as biochemical findings like impairment of AVP release might be related to a minor structural hypothalamic damage by a vascular lesion, caused, for example, by an atheromatous (cholesterol) embolism in the hypothalamic region responsible for integration of osmoreceptor function and AVP-secretion. The patient's atherosclerosis and aortic stenosis might be responsible for this event.
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PMID:Atherosclerosis, aortic stenosis and sudden onset central diabetes insipidus. 928 11

Lithium is widely used in the prophylaxis of episodic cluster headache without formal evidence of efficacy. Placebo-controlled clinical trials are not easy in conditions characterized by frequent severe pain. In this study, it was assumed that lithium would work quickly if at all, and placebo response would be zero. Strict diagnostic criteria excluded uncertain or atypical cases. Patients were male in so-far untreated episodes expected to last for at least 3 weeks more. In a double-blind, placebo-controlled comparison of matched parallel groups, treatment was either slow-release lithium carbonate, 800 mg/day, or placebo. After 7 days, compliance was estimated by tablet count, blood was taken for lithium assay, efficacy was assessed (attacks stopped or substantially improved) and adverse reactions were recorded. The study was stopped after planned sequential analysis of the 27th patient (13 on lithium, 14 on placebo). Estimated compliance was usually but not always good. Plasma lithium levels were mostly in the range 0.5-0.6 mmol/l on lithium, zero on placebo. Cessation of attacks within 1 week occurred in two patients in each group, substantial improvement in 6/14 (43%) on placebo, 8/13 (62%; NS) on lithium. Only minor adverse events were reported. Lithium treatment was therefore associated with a useful subjective improvement rate but the assumptions made at outset had proved wrong. The trial was stopped because superiority over placebo could not be demonstrated. There were lessons for future trials.
Cephalalgia 1997 Oct
PMID:Double-blind placebo-controlled trial of lithium in episodic cluster headache. 960 14

Patients with cluster headache are often treated with lithium. However, there are some patients who can not be fully treated with lithium alone. Two patients with cluster headache were treated with clonazepam, one of the most potent benzodiazepines. Lithium prolonged the period of remission, and the addition of clonazepam further prolonged it in case 1. Treatment with clonazepam reduced the symptoms in case 2, and when combined with lithium, the disorder went into remission after 6 months. These findings suggest that the combination of lithium and clonazepam may be effective in patients with cluster headache.
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PMID:Lithium and clonazepam treatment of two cases with cluster headache. 1049 39

Hypnic headache syndrome is a benign, recurrent, late-onset headache disorder that occurs exclusively during sleep. Lithium has been reported to be an effective treatment, but the side effects of this medication are sometimes prohibitive, particularly in the elderly. Other drugs have been reported to be effective in this disorder, including caffeine, flunarizine, and verapamil. Recently, indomethacin has been reported to effectively suppress hypnic headaches. We report the response of seven patients with hypnic headache who were treated with indomethacin. Hypnic headache syndrome appears to represent yet another headache disorder in which there is sometimes an impressive response to indomethacin.
Headache
PMID:Hypnic headache: another indomethacin-responsive headache syndrome? 1113 28

Management of cluster headache has greatly changed in recent years although most of the drugs used have not received approval for this indications. Subcutaneous injections of sumatriptan has been found to be remarkable effective for acute episodes. This drug continues to exhibit efficacy for long periods of use up to several months and has no serious adverse effects if used according to recommendations. Nasal administration of oxygen (not approved for this indication in France) continues to be an adjuvant treatment for patients with a contraindication for sumatriptan or for those with more than two acute episodes per day. Other treatments are under debate. Prophylactic first intention verapamil (not approved in France for this indication) could be useful. Lithium (not approved in France for this indication) could also be helpful, particularly for certain clinical forms. Other options are discussed.
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PMID:[Treatment of cluster headache]. 1113 56

Hypnic headache has been described in several case reports since 1981 and is regarded as an idiopathic headache disorder. In this review of 71 cases in the literature, the clinical features, neurophysiologic including polysomnographic findings, and treatment procedures are analyzed and the pathophysiology of this condition, which remains however speculative, is discussed. There is some evidence that hypnic headache is related to REM sleep. The analysis shows that hypnic headache most probably is an entity among the idiopathic headache disorders unassociated with structural lesions and does not belong to the trigeminal-autonomic cephalalgias. Lithium shows the best efficacy; indomethacin, flunarizine, and caffeine may also be useful.
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PMID:Hypnic headache: clinical features, pathophysiology, and treatment. 1265 50

Patients must be cognizant of the time course of the cluster headache periods to optimally tailor their therapy. Steroids provide the fastest onset of prophylactic effect. Once steroids are initiated, it remains difficult to wean patients off of them, and that is why it is always recommended to associate another prophylactic agent from the onset with the steroids. All triptans can be considered; however, only injectable sumatriptan and zolmitriptan have been the subject of controlled studies, and the former remains the gold standard because of its speed of action. Lithium, although not a first-line therapy, remains mainly efficacious for the chronic form of cluster headache. There does not seem a significant tendency for analgesic rebound-withdrawal headache with cluster headache compared with migraine. Scientific studies of the treatment of cluster headache are inherently difficult because of the rarity of the syndrome, the short duration of attacks, and the relatively short duration of the cluster period, along with the presence of spontaneous remissions. Moreover, still a significant proportion of the available evidence on this subject is uncontrolled. Active, rather than placebo, control individuals are recommended. As far as surgical procedures are concerned, although only recently introduced and less documented, gamma-knife radiosurgery should be preferred to the procedures associated with craniotomy, which are inherently associated with a higher complication potential risk.
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PMID:Cluster Headache and Cluster Variants. 1451 23

We report on a case of nocturnal headache attacks fulfilling the criteria for hypnic headache syndrome. Using an overnight polysomnography, one nocturnal headache attack was captured during the REM phase of sleep. Quality of sleep was poor with desaturation episodes. However, the hypnic headache attack was not associated with oxygen desaturation. This additional case supports the view of a relationship between the hypnic headache syndrome and the REM sleep stage. Lithium therapy decreased the intensity and frequency of headache attacks.
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PMID:Hypnic headache: a case report with polysomnography. 1514 61


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