Cluster-tic Syndrome Research Articles

PO219 / #740 SINGLE CASE OF INTRACTABLE CLUSTER-TIC SYNDROME TREATED BY MICROVASCULAR DECOMPRESSION AND SPHENOPALATINE GANGLION STIMULATION: E-POSTER VIEWING

some conditions may not be noticed immediately, may mimic other pathologies and surgical treatment may be limited. Here, we present a rare case of successful treatment of a patient with a combination of chronic refractory cluster headache and trigeminal neuralgia (cluster-tic syndrome).

The Pediatric Trochlear Migraine: Diagnostic and Therapeutic Implications.

Trochlear Migraine has been recently described as the concurrence of strictly unilateral migraine and ipsilateral trochleodynia with relief of migraine after successful treatment of trochleodynia. This disorder has been interpreted as “cluster-tic syndrome” or “seizure-triggered migraine”. Trochlear Migraine is unrecognized and rarely described in childhood. The aim of this study is to review the few cases of Trochlear Migraine reported in the literature in addition to the cases observed in our clinical experience. In particular, our cases showed recurrent attacks of severe and pulsating headache associated with nausea, vomiting, phonophobia, photophobia, and strict trochlear localization of pain. They often presented with alternating side attacks. Therefore, we suggest that the term “Trochlear Migraine” should be reserved for clinical migraine attacks strictly localized in the trochlear region, and we assume that the excessive increase in descriptions of new primary headache syndromes, according to the International Classification of Headache Disorders, can be probably be ascribed to the common physiopathological mechanisms characterizing these forms of migraine.

Symptomatic cluster-tic syndrome due to a meningioma

The combination of TAC headaches with trigeminal neuralgia (tic-doloroux) is a rare occurrence. Several cases have been reported, including from Sri Lanka. Some were symptomatic TAC-tics, whilst a definite cause was not identified in others.

Refractory cluster-tic syndrome: The Hickam’s dictum

A 50-year-old man debuted with right trigeminal neuralgia. In the following years, it became refractory to medical treatment and ipsilateral cluster headache appeared. He was diagnosed with cluster-tic syndrome. A brain magnetic resonance with high-spatialresolution 3D T2 sequences (FIESTA) excluded the existence of neurovascular conflict, but a surgical exploration was indicated due to its torpid evolution. A venous contact with the right trigeminal nerve was confirmed in the surgery and microvascular decompression was performed. The patient’s evolution was favorable, improving the trigeminal neuralgia as well as the cluster headache.

Cluster-Tic or Tic-Cluster? Trigeminal Neuralgia (Tic) Turning to Trigeminal Autonomic Cephalalgia (TAC) Following Venous Decompression of the Trigeminal Nerve: A Case Report and Review of the Literature

Abstract Objective: We present a rare case of Tic-cluster in the context of venous compression of the trigeminal nerve. Background: Cluster-Tic syndrome is a rare headache condition with features of both trigeminal neuralgia (Tic) and trigeminal autonomic cephalalgia symptom (TAC). Methods: Case report and review of literature. Results: A 75-year old man presents with left sided paroxysmal pain consistent with trigeminal neuralgia (Tic). Magnetic resonance demonstrated a venous compression of the posterior-medial aspect of the left trigeminal ganglion. He underwent microvascular decompression which confirmed petrosal vein compression with subsequent symptomatic resolution. After two years of remission, he had a new left unilateral throbbing headache consistent with International Classification of Headache Disorders (ICHD)- 3 cluster headache definition, which improved with steroids. Conclusion: Cluster-Tic syndrome has variable clinical presentations. Tic can precede cluster and the possible role of venous trigeminal compression in this headache remains unclear.

Cluster-tic syndrome: case report and literature review

Case Report

Tics in TACs: A Step into an Avalanche? Systematic Literature Review and Conclusions.

Trigeminal autonomic cephalalgias (TACs) comprise cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua. In some cases, trigeminal neuralgia (TN, "tic douloureux") or TN-like pain may co-occur with TACs. This article will review the co-occurrence and overlap of TACs and tics in order to contribute to a better understanding of the issue and an improved management of the patients. For performing a systematic literature review Pubmed was searched using a total of ten terms. The articles identified were screened for further articles of relevance. TACs are related to tics in various ways. TN or TN-like paroxysms may co-occur with CH, PH, and HC, labeled as cluster-tic syndrome, PH-tic syndrome, and HC-tic syndrome. Such co-occurrence was not only found in the primary TACs but also in secondary headaches resembling TACs. The initial onset of TAC and tic may be simultaneous or separated by months or years. In acute attacks, tic and TAC may occur concurrently or much more often independently of each other. The term "cluster-tic syndrome" was also used in patients with a single type of pain in a twilight zone between TACs and TN fulfilling none of the relevant diagnostic criteria. Short-lasting neuralgiform headache attacks overlap with TN in terms of clinical features, imaging findings, and therapy.

A cluster-tic syndrome: a case report

A cluster-tic syndrome: a case report

Cluster‐Tic Syndrome: A Cross‐Sectional Study of Cluster Headache Patients

To determine the prevalence and nature of trigeminal neuralgia in a large group of cluster headache patients. Cluster-tic syndrome is a rare headache syndrome in which trigeminal neuralgia and cluster headache co-occur. The existence of cluster-tic syndrome as a separate entity is questioned, and figures on prevalence of simultaneous existence of cluster headache and trigeminal neuralgia are not available. As part of a nationwide study on headache mechanisms in cluster headache (Leiden University Medical Centre Cluster headache Neuro Analysis programme), we collected clinical data of 244 cluster headache patients using a semistructured telephone interview in a cross-sectional design. In 11 (4.5%) cluster headache patients, attacks fulfilling International Headache Society criteria for trigeminal neuralgia were also present. In all cases, trigeminal neuralgia occurred ipsilateral to cluster headache and in the majority (82%) in the ophthalmic branch. In 8 of these 11 patients (73%), the frequency and time pattern of trigeminal neuralgia seemed to parallel cluster headache and was likely a part of the cluster headache spectrum. In the 3 remaining patients, cluster headache and trigeminal neuralgia were unrelated in time and appeared to occur independently. Trigeminal neuralgia co-occurred in 11/244 (4.5%) of cluster headache patients. In only 3 (1.2%) patients, trigeminal neuralgia seemed to occur independently from cluster headache episodes. Trigeminal neuralgia (-like) attacks in cluster headache patients are most of the time part of the cluster headache spectrum and should then probably not be treated separately. A shared underlying pathophysiological mechanism of cluster headache and trigeminal neuralgia is not supported by this study.

Cluster-tic syndrome as the initial manifestation of multiple sclerosis

We report the case of a patient diagnosed as having cluster-tic syndrome as the initial manifestation of multiple sclerosis (MS). The patient’s headache bouts improved after treatment with antiepileptic drugs, steroids, and beta-interferon. Magnetic resonance imaging (MRI) scans showed a pontine demyelinating lesion involving the area of the trigeminal root inlet and main sensory nucleus. Neurophysiological studies correlated well with MRI lesions. The association between cluster-tic syndrome and MS is an exception, and the mechanism of the pain is still unknown; therefore, this case might suggest a pathophysiological relationship between the trigeminal main sensory nucleus and cluster-tic syndrome.

Predilection to deafferentation pain syndrome after radiosurgery in cluster headache

Cluster-tic syndrome is a rare, disabling disorder. We report the first case of cluster-tic syndrome with a successful response to stereotactic radiosurgery. After failing optimal medical treatment, a 58-year-old woman suffering from cluster-tic syndrome was treated with gamma knife radiosurgery. The trigeminal nerve and sphenopalatine ganglion were targeted with a maximum dose of 85 and 90 Gy respectively. The patient experienced a complete resolution of the initial pain, but developed, as previously described after radiosurgical treatment for cluster headache, a trigeminal nerve dysfunction. This suggests that trigeminal nerve sensitivity to radiosurgery can be extremely different depending on the underlying pathological condition, and that there is an abnormal sensitivity of the trigeminal nerve in cluster headache patients. We do not recommend trigeminal nerve radiosurgery for treatment of cluster headache.

Cluster–tic Syndrome Resolved by Removal of Pituitary Adenoma: The First Case

Cluster–tic Syndrome Resolved by Removal of Pituitary Adenoma: The First Case

Use of streptomycin-lidocaine injections in the treatment of the cluster-tic syndrome: Clinical perspectives and a case report

Trigeminal neuralgia and cluster headache syndrome are complex pain conditions of the craniofacial region. Both diseases can coexist in the same patient, comprising the cluster-tic syndrome. This article reviews the literature on this condition and reports a new case who responded well to peripheral streptomycin-lidocaine injections.

Cluster tic syndrome

Cluster tic syndrome (CTS) is a disorder characterized by three types of pain attacks. One resembles trigeminal neuralgia, the second resembles cluster headache, and the third is mixed, starting as a neuralgic pain immediately followed by a homolateral headache accompanied by autonomic signs. This type of attack is pathognomonic for CTS. The three pain types can all be provoked. CTS appears between ages 20 and 70 and may be either episodic or chronic; medical treatment is poor.

Relief of Cluster-Tic Syndrome by the Combination of Lithium and Carbamazepine

This paper presents a further case of cluster-tic syndrome. Cluster headache and trigeminal neuralgia have coexisted in our patient for 18 years. Carbamazepine has selectively relieved the tic douloureux, while lithium has completely controlled the cluster headache. Our case shows again that the simultaneous occurrence of cluster headache and trigeminal neuralgia seems to be more than coincidental.