Abstract:
INTRODUCTION:Tolosa-Hunt syndrome (THS), a condition characterized by painful ophthalmoplegia and accompanied by cranial nerve palsies, remains as a diagnosis of exclusion. Nevertheless, the 3rd Edition of the International Classification of Headache Disorders (ICHD) has refined its diagnostic criteria to require the demonstration of granulomatous inflammation on magnetic resonance imaging or biopsy. We sought to assess the effectiveness of the new criteria in arriving at accurate diagnoses. METHODS:We extracted all patient charts from our institution's electronic medical record associated with ICD-9 code 378.55 (external ophthalmoplegia). We then completed the retrospective diagnostic workups to determine if subjects met ICHD-3 criteria for THS and compared our findings with their final diagnoses. RESULTS:Of 62 patients associated with ICD-9 code 378.55, 10 (16%) was identified to have presenting symptoms concerning THS. The average age at the first onset of THS-like symptoms was 58 years. Five of the 10 (50%) met ICHD-3 criteria for THS. Two of the 5 (40%) meeting ICHD-3 criteria for THS were discovered to have other diagnoses. Two of the 5 (40%) patients not meeting ICHD-3 criteria for THS nevertheless received a final diagnosis of THS. DISCUSSION:Our false-negative rate of 40% is consistent with previous case series found in the literature. Our false-positive rate of 40% is, to our knowledge, a new contribution to the literature as no other case series includes more than a single false-positive. The false-positive rate is most concerning, as a preliminary misdiagnosis of THS can delay treatment tailored to the true etiology. Furthermore, infectious etiologies can be exacerbated with steroid treatment. CONCLUSION:Our case series suggests that ICHD-3 criteria are suboptimal for the accurate diagnosis of THS. We recommend a close follow-up for all patients with symptoms concerning THS until a definitive responsible etiology is discovered and we encourage further studies assessing ICHD-3 guidelines to optimize their sensitivity and specificity in the diagnosis of THS.
journal_name
Headachejournal_title
Headacheauthors
Mullen E,Rutland JW,Green MW,Bederson J,Shrivastava Rdoi
10.1111/head.13692subject
Has Abstractpub_date
2020-01-01 00:00:00pages
259-264issue
1eissn
0017-8748issn
1526-4610journal_volume
60pub_type
杂志文章相关文献
HEADACHE文献大全abstract::The ideal migraine medication would provide rapid “one and done” treatment of migraine for all sufferers. Unfortunately, no such intervention is available. While most people respond to triptans or DHE, some will need to combine these with an NSAID, or will choose to use an NSAID alone because of personal preference or...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12474
更新日期:2014-11-01 00:00:00
abstract::Objective - To briefly describe the history of and available data on anti-calcitonin gene-related peptide (CGRP) therapies for headache. Background - CGRP was proposed as a target for primary headache therapies. Translational research involved moving from delineating the relationships between CGRP and primary headache...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.13379
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the impact on costs and outcomes of early migraine treatment with sumatriptan while pain is mild versus sumatriptan treatment of moderate to severe pain. BACKGROUND:Migraines result in substantial pain, impairment, and costs. Recent clinical studies have shown that early treatment with sumatripta...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2002.02228.x
更新日期:2002-11-01 00:00:00
abstract::In a questionnaire survey we determined the prevalence of problems with reading, at present as well as in the past, in adult chronic headache sufferers as compared with age- and sex-matched controls. The reading problems inquired about were those with reading in general, reading quickly, prolonged reading and reading ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1991.hed3104244.x
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVES:The primary objective of the proposed systematic review is to determine if there is an association between internalizing disorders and symptoms (ie, subclinical symptoms) and migraine in children and adolescents. METHODS:We will perform a peer-reviewed Peer Review of Electronic Search Strategies search of M...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13778
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To determine the pain intensity of cluster headache through a large survey by comparing it to other painful disorders. Furthermore, to investigate the relationship between maximal pain, autonomic, and other clinical symptoms, as well as demographic attributes of cluster headache. BACKGROUND:The pain of clust...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.14021
更新日期:2020-12-18 00:00:00
abstract::Epidemiologic studies provide estimates of the scope and distribution of the public health problems posed by migraine. These studies have been facilitated by the development of the International Headache Society criteria for migraine, which have now been used in separate prevalence studies in several countries. In thi...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/j.1526-4610.1994.hed3406319.x
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:To determine the association between the severity of premenstrual (PMS) symptoms and headache outcome measures during natural menstrual cycles and after medical oophorectomy. BACKGROUND:Premenstrual syndrome may occur in 64% of those with pure menstrual migraine and 33% of those with menstrually related mig...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1526-4610.2006.00306.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To determine (1) the clinical course of a sample of chronic migraine patients with drug overuse 6 and 12 months following in-patient treatment and (2) whether functional impairment, assessed by the Migraine Disability Assessment (MIDAS) questionnaire, improved upon treatment. BACKGROUND:Patients with chronic...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2004.04127.x
更新日期:2004-07-01 00:00:00
abstract::The symptoms of migraine are non-specific and can be present in many other primary and secondary headache disorders, which are reviewed. Even experienced headache specialists may be challenged at times when diagnosing what appears to be first or worst, new type, migraine status, and chronic migraine. ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12518
更新日期:2015-02-01 00:00:00
abstract::A considerable proportion of headache patients fulfill the criteria of "drug abuse" (definition according to the International Headache Society [IHS] criteria). These patients exhibit markedly reduced vigilance and continuous performance, as shown by the results of critical flicker frequency (CFF) analysis. The presen...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1995.hed3505269.x
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVE:This post hoc study investigated the relationship between patient response in terms of migraine headache day reduction and patient-reported outcomes of health-related quality of life (HRQoL) and disability categories. BACKGROUND:Migraine causes considerable disease-related disability and negatively impacts H...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.14013
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the long-term tolerability of telcagepant for acute treatment of intermittent migraine attacks. Background.- Telcagepant is a calcitonin gene-related peptide (CGRP) receptor antagonist being investigated for the acute treatment of migraine. METHODS:Migraine patients were randomized 2:1 to double-...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1526-4610.2010.01799.x
更新日期:2011-01-01 00:00:00
abstract::A 25-year-old female patient developed headache and papilledema under sulphasalazine treatment for ulcerative colitis. The patient met the International Headache Society's criteria for idiopathic intracranial hypertension. Sulphasalazine was discontinued and the patient was given azathioprine for ulcerative colitis an...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.00992.x
更新日期:2008-02-01 00:00:00
abstract::We report the case of a 73-year-old woman who presented with right VI nerve palsy and homolateral atypical trigeminal neuralgia; standard neuroradiological investigation of orbital/retroorbital regions and intracranial arteries excluded the most commonly demonstrable underlying causes while brain magnetic resonance (T...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2008.01258.x
更新日期:2009-03-01 00:00:00
abstract::Seven SUNCT patients (six men, one woman) took part in this study. In four patients, respiratory variables were compared during and outside attacks. In five patients, peripheral chemosensitivity was tested and compared with a control group matched with respect to age, sex, and smoking habits. The results indicate that...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1995.hed3506344.x
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND:Previous observational studies reported an increased prevalence of asthma in migraine patients. Whether triptans affect the asthma risk has not yet been explored in an epidemiological study. OBJECTIVE:To estimate the risk of newly diagnosed asthma in patients with a general practitioner-diagnosed migraine i...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.01030.x
更新日期:2008-04-01 00:00:00
abstract::Imaging studies of spontaneous migraine aura have proved challenging because of the episodic and unpredictable nature of migraine attacks. Two patients with signs of acute ischemic stroke were evaluated for thrombolysis and turned out to suffer from familial hemiplegic migraine. It was possible to record the early pha...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2011.01963.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Neuromodulators such as topiramate (TPM) and divalproex sodium (DVS) are effective in the preventive treatment of migraine. Nonetheless, patients often discontinue their use due to side effects. OBJECTIVES:The study aims to determine whether the combination of lower doses of TPM and DVS may be useful for pa...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2011.02035.x
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To assess the measurement properties of the Migraine-Specific Quality of Life Questionnaire version 2.1 (MSQv2.1) electronic patient-reported outcome (ePRO) Role Function-Restrictive (RFR) domain to evaluate the functional impact of migraine in patients with episodic (EM) or chronic migraine (CM) enrolled in...
journal_title:Headache
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/head.13497
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:To discuss the results of a multicenter randomized controlled trial of the efficacy of verum acupuncture in treating acute migraine attacks. BACKGROUND:Acupuncture has been used in China for centuries to treat migraine headache. Convincing evidence of its efficacy in alleviating pain, however, has been inade...
journal_title:Headache
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1526-4610.2009.01424.x
更新日期:2009-06-01 00:00:00
abstract::The aim of the present study was to examine the ability of pericranial muscle tenderness and the second exteroceptive suppression period to distinguish chronic tension-type headache sufferers, migraine sufferers, and controls in a young adult population utilizing a blind design. The second exteroceptive suppression pe...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.1997.3706368.x
更新日期:1997-06-01 00:00:00
abstract:PREMISE:Trigeminal neuralgia is a severe facial pain disorder that has been studied for decades. Classical trigeminal neuralgia (CTN) is either idiopathic or caused by neurovascular compression. The related painful trigeminal neuropathies are often secondary to other causes, such as multiple sclerosis or trauma. PROBL...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.13166
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The present study endeavored to identify predictors of headache during pregnancy, shortly after delivery, and at 8-week follow-up. BACKGROUND:Many women suffer from headaches during pregnancy and the post-partum period. However, little is known about factors that predict headache surrounding childbirth. MET...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2011.02066.x
更新日期:2012-03-01 00:00:00
abstract::Over the past few years, sports-related concussion has received significant media attention making it one of the most, if not highest profile neurological disorder. Thirty-one states now have passed sports concussion laws, with 14 states pending legislation. Most concussions are managed by primary care physicians, ie,...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/j.1526-4610.2012.02138.x
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To evaluate whether self-reported past migraine response to reproductive life events (menses, pregnancy, menopause) alters the likelihood of worsening of migraine with exogenous hormone use. METHODS:A retrospective study was conducted on 451 female patients at the University Headache Center who had a diagnos...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2000.00027.x
更新日期:2000-03-01 00:00:00
abstract::Cyclic AMP (CAMP) accumulation induced by isoproterenol (IP) and forskolin in intact lymphocytes was determined in 12 patients with migraine and 12 healthy controls. Our data showed that IP CAMP accumulation (8.20 + 1.08 Pmol/million cells) was significantly (P = 0.033) lower than accumulation in the controls (14.39 +...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1993.hed33040198.x
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:To determine the pharmacological profile of frovatriptan. BACKGROUND:Frovatriptan is a new 5-HT(1B/1D) agonist developed for the treatment of migraine. METHODS:Pharmacological studies were performed using in vitro and in vivo techniques. RESULTS:Radioligand-binding studies showed that frovatriptan has a hi...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.42.s2.2.x
更新日期:2002-04-01 00:00:00
abstract::This review aims to understand the prevalence of premonitory symptoms in migraine, postulate their mechanisms, and compare these with functional imaging studies. A thorough literature review was conducted using PubMed for prevalence studies of premonitory symptoms in migraine and functional imaging studies in the prem...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12572
更新日期:2015-05-01 00:00:00
abstract::Life stress is found to be related to headache frequency in some studies, but not others. Research designs that find a relationship between the two tend to evaluate young subjects and employ large sample sizes. The purpose of this study was to evaluate the relationship between headache frequency and life stress, while...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2000.00016.x
更新日期:2000-02-01 00:00:00