Temporary resolution of hemicrania continua following ipsilateral ear piercing
Background Hemicrania continua is an uncommon subtype of trigeminal autonomic cephalgia that exhibits dramatic therapeutic response to indomethacin. Unfortunately, indomethacin is associated with a range of adverse effects, including neuropsychiatric complications, which limits its use in many patie...
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BMJ Publishing Group
2021-09-01
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| Series: | BMJ Neurology Open |
| Online Access: | https://neurologyopen.bmj.com/content/3/2/e000193.full |
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| author | Alexander Bryson |
| author_facet | Alexander Bryson |
| author_sort | Alexander Bryson |
| collection | DOAJ |
| description | Background Hemicrania continua is an uncommon subtype of trigeminal autonomic cephalgia that exhibits dramatic therapeutic response to indomethacin. Unfortunately, indomethacin is associated with a range of adverse effects, including neuropsychiatric complications, which limits its use in many patients. Although no other effective pharmacologic agents exist, there is emerging evidence for interventional treatments such as occipital nerve and vagus nerve stimulation, which may act by modulating neural activity within the trigeminovascular system.Case We present a 30-year-old woman with long-standing refractory hemicrania continua who suffered adverse effects to indomethacin. She experienced temporary, but near-complete, symptom resolution following piercing of the crus of the ear helix ipsilateral to her headache, whereas contralateral piercing produced no benefit.Conclusions To our knowledge, this case is the first to describe a therapeutic benefit following ear piercing in a patient with trigeminal autonomic cephalgia. We argue that symptom relief was obtained through a similar mechanism to occipital or vagus nerve stimulation. |
| format | Article |
| id | doaj-art-fa1565e1757040749a95d46b16ff5a0f |
| institution | OA Journals |
| issn | 2632-6140 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Neurology Open |
| spelling | doaj-art-fa1565e1757040749a95d46b16ff5a0f2025-08-20T02:11:17ZengBMJ Publishing GroupBMJ Neurology Open2632-61402021-09-013210.1136/bmjno-2021-000193Temporary resolution of hemicrania continua following ipsilateral ear piercingAlexander Bryson0Department of Neurology, Austin Health, Heidelberg, Victoria, AustraliaBackground Hemicrania continua is an uncommon subtype of trigeminal autonomic cephalgia that exhibits dramatic therapeutic response to indomethacin. Unfortunately, indomethacin is associated with a range of adverse effects, including neuropsychiatric complications, which limits its use in many patients. Although no other effective pharmacologic agents exist, there is emerging evidence for interventional treatments such as occipital nerve and vagus nerve stimulation, which may act by modulating neural activity within the trigeminovascular system.Case We present a 30-year-old woman with long-standing refractory hemicrania continua who suffered adverse effects to indomethacin. She experienced temporary, but near-complete, symptom resolution following piercing of the crus of the ear helix ipsilateral to her headache, whereas contralateral piercing produced no benefit.Conclusions To our knowledge, this case is the first to describe a therapeutic benefit following ear piercing in a patient with trigeminal autonomic cephalgia. We argue that symptom relief was obtained through a similar mechanism to occipital or vagus nerve stimulation.https://neurologyopen.bmj.com/content/3/2/e000193.full |
| spellingShingle | Alexander Bryson Temporary resolution of hemicrania continua following ipsilateral ear piercing BMJ Neurology Open |
| title | Temporary resolution of hemicrania continua following ipsilateral ear piercing |
| title_full | Temporary resolution of hemicrania continua following ipsilateral ear piercing |
| title_fullStr | Temporary resolution of hemicrania continua following ipsilateral ear piercing |
| title_full_unstemmed | Temporary resolution of hemicrania continua following ipsilateral ear piercing |
| title_short | Temporary resolution of hemicrania continua following ipsilateral ear piercing |
| title_sort | temporary resolution of hemicrania continua following ipsilateral ear piercing |
| url | https://neurologyopen.bmj.com/content/3/2/e000193.full |
| work_keys_str_mv | AT alexanderbryson temporaryresolutionofhemicraniacontinuafollowingipsilateralearpiercing |