PubMed · 729468
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1978-12-08. Lumbar-puncture headache.. https://pubmed.ncbi.nlm.nih.gov/729468/
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A patient with more than 20 years of SUNCT, i.e., long lasting periods with frequent attacks of intense orbital pain with a duration of about one minute, associated with ipsilateral conjunctival injection, lacrimation, rhinorrhea and facial sweating is described. Some attacks were possibly related to increased cerebral blood flow but could also be triggered from the oral area. Orbital phlebography showed pathologic changes on the side of the pain, changes which were normalized when these attacks ceased to appear. Due to these findings in conjunction with serum evidence of inflammation, associated systemic symptoms and susceptibility to steroids and azathioprine, venous vasculitis is suggested to be the cause of SUNCT in this patient. Carbamazepine and sumatriptan decreased the frequency, intensity and duration of attacks, although not completely.
A twenty-six article review of the literature pertaining to non-pharmacological treatment of headache was undertaken. The data supports no significant difference in the efficacy of hypnosis, biofeedback and relaxation training. These studies demonstrated no relationship between hypnotizability or capacity for temperature elevation and headache improvement. The literature reviewed suggests the mechanism for improvement with non-pharmacological treatment may be physiologically nonspecific, with patient age, perceived locus of control and motivation likely to predict successful treatment. Home-based, minimal therapist contact, biofeedback and relaxation treatment appear to work as effectively as intensive clinic-based treatment.