Numerous mafic dykes, sills and intrusions with ages between 1985 Ma and 1960 Ma are exposed near the Onega Lake in southern Karelia, Russia. The paleomagnetic analysis of these rocks has revealed a ...stable remanence with directions belonging to two groups. The directions of the first group characterize ten intrusions including the dated 1970 ± 3 Ma Unoi sill and 1976 ± 9 Ma Suna River Canyon dolerite, the corresponding paleomagnetic pole is 44.4°N, 101.5°E, A95 = 6.3°. The second group comprises two intrusions including the 1984 ± 8 Ma Pudozhgora intrusion and Krestoviy Navolok dyke with the corresponding paleopole calculated from 5 site mean poles is 60.9°N, 144.8°E, A95 = 6.8°. Both remanence directions are supported by robust baked contact tests. We propose the first group's pole as the key 1975 Ma Fennoscandian pole. The second one is well dated, but based only on two intrusions without proper averaging of the paleosecular variations. We have also carried out a complimentary paleomagnetic study of the previously investigated 2504 Ma Shalskiy gabbronorite dyke. The remanence of this dyke is now supported by the inverse contact test and statistics can be improved. Using our 1975 Ma pole together with coeval poles from Superior, Slave and Amazonia cratons we propose a provisional 1975 Ma paleogeographic reconstruction.
The International Classification of Headache Disorders, 3rd edition (ICHD3) defines Short-lasting Unilateral Neuralgiform Headache Attacks (SUNHA) as attacks of moderate or severe, strictly ...unilateral head pain lasting from seconds to minutes, occurring at least once a day and usually associated with prominent lacrimation and redness of the ipsilateral eye. Two subtypes of SUNHA are identified: Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT) and Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic symptoms (SUNA). These pathologies are infrequent in children and difficult to diagnose. The authors reviewed the existing literature on SUNCT and SUNA, especially in the developmental age, which describes the pathophysiology in detail and focuses on the therapeutic options available to date. SUNHA-type headaches must be considered on the one hand, for the possibility of the onset of forms secondary to underlying pathologies even of a neoplastic nature, and on the other hand, for the negative impact they can have on an individual’s quality of life, particularly in young patients. Until now, published cases suggest that no chronic variants occur in childhood and adolescents. In light of this evidence, the authors offer a review that may serve as a source to be drawn upon in the implementation of suitable treatments in children and adolescents suffering from these headaches, focusing on therapies that are non-invasive and as risk-free as possible for pediatric patients.
SUNCT and SUNA: an Update and Review Arca, Karissa N.; Halker Singh, Rashmi B.
Current pain and headache reports,
08/2018, Letnik:
22, Številka:
8
Journal Article
Recenzirano
Purpose of Review
The purpose of this review is to provide an update on the clinical features, diagnosis, pathogenesis, epidemiology, and treatment of the rare primary headache disorders ...short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA). Together these entities are known as short-lasting unilateral neuralgiform headache attacks (SUNHA).
Recent Findings
Recent case reports of secondary SUNCT and SUNA due to medullary infarcts support the theory that the trigeminohypothalamic pathway is involved in the pathophysiology of SUNHA. While medical therapy for SUNHA has not significantly changed, surgical therapy for refractory SUNCT and SUNA has made advancements with a recent case series demonstrating the efficacy of deep brain stimulation.
Summary
We will discuss the pathophysiology of both the pain and the autonomic symptoms experienced in SUNCT and SUNA attacks as well the medical, procedural, and surgical options for treatment with emphasis on recent advances. Specific secondary causes reported in the recent literature will be discussed in brief.
Purpose of Review
This review presents a critical appraisal of the treatment strategies for short-lasting unilateral neuralgiform headache attacks (SUNHA), paroxysmal hemicrania (PH), and hemicrania ...continua (HC). We assess the available, though sparse, evidence on both medical and surgical treatments. In addition, we present estimated pooled analyses of the most common treatments and emphasize recent promising findings.
Recent Findings
The majority of literature available on the treatment of these rare trigeminal autonomic cephalalgias are small open-label observational studies and case reports. Pooled analyses reveal that lamotrigine for SUNHA and indomethacin for PH and HC are the preventative treatments of choice. Second-line choices include topiramate, gabapentin, and carbamazepine for SUNHA; verapamil for PH; and cyclooxygenase-2 inhibitors and gabapentin for HC. Parenteral lidocaine is highly effective as a transitional treatment for SUNHA. Novel therapeutic strategies such as non-invasive neurostimulation, targeted nerve and ganglion blockades, and invasive neurostimulation, including implanted occipital nerve stimulators and deep brain stimulation, appears to be promising options.
Summary
At present, lamotrigine as a prophylactic and parenteral lidocaine as transitional treatment remain the therapies of choice for SUNHA. While, by definition, both PH and CH respond exquisitely to indomethacin, evidence for other prophylactics is less convincing. Evidence for the novel emerging therapies is limited, though promising.
Background
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.
Aim
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.
Methods
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.
Summary
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.
For the control and elimination of malaria, information on the local vector dynamics is essential. This information provides guidance on appropriate and timely deployment of vector control tools and ...their subsequent success. The data on the dynamics of local mosquito populations can be collected using many different Anopheles sampling methods. Dependent on the objectives, resources, time, and local environment, different traps and methods can be chosen. This chapter describes the sampling of adult populations, focusing on the important preparatory stages and some of the widely used sampling methods. The trapping methods discussed in this chapter are the human landing catch, human-baited net trap, animal landing catch, animal-baited net trap, CDC miniature light trap, Biogents Suna trap, peripheral net collection, pyrethrum collection, exit/entry trap, and resting shelter. For optimal deployment in the field, a step-by-step description of the sampling methods is given.
The review was designed to summarize recent research relevant to the trigeminal autonomic cephalalgias, which include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform ...headache attacks with conjunctival injection and tearing/cranial autonomic features (SUNCT/SUNA). Hemicrania continua is included for completeness.
Cluster headache has the longest attack duration and relatively low attack frequency. Paroxysmal hemicrania has intermediate duration and intermediate attack frequency. Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing have the shortest attack duration and the highest attack frequency. Hemicrania continua has a continuous pain with exacerbations that can include cranial autonomic symptoms as part of the phenotype. The importance of diagnosing these syndromes resides in their excellent but highly selective response to treatment.
Considerable advances have been made in the diagnostic and therapeutic approaches to trigeminal autonomic cephalalgias and these are important for neurologists to consider.
Background
Paresthesia-free cervical 10 kHz spinal cord stimulation (HF10 SCS) may constitute a novel treatment modality for headache disorders, when pharmacological approaches fail. We report the ...results of a retrospective analysis assessing the long-term safety, tolerability and efficacy of HF10 SCS in a group of patients with chronic refractory primary headache disorders.
Findings
Four patients with chronic migraine (CM), two with chronic SUNA (Short-lasting Unilateral Neuralgiform headache attacks with Autonomic symptoms) and one with chronic cluster headache (CCH) refractory to medical treatments, were implanted with cervical HF10 SCS. Pre- and post-implantation data were collected from the medical notes and from headache charts. At an average follow-up of 28 months (range: 12–42 months) we observed an improvement of at least 50 % in headache frequency and/or intensity in all CM patients. One SUNA patient became pain free and the other reported at least 50 % improvement in attacks frequency an duration. The CCH patient reported a significant reduction in CH attacks duration. Two patients underwent a surgical revision due to lead migration.
Conclusions
Paresthesia-free high cervical HF10 SCS appears to be a long-term safe and likely effective therapeutic approach for patients with chronic refractory primary headache disorders. These results warrant further prospective studies in larger series of patients.
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