Recently a series of patients with Prolactinomas (a pituitary prolactin – secreting tumor in brain) was published. They found they often presented with either one sided migraines (often orbital) or SUNCT (short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing). They felt prolactin levels should be done in those with with trigeminal autonomic cephalalgias like SUNCT. Cabergoline, a dopamine agonist, worked well.
Cephalalgia. 2013 Dec 18. [Epub ahead of print]
Prolactinoma-associated headache and dopamine agonist treatment.
Kallestrup MM, Kasch H, Osterby T, Nielsen E, Jensen TS, Jørgensen JO.
- 12 cases average 40 years old – both men and women
- all unilateral headaches
- all hyperprolactinemic with levels ranging between 1.44 and 109.70 IU/l normal range: 0.09—0.58 IU/l)
- 3 presented with SUNCT, 4 with migraine, one with cluster headaches and one with mixed picture (2 cases missing data)
- less than half missed work due to headaches
- all received cabergoline except one who got quinagolide.
- Treatment worked well.
Comment – SUNCT causes short jabbing one sided headaches that are not as severe as cluster. They occur often when they flare. A simple answer like this is appreciated…