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Provocation of Unilateral Pain in Cluster Headache Patients by Breathing CO 2
Author(s) -
Hannerz Jan,
Jogestrand Tomes
Publication year - 1995
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.1995.hed3501038.x
Subject(s) - provocation test , medicine , cluster headache , anesthesia , heart rate , breathing , respiratory rate , blood pressure , cardiology , migraine , alternative medicine , pathology
Ten patients with cluster headache in an active period and 6 controls were studied as to heart rate, blood pressure, blood flow in the common carotid arteries (CCA), end‐tidal PCO 2 and pain before, during and after 6 minutes of breathing 6% CO 2 In air. Heart rate increased significantly during C0 2 breathing in controls but not in patients. The cluster headache patients had significantly lower baseline end‐tidal PCO 2 than controls. CCA blood flow increased significantly during CO 2 breathing in both groups. Vascular resistance decreased during CO 2 provocation and increased above baseline levels 5 minutes after provocation in both groups and related to the end‐tidal PCO 2 . Six of eight cluster headache patients, who had an increase of blood flow at provocation, reported slight to moderate unilateral pain in relation to the CO 2 provocation in contrast to controls. One patient treated with 6 mg sumatriptan 2.5 hours before the provocation had an end‐tidal PCO 2 within the range of the controls, and did not get an increase of CCA blood flow or pain at provocation. Six of the cluster headache patients were restudied when out of the active period. There was still no heart rate increase during CO 2 breathing and end‐tidal PCO 2 was still lower than in the controls. Unilateral headache was not provoked.