Clomiphene citrate as a new treatment for SUNCT: hormonal manipulation for hypothalamic-influenced trigeminal autonomic cephalalgias.
We present a patient with treatment refractory short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) who was found to have low levels of serum testosterone supporting the hypothalamic connection to this trigeminal autonomic cephalalgia. Clomiphene citrate therapy induced a significant elevation of testosterone levels (by its effect on hypothalamic estrogen receptors) and led to a dramatic reduction in SUNCT attacks. Hormonal manipulation may be a treatment strategy for hypothalamic-influenced trigeminal autonomic cephalalgias.
Rozen
Todd D
TD
Michigan Head Pain & Neurological Institute, Dept. Neurology, 3120 Professional Drive, Ann Arbor, MI, USA.
Saper
Joel R
JR
Sheftell
Fred D
FD
Dodick
David W
DW
D001342:Autonomic Nervous System Diseases / Q000150:complications; D002996:Clomiphene / Q000627:therapeutic use*; D003229:Conjunctival Diseases / Q000150:complications; D006261:Headache / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007031:Hypothalamus / Q000378:metabolism; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use*; D013666:Tears / Q000378:metabolism; D013739:Testosterone / Q000097:blood*; D014277:Trigeminal Neuralgia / Q000150:complications
D020845:Selective Estrogen Receptor Modulators; D002996:Clomiphene; D013739:Testosterone