title: Uncontrolled headache induced by oxcarbazepine.
abstract: Headache induced by acute exposure to a specific drug constitutes an idiosyncratic side effect. Metabolic imbalance appears as the leading aetiology, among several other hypotheses. Either primary headaches show a higher susceptibility to this idiosyncratic reaction or a drug-induced primary headache evolves in intensity and duration, becoming uncontrolled until the complete discontinuation of the drug in consideration. The goal of this study is to describe three patients diagnosed with migraine and epilepsy (both under control) who evolved into status migrainosus after the introduction of oxcarbazepine (OXC), as part of a switch off from carbamazepine (CBZ). Twenty-four to seventy-two hours following the switch, all patients developed intractable headache, despite the use of different symptomatic drugs. Complete recovery of the headache symptoms occurred only after OXC was discontinued. We discuss the potential mechanisms associated to OXC and status migrainosus, drug-induced headaches and uncontrolled headaches.
authors.affiliation: Headache Clinic, Neurology Service, Department of Internal Medicine, Hospital de Clínicas, Federal University of Paraná, Rua General Carneiro 181, 120 andar, sala 1236, CEP-80060-900, Curitiba-Paraná, Brazil. piovesan@avalon.sul.com.br
authors.forename: Elcio Juliato
authors.initials: EJ
authors.lastname: Piovesan
authors.forename: Helio Ghizoni
authors.initials: HG
authors.lastname: Teive
authors.forename: Luciano
authors.initials: L
authors.lastname: de Paola
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Silvado
authors.forename: Ana
authors.initials: A
authors.lastname: Crippa
authors.forename: Vanise Campos Gomes
authors.initials: VC
authors.lastname: Amaral
authors.forename: Marcos Vinicius
authors.initials: MV
authors.lastname: Della Colleta
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Stani
authors.forename: Lineu Cesar
authors.initials: LC
authors.lastname: Werneck
mesh_terms: D000208:Acute Disease; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications* / Q000175:diagnosis; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives*; D020785:Central Nervous System Vascular Malformations / Q000150:complications / Q000175:diagnosis; D018450:Disease Progression; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D005260:Female; D020773:Headache Disorders / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008881:Migraine Disorders / Q000139:chemically induced* / Q000503:physiopathology; D018302:Neoplasms, Neuroepithelial / Q000150:complications* / Q000175:diagnosis; D000078330:Oxcarbazepine
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine