title: Cluster-tic syndrome as the initial manifestation of multiple sclerosis.
abstract: We report the case of a patient diagnosed as having cluster-tic syndrome as the initial manifestation of multiple sclerosis (MS). The patient's headache bouts improved after treatment with antiepileptic drugs, steroids, and beta-interferon. Magnetic resonance imaging (MRI) scans showed a pontine demyelinating lesion involving the area of the trigeminal root inlet and main sensory nucleus. Neurophysiological studies correlated well with MRI lesions. The association between cluster-tic syndrome and MS is an exception, and the mechanism of the pain is still unknown; therefore, this case might suggest a pathophysiological relationship between the trigeminal main sensory nucleus and cluster-tic syndrome.
authors.affiliation: University Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: V
authors.initials: V
authors.lastname: González-Quintanilla
authors.forename: A
authors.initials: A
authors.lastname: Oterino
authors.forename: M
authors.initials: M
authors.lastname: Toriello
authors.forename: C
authors.initials: C
authors.lastname: de Pablos
authors.forename: Y
authors.initials: Y
authors.lastname: Wu
authors.forename: E
authors.initials: E
authors.lastname: de Marco
authors.forename: J
authors.initials: J
authors.lastname: Pascual
mesh_terms: D000328:Adult; D001767:Blinking / Q000502:physiology; D002531:Cerebellum / Q000473:pathology; D004558:Electric Stimulation; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis; D011149:Pons / Q000473:pathology; D011930:Reaction Time; D012018:Reflex / Q000502:physiology; D013981:Tic Disorders / Q000150:complications*; D014278:Trigeminal Nuclei / Q000473:pathology