María de Lourdes Figuerola

SUNCT syndrome responding absolutely to steroids in two cases with different etiologies

SUNCT is a syndrome of short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing. We are presenting now two cases absolutely responders to steroid therapy, one of them a SUNCT-like secondary to a prolactinoma and the other primary.

Possible autocrine enkephalin regulation of catecholamine release in human pheochromocytoma cells

AIMS Pheochromocytomas are catecholamine-secreting tumors that also synthesize and secrete several neuropeptides, including opioids. A negative regulation of catecholamine secretion by opioids has been postulated in chromaffin cells. However, results obtained so far are contradictory when referred to human pheochromocytomas. The aim of this study was to define the role of locally produced enkephalins on catecholamine release in human pheochromocytoma cells. MAIN METHODS Cells obtained from eleven human pheochromocytomas of different genetic origins were cultured for 5 days. Cultures were maintained under basal condition or under enkephalin, dexamethasone and naloxone alone or in combination with enkephalin or dexamethasone-stimulated conditions. Catecholamine and enkephalin levels in the culture medium were measured by HPLC-ED and RIA respectively. KEY FINDINGS Enkephalin induced a decrease in norepinephrine levels in all tumor cultures. Dexamethasone treatment, which increased enkephalin levels, also decreased catecholamine levels. On the other hand, the addition of naloxone to the cultures reverted to normal the inhibitory action exerted by enkephalin and dexamethasone treatments. SIGNIFICANCE These results suggest the existence of an autocrine negative regulatory loop exerted by enkephalin on norepinephrine release in human pheochromocytoma cells.

Opioid and Sympathetic Nervous System Activity in Cluster Headache Under Verapamil or Prednisone Treatment

SYNOPSIS

Changes in neutrophil met-enkephalin containing peptides in episodic cluster headache.

SYNOPSIS

Increase in plasma methionine‐enkephalin levels during the pain attack in episodic cluster headache

Since high levels of endogenous opioids (endorphins, enkephalins) were found in brain areas classically related to nociception, their peripheral levels in humans were studied in different pain syndromes yielding contradictory results. This study was undertaken to assess changes in plasma methionine-enkephalin (met-enkephalin) levels in patients with episodic cluster headache associated with the pain period. Twenty-nine patients, 24 in the cluster period (6 of them during an attack) and 3 in the remission period were studied. Two other patients were subjected to a longitudinal follow-up. Plasma met-enkephalin levels were determined by radioimmunoassay (RIA) with specific antibody. Plasma peptide concentration (pmol/ml) was higher (p < 0.001) in patients during the pain attack (3.97 ± 1.18) than in controls (0.25 ± 0.03). When measured 4 and 48 h after the pain attack lower levels were found (0.46 ± 0.06) which decreased to control values after 24 h. These results may suggest involvement of peripheral enkephalins in pain modulation in patients with episodic cluster headache.

Sporadic hemiplegic migraine and CREST syndrome

Hemiplegic migraines are characterised by attacks of migraine with aura accompanied by transient motor weakness. There are both familial and sporadic subtypes, which are now recognised as separate entities by the International Classification of Headache Disorders, edition II (ICHD-II). The sporadic subtype has been associated with other medical conditions, particularly rheumatological diseases. We report the case of a woman with sporadic hemiplegic migraine associated with CREST syndrome (calcinosis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia). Since there is a close relationship between migraine and Raynaud’s phenomenon, it could be speculated that the sporadic hemiplegic migraines in our patient might be secondary to CREST syndrome.

Plasma met-enkephalin levels: its relationship with age and type of headache

The aim of the present study was to assess the peripheral proenkephalin-A system in order to determine if it is related in any way to age and/or the type of headache. Our results show no significant change in plasma met-enkephalin (ME) and neutrophil met-enkephalin-containing peptide (NMECP) with aging in controls. Plasma ME levels and NMECP in patients suffering from migraine without aura and tension-type headaches were found to be similar in both groups, younger and older than 60 years old. When ME plasma levels were compared among the three groups of subjects in the two age-groups, only chronic tension-type headache patients differed ( [Formula: see text] ) from both controls and migraine without aura subjects.