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.
Keywords: Headache, Migraine, Oxcarbazepine, Side effects, Status migrainosus
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References
- 1.Headache Classification Committee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2004;24(Suppl-1):1–160. [Google Scholar]
- 2.Askmark H., Lundberg P.O., Olsson S. Drug related headache. Headache. 1989;29:441–444. doi: 10.1111/j.1526-4610.1989.hed2907441.x. [DOI] [PubMed] [Google Scholar]
- 3.Monteiro J.M., Dalhof C.G. Single use of substances. In: Olesen J., Tfelt-Hansen P., Welch K.M.A., editors. The headaches. Philadelphia: Lippincott Williams & Wilkins; 2000. pp. 861–869. [Google Scholar]
- 4.Glauser T.A. Oxcarbazepine in the treatment of epilepsy. Pharmacotherapy. 2001;21:904–919. doi: 10.1592/phco.21.11.904.34513. [DOI] [PubMed] [Google Scholar]
- 5.Dong X., Leppik I.E., White J., Rarick J. Hyponatremia from oxcarbazepine and carbamazepine. Neurology. 2005;65:1976–1978. doi: 10.1212/01.wnl.0000188819.45330.90. [DOI] [PubMed] [Google Scholar]
- 6.Sachdeo R.C., Wasserstein A., Mesenbrink P.J., D’souza J. Effects of oxcarbazepine on sodium concentration and water handling. Ann Neurol. 2002;51:613–620. doi: 10.1002/ana.10190. [DOI] [PubMed] [Google Scholar]
- 7.Palmieri A. Oxcarbazepine-induced headache. Cephalalgia. 2007;27:91–93. doi: 10.1111/j.1468-2982.2007.01246.x. [DOI] [PubMed] [Google Scholar]
- 8.Goh K.P. Management of hyponatremia. Am Fam Physician. 2004;69:2387–2394. [PubMed] [Google Scholar]
- 9.Saper J, Silberstein S, Somogyi M, McCague K (2005) Efficacy and safety of oxcarbazepine in patients with migraine headaches: a multicenter, double-blind, randomized, placebocontrolled study. Neurology (P05):152 [DOI] [PubMed]
- 9.Couch J.R., Diamond S. Status migrainosus: causative and therapeutic aspects. Headache. 1983;23:94–101. doi: 10.1111/j.1526-4610.1983.hed2303094.x. [DOI] [PubMed] [Google Scholar]
- 10.Oxford English Dictionary. http://dictionary.oed.com Last accessed 20 march 2007
- 11.Goadsby P.J., Schoenen J., Ferrari M.D., et al. Towards a definition of intractable headache for use in clinical practice and trials. Cephalalgia. 2006;26:1168–1170. doi: 10.1111/j.1468-2982.2006.01173.x. [DOI] [PubMed] [Google Scholar]
- 12.Silberstein S.D., Lipton R.B., Goadsby P.J., Smith R.T. Headache in primary care. Oxford: Isis Medical Media; 1999. Migraine diagnosis and treatment; pp. 53–82. [Google Scholar]