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Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances

Goadsby, Peter J. MD, PhD

CONTINUUM: Lifelong Learning in Neurology: August 2015 - Volume 21 - Issue 4, Headache - p 1032–1040
doi: 10.1212/CON.0000000000000195
Review Articles

Purpose of Review: The medical aphorism that common things happen commonly makes unique (and less common) migraine subtypes especially appropriate to review for the general neurologist. This article also identifies some rare headache disorders and other disturbances, and offers strategies to manage them.

Recent Findings: This article discusses migraine with brainstem aura, which is troublesome clinically and has had a change in terminology in the International Classification of Headache Disorders, Third Edition, beta version (ICHD-3 beta), and hemiplegic migraine, which is also troublesome in practice. The rare headache disorder hypnic headache and the exploding head syndrome are also discussed. When hypnic headache is recognized, it is eminently treatable, while exploding head syndrome is a benign condition with no reported consequences.

Summary: Unique migraine subtypes, rare headache disorders, and other disturbances present to neurologists. When recognized, they can often be managed very well, which offers significant benefits to patients and practice satisfaction to neurologists.

Address correspondence to Dr Peter J. Goadsby, NIHR-Wellcome Trust Clinical Research Facility, King’s College Hospital, London SE5 9PJ UK,

Relationship Disclosure: Dr Goadsby has served on the medical advisory boards of Allergan, Inc; and eNeura, Inc. Dr Goadsby has served as a consultant for Alder Biopharmaceuticals Inc; Autonomic Technologies, Inc; Avanir Pharmaceuticals, Inc; Bristol-Myers Squibb Company; CoLucid Pharmaceuticals, Inc; Dr. Reddy’s Laboratories; Eli Lilly and Company; Heptares Therapeutics; Impax Laboratories, Inc; Medtronic plc; NuPathe Inc; Pfizer Inc; Teva Pharmaceutical Industries Ltd; WL Gore and Associates; and Zosano Pharma Corporation. Dr Goadsby receives royalties from UpToDate, Inc, and has provided expert legal testimony for a number of companies.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Goadsby discusses the unlabeled/investigational use of pharmaceuticals for the treatment of unique migraine subtypes and rare headache disorders, none of which are approved by the US Food and Drug Administration.

© 2015 American Academy of Neurology
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