LETTER TO THE EDITOR Therapeutic stimulation of the hypothalamus: pathophysiological insights and prerequisites for management
نویسندگان
چکیده
We thank Dr Gupta for his interest in our work. Verapamil was in fact tried in this patient up to 960 mg day with no benefit (Attanasio et al., 2000), as were all known cluster headache (CH) prophylactics. In our patient, the pain attacks were always accompanied by drug-resistant blood pressure crises (diastolic pressure up to 160 mmHg), during which repeated retinal and vitreous humour haemorrhages occurred, resulting in right eye blindness and severely compromised left visus—clear evidence of target organ damage. These hypertensive crises would inevitably have caused irreversible damage to other organs, had they not been controlled; they have not recurred since DBS. Furthermore, the pressure crises only occurred with CH attacks, beginning at the same time but peaking long before the pain peak, indicating they were pain-independent. The patient also had sleep disturbances, hyperphagia, aggression and hypersexuality (Attanasio et al., 2000), all of which ceased completely under hypothalamic stimulation, thereby implicating the hypothalamus (Fig. 1).
منابع مشابه
Competence of hospital managers as a necessity for optimal and effective management of the Iranian health system; Letter to the Editor
-
متن کاملLetter to editor: Recent advances in management of mycetoma in Iran
Mycetoma usually involves the skin, the subcutaneous tissues and deep structures such as the muscle and bone, but infection can also spread to more distant sites through the blood and lymph. If left untreated, the disease leads to deformity and loss of function, which may be fatal. The disease has a severe medical and socioeconomic impact on individuals, communities and health authorities. Elab...
متن کاملMigration of Medical Staff; Has the Alarm Sounded? Letter to Editor
Among the types of migration, the migration of expert human resources is one of the most challenging for the immigrant sender countries. With the outbreak of COVID-19 worldwide, the importance of medical staff and the need for providing sufficient human resources in the healthcare section appeared more prominent. COVID-19 along with the existing economic challenges has intensified the process o...
متن کاملTherapeutic stimulation of the hypothalamus: pathophysiological insights and prerequisites for management.
We thank Dr Gupta for his interest in our work. Verapamil was in fact tried in this patient up to 960 mg day with no benefit (Attanasio et al., 2000), as were all known cluster headache (CH) prophylactics. In our patient, the pain attacks were always accompanied by drug-resistant blood pressure crises (diastolic pressure up to 160 mmHg), during which repeated retinal and vitreous humour haemorr...
متن کامل