[SUNCT-type headache secondary to herpes zoster virus infection. A case report]. / Cefalea de tipo SUNCT secundaria a infección por el virus herpes zóster. A propósito de un caso.

INTRODUCTION: Headache is one of the most frequent reasons for medical consultation. The SUNCT type is classified as a primary trigeminal-autonomic headache and should be considered in cases of short-lasting, hemifacial pain associated with autonomic dysfunction. Additionally, in the approach to this disease, secondary causes that facilitate its onset must be ruled out. CASE REPORT: We describe a case of a new-onset SUNCT-type headache in which involvement of the first branch of the trigeminal nerve due to herpes zoster virus infection was documented six days after the onset of pain. CONCLUSION: Trigeminal autonomic headaches are usually primary; yet, multiple conditions have been described that are associated with SUNCT-type headaches and have a secondary etiology. Among these, herpes zoster virus infection should be considered at the onset of episodes consistent with SUNCT-type headache unresponsive to medical treatment.

TITLE: Cefalea de tipo SUNCT secundaria a infección por el virus herpes zóster. A propósito de un caso.Introducción. La cefalea es uno de los motivos más frecuentes de consulta médica. La de tipo SUNCT forma parte de las cefaleas primarias de tipo trigeminoautonómico y debe considerarse en casos de dolor hemifacial de corta duración asociado a signos disautonómicos. Adicionalmente, dentro del enfoque de esta enfermedad se deben descartar causas secundarias que faciliten su aparición. Caso clínico. Se describe un caso de cefalea de novo de tipo SUNCT en el cual se documentó afectación de la primera rama del nervio trigémino por infección del virus herpes zóster tras seis días de aparición del dolor. Conclusión. Habitualmente, las cefaleas trigeminoautonómicas son primarias; sin embargo, existen múltiples entidades descritas asociadas a cefalea de tipo SUNCT de etiología secundaria. Dentro de éstas debe considerarse la infección por el virus herpes zóster en el inicio de episodios compatibles con cefalea de tipo SUNCT que no respondan al tratamiento médico.

[Interobserver reliability among neurology resident physicians in the diagnosis of primary headaches according to the 2004]. / Concordancia interobservador entre médicos residentes de neurología en el diagnóstico de las cefaleas primarias según la clasificación de la IHS 2004.

INTRODUCTION: We determine the interobserver reliability among neurology resident physicians when diagnosing primary headaches using the 2004 International Headache Classification (IHC) compared to that obtained when compared with these observers and those of a consensus group (CG) made up of investigators and observers. PATIENTS AND METHODS: The study was performed in an adult and pediatric population from a 4th level Colombian hospital out-patient neurology clinic. After informed consent was obtained from each patient, a video was recorded, eliminating the facial images in order to prevent patient identification. Two same level residents (observer 1 and observer 2) with previous training in the international classification of headache disorders (IHD-2) examined the video. Each video was examined separately with the classification in hand, making the diagnoses. The diagnoses obtained were compared between the observers and with the CG. RESULTS: We obtained a kappa index: 0.64 comparing residents, k: 0.66 comparing resident 1 to CG and kappa index 0.70 comparing resident 2 to CG in the level of groups. The kappa value obtained for the headache type level was 0.51 interobservers, 0.61 on comparing observer one with CG and 0.65 on comparing observer two with CG. CONCLUSION: Our results indicate that there is adequate reliability in the application of the 2004 IHC classification in the diagnosis of primary headaches among neurology resident physicians.