Background.— Occipital neuralgia is an uncommon cause of headaches. Very little is known about the pain characteristics and associated features of patients with ON + M and whether these pain characteristics differ from those of patients with isolated ON. Methods.— We studied 35 consecutive patients presenting with ON to the University of Southern California

headache clinic. All patients met International Headache Society criteria for diagnosis of ON. Patients completed a questionnaire designed for this study. We also collected demographic data, including age, gender, and ethnicity. Results.— Twenty patients had ON + M and 15 had isolated ON. There was no difference in age, gender or ethnicity between patients with ON + M and those with isolated ON. Patients with ON + M had significantly PS341 more complaints of pain Tanespimycin supplier traveling to the scalp and presence of scalp tenderness and tingling compared with patients with isolated ON; 25% patients in the ON + M group described the pain as “dull” whereas none of the isolated ON group reported this characteristic. There was higher use of chiropractors and massage therapy in patients from ON + M group than from isolated ON. Conclusion.— There may be significant differences in pain characteristics for patients with ON + M and those for patients with isolated ON. The data indicate that patients with migraine should also be screened for symptoms of ON, as there may

be similarities in presentation. The clinical implications of distinguishing ON + M and isolated ON include differences in treatment regimen, avoidance of inappropriate use of medical resources, and differences in long-term outcomes. “
“To assess the prevalence of chronic insomnia and the periodicity of headache attacks in an Arctic cluster headache population. Cluster headache

is a sleep-related disorder, and attacks have both circadian and circannual rhythmicity. Through a retrospective learn more hospital chart review, we identified all subjects diagnosed with episodic cluster headache (ICD-10 G 44.0) at the Neurological Departments in Northern Norway (located north of 66°33′N) between January 1, 2000 and December 31, 2010. Patients with a confirmed diagnosis (ICHD-2) received a comprehensive questionnaire covering demographic data, clinical characteristics, sleep, and periodicity of attacks. A total of 196 subjects were registered, and 178 received the questionnaire. The response rate was 88/178 (49%). Fifty-eight men (aged 49.2 ± 13.6) and 12 women (aged 49.7 ± 15.5) were included. Forty percent of the responders suffered from chronic insomnia (Diagnostic and Statistical Manual of Mental Disorders 4th edition). Forty-nine percent of the responders and 42% of the non-responders were shift workers, which is much higher than compared with the general population (24%). Insomnia was significantly associated with shift work and experiencing longer-lasting cluster bouts.