Possible Involvement of Hypotension in Postprandial Headache: A Case Series. Issue 9 (3rd July 2017)

• Record Type: Journal Article
• Authors: Takizawa, Tsubasa; Shibata, Mamoru; Hiraide, Takahiro; Seki, Morinobu; Takahashi, Shinichi; Suzuki, Norihiro
• Is Part Of: Headache. Volume 57:Issue 9(2017)
• Page Start: 1443
• Page End: 1448
• Publication Date: 2017-07-03
• Subjects: headache induced by food and/or additive -- postprandial hypotension -- meta‐iodobenzylguanidine (MIBG) myocardial scintigraphy -- head‐up tilt testing; Headache -- Periodicals; Headache -- Periodicals; 616.8491
• DOI: 10.1111/head.13136
• Languages: English
• ISSNs: 0017-8748

Abstract

Abstract : Background: It is commonly known that headaches are induced by intake of specific food, drink, and/or additive. In addition, some patients experience postprandial headache independent of ingestion of specific items. Currently, information on the pathophysiology underlying this particular type of headache is scarce. Case reports: We report two cases in which headaches were observed after each meal. Postprandial hypotension was demonstrated in both cases. Tonometry‐based continuous blood pressure measurement during head‐up tilt revealed sympathetic dysfunction. In one patient, meta‐iodobenzylguanidine (MIBG) myocardial scintigraphy detected cardiac sympathetic denervation, and diagnosis of pure autonomic failure was made. In both cases, treatment of postprandial hypotension was effective in relieving postprandial headache. Discussion: The possibility of postprandial hypotension should be explored in patients with headache that occurs after meal. To this end, tonometry‐based blood pressure measurement and MIBG myocardial scintigraphy may be useful diagnostic investigations. Treating postprandial hypotension may be effective in alleviating the symptoms.