Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Centre of Neurology, Vilnius University, Vilnius, Lithuania.
Cephalalgia. 2022 Jun;42(7):680-683. doi: 10.1177/03331024221075074. Epub 2022 Feb 15.
Primary headache associated with sexual activity is a rare benign headache disorder that is provoked by sexual excitement. It is a diagnosis of exclusion after the underlying secondary causes have been ruled out. The cause of this headache disorder is still unknown. Cerebral vasospasm, pericranial muscular contraction, hemodynamic and respiratory changes during sexual activity are most commonly listed as possible pathophysiological mechanisms. Several acute and prophylactic options with good clinical response have been described in the case series.
We present a case of a 30-year-old woman with primary headache associated with sexual activity and comorbid with frequent episodic migraine without aura. Both headache disorders were successfully managed with monoclonal antibody against calcitonine gene-related peptide (CGRP) receptor erenumab 70 mg.
The efficacy of erenumab in our case presumes that CGRP might also be an important mediator in facilitating primary headache associated with sexual activity.
与性行为相关的原发性头痛是一种罕见的良性头痛疾病,由性兴奋引发。在排除潜在的继发性原因后,才可做出该头痛疾病的诊断。目前,这种头痛疾病的病因仍不清楚。性活动期间脑血管痉挛、颅周肌肉收缩、血流动力学和呼吸变化最常被列为可能的病理生理机制。在病例系列研究中,已经描述了几种具有良好临床反应的急性和预防选择。
我们报告了一例 30 岁女性患者,患有与性行为相关的原发性头痛,且常伴有无先兆的频发阵发性偏头痛。两种头痛疾病均通过使用降钙素基因相关肽(CGRP)受体单克隆抗体依那西普(erenumab)70mg 成功治疗。
依那西普在我们病例中的疗效表明 CGRP 也可能是促进与性行为相关的原发性头痛的重要介质。