Cephalic hypersensitivity syndromes: A new concept for chronic headache

The number of patients suffering from chronic headache accompanied by dizziness and cephalic ringing is gradually increasing. Pathophysiology of migraine has been commonly explained by trigeminovascular theory, although recent studies have suggested that the cause of the migraine stems from cortical hyperexcitability. The "Cortical Hypersensitivity Syndromes" is defined as a syndrome in which cortical hyperexcitability increases over time in patients suffering from long-term headache but left untreated. The primary symptoms include unilateral or bilateral cephalic ringing, insomnia, enhanced anxiety, short-term impairment of higher brain function, and daily heaviness of the head. Electroencephalogram (EEG) finding suggests widespread hypersensitivity. The syndrome can be attributed to a history of migraine, or attributed to family history within second-degree, or not attributed to another disorder. We measured EEG in 1000 patients suffering from daily headache accompanied by dizziness and cephalic ringing. Here we defined a new syndrome, "cephalic hypersensitivity syndrome" as a subliminal cortical hyperexcitability which itself is invisible but apparently seen as some symptoms such as dizziness and cephalic ringing. The cephalic hypersensitivity syndrome should be treated to attenuate the excitability by an appropriate triptan medication during attacks so as to exhibit its recurrence.