Serotonin Mediated Cluster Headache, Trigeminal Neuralgia, Glossopharyngeal Neuralgia, and Superior Laryngeal Neuralgia with SAD Chronicity

Abstract

Cluster headache is a rare and severe pain syndrome with elusive pathophysiology. Serotonin pathways within the brainstem may be implicated in cluster headache with seasonal affective disorder and a subset of cranial nerve neuralgias. We describe and chronicle a syndrome consisting of cluster headache, seasonal affective disorder, with associated trigeminal, glossopharyngeal, superior laryngeal neuralgias in an 11-year-old female. Pharmacologic interventions for this patient were examined in conjunction with current classification, location and function of serotonin receptors. Etiology is postulated as mixed cranial nerve excitation via endogenous 5-HT (agonist) activity of 5-HT 3 receptors within the nucleus tractus solitarius and trigeminal tract nucleus.