Thermal sensitivity in unilateral headaches

Thermal thresholds were measured in the face (first and second trigeminal a rea), over the mastoid process (C2-3 area), and in the hands in patients wi th migraine (n = 17), cluster headache (n = 22), and cervicogenic headache (n = 20). Significant symptomatic versus nonsymptomatic side differences we re generally not found for any headache group. Cluster headache patients ha d significantly higher warm thresholds than controls (n = 24) for most of t he cephalic points. Cervicogenic headache patients had significantly higher warm and cold thresholds than controls (n = 56) at several cephalic and no ncephalic points. Warm thresholds over the mastoid process on the symptomat ic side were higher in cervicogenic headache patients compared to the other groups. In migraine patients, thermal thresholds were similar to those in controls. Thus, we found no evidence of focal or unilateral peripheral soma tic nerve dysfunction involving C or A-delta fibers in any of the studied h eadache groups, although a C2-3 root dysfunction in cervicogenic headache c ould not be excluded. A bilateral central sensory dysfunction in cluster he adache and cervicogenic headache may be hypothesized but a generalized peri pheral dysfunction can also explain our results.