Posted by Bennie Sue (63.11.65.189) on October 23, 2000 at 04:27:37:
In Reply to: Novak Bonaccorsi posted by Ueli on October 22, 2000 at 19:37:49:
If this means that a malformation in the septum and other surrounding areas causes a block in circulation there and allows the accumulation of serotonin and other neurotransmitters, a process which leads to hypoxia in the area, then that could possibly explain why the administration of oxygen often aborts the pain.
The severity of the physical abnormality might have something to do with the fact that some of us are chronic and some episodic. It might also explain why such high flow rates of oxygen are needed.
The Goadsby et al study on high levels of neurotransmitters found in the blood of patients during a CH attack seems to be related to the above. Oxygen and Imitrex treatments both brought the neurotransmitter levels to normal and aborted the pain in every case, I believe. Narcotic treatment did not reduce the neurotransmitter levels, and little pain relief was obtained.
Perhaps the deviated septum is simply a visible manifestation of a more complicated abnormality. And perhaps some people have a more severe abnormality than others. This might account for the frequency of attacks. But it seems there must be an additional trigger for many of us. I mean, I have a deviated septum, but I am an episodic sufferer. Why do I not have constant head pain? Why does this "circulation block" only occur every year or 18 months in my case?
All this speculation makes a certain amount of sense to me but does not seem to be the total answer to why we have CH or why it affects us differently.
If I were in constant pain I might want to try this surgery, but I would not personally expect miraculous results.