Abstract
Headache is among the most frequently encountered symptoms in clinical practice. Occipital neuralgia is characterized by sudden, sharp, electric shock-like pains in the distribution area of the occipital nerve. In this report, we present a 54-year-old female patient who developed occipital neuralgia-like symptoms shortly after the initiation of metformin treatment for type 2 diabetes mellitus. The symptoms resolved following the discontinuation of the drug. This case is discussed in light of the literature to highlight a potentially rare headache pattern triggered by metformin.
This case describes an unusual form of headache possibly associated with metformin therapy. It underscores the importance of considering uncommon side effects of commonly prescribed medications, such as metformin in differential diagnoses.
References
- Viollet B, Guigas B, Garcia NS, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: an overview. Clin Sci (Lond). (2012);122(6):253–270.
- Wile DJ, Toth C. Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy. Diabetes Care. (2010);33(1):156–161.
- Akpınar ÇK, Erdoğan S, Yazıcı T, Özbenli T. "Cluster-like headache due to metformin therapy." Agri: Agri (Algoloji) Dernegi'nin Yayin Organidir= The Journal of the Turkish Society of Algology (2016): 118-118.
- Aydın M, Armutçu F, Yiğitoğlu M. Asimetrik Dimetil Arjinin (ADMA) Metabolizması. International Journal of Basic and Clinical Medicine. (2015);1(1):61-6.
- Austin M, Hinson MR. Occipital Nerve Block. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK580523/
- Fan Z, Su D, Li ZC, Sun S, Ge Z "Metformin attenuates central sensitization by regulating neuroinflammation through the TREM2-SYK signaling pathway in a mouse model of chronic migraine." Journal of Neuroinflammation 21.1 (2024): 1-17.
- Bennett DL, Woods CG. Painful and painless channelopathies. Lancet Neurol. 2014;13(6):587-599. doi:10.1016/S1474-4422(14)70024-9
- Lindner D, Scheffler A, Nsaka M, Holle-Lee D. Hypnic Headache - What do we know in 2022?. Cephalalgia. 2023;43(3):3331024221148659. doi:10.1177/03331024221148659
- Liang, Jen-Feng, and Shuu-Jiun Wang. "Hypnic headache: a review of clinical features, therapeutic options and outcomes." Cephalalgia 34.10 (2014): 795-805.
Abstract
Baş ağrısı, klinik pratikte en sık karşılaşılan semptomlardan biridir. Oksipital nevralji, özellikle oksipital sinirin innervasyon alanında ani, keskin, elektrik çarpması tarzında ağrılarla karakterizedir. Bu çalışmada, tip 2 diabetes mellitus tanısıyla başlanan metformin tedavisinden kısa süre sonra gelişen ve ilacın kesilmesiyle gerileyen, oksipital nevralji benzeri semptomlar gösteren 54 yaşındaki kadın hasta sunulmuştur. Bu olgu, metformin ile tetiklenmiş olabilecek nadir bir baş ağrısı paternini vurgulamak amacıyla literatür ışığında tartışılmıştır.
Bu olgu, metformin tedavisi ile ilişkili nadir bir baş ağrısı formunu tanımlamaktadır. Metformin gibi sık kullanılan ilaçların, alışılmadık yan etkilerle ilişkili olabileceği akılda tutulmalı ve ayırıcı tanıda bu tür ilişkiler göz önünde bulundurulmalıdır.
References
- Viollet B, Guigas B, Garcia NS, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: an overview. Clin Sci (Lond). (2012);122(6):253–270.
- Wile DJ, Toth C. Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy. Diabetes Care. (2010);33(1):156–161.
- Akpınar ÇK, Erdoğan S, Yazıcı T, Özbenli T. "Cluster-like headache due to metformin therapy." Agri: Agri (Algoloji) Dernegi'nin Yayin Organidir= The Journal of the Turkish Society of Algology (2016): 118-118.
- Aydın M, Armutçu F, Yiğitoğlu M. Asimetrik Dimetil Arjinin (ADMA) Metabolizması. International Journal of Basic and Clinical Medicine. (2015);1(1):61-6.
- Austin M, Hinson MR. Occipital Nerve Block. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK580523/
- Fan Z, Su D, Li ZC, Sun S, Ge Z "Metformin attenuates central sensitization by regulating neuroinflammation through the TREM2-SYK signaling pathway in a mouse model of chronic migraine." Journal of Neuroinflammation 21.1 (2024): 1-17.
- Bennett DL, Woods CG. Painful and painless channelopathies. Lancet Neurol. 2014;13(6):587-599. doi:10.1016/S1474-4422(14)70024-9
- Lindner D, Scheffler A, Nsaka M, Holle-Lee D. Hypnic Headache - What do we know in 2022?. Cephalalgia. 2023;43(3):3331024221148659. doi:10.1177/03331024221148659
- Liang, Jen-Feng, and Shuu-Jiun Wang. "Hypnic headache: a review of clinical features, therapeutic options and outcomes." Cephalalgia 34.10 (2014): 795-805.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences (Other) |
| Journal Section | Case Report |
| Authors | |
| Publication Date | April 30, 2025 |
| Submission Date | March 22, 2025 |
| Acceptance Date | March 25, 2025 |
| Published in Issue | Year 2025 Volume: 12 Issue: 1 |
