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The existing relationship between genetic markers of the cluster headache and the efficacy of lithium salts therapy was described in the present study. Thirty-five patients suffering from cluster headache, who were already typed for the HLA antigens, were studied. Typing was carried out with the microlymphocytotoxicity technique used by US National Institutes of Health. The patients were treated with lithium carbonate for a period of three months. Three parameters for evaluation of the efficacy of lithium therapy was used: the percentage of improvement, the wake-sleep rhythm and the pupil diameter measurement. The parameters were statistically (Student's t-test) evaluated and it was possible to separate two subgroups of patients: "responders" and "non-responders" to the lithium therapy. The phenotypical frequencies in the two subgroups was analysed using the chi 2 test, Data emerging showed a higher frequency of antigen HLA-B18 (23.8% versus 0%; p less than 0.005 pc less than 0.06) and of antigen HLA-A9 (42.9% versus 14.3%) in the "responders" subgroup. In the "non-responders" subgroup a higher frequency of antigen HLA-A1 (35.7% versus 14.3%) was found.

The clinical definition of carotidynia is not a controversial one, whereas how its etiology should be interpreted is still uncertain. The study of the clinical features and the therapeutical results in 12 patients suffering from carotidynia reveals a marked resemblance to migraine. In particular, the case history reported points out a significant incidence of migraine as a familial disease, its special localization and the type of pain, the possible presence of a prodromal stage and the favourable response to the drugs that are known to be effective in migraine treatment. The theory that carotidynia should be ascribed to the group of vascular headaches is therefore suggested.

The author analysed from the standpoint of familial history of headaches 89 cases of headaches treated at a neurological outpatient clinic in a period of 3 years. In 14 cases migraine was diagnosed, in 31 cases vasomotor headaches, in 16 post-traumatic headaches, in 7 psychogenic headaches, in 5 cases sinusitis, in 4 intracranial hypertension, in 12 cases the aetiology was unclear. In cases of vasomotor headaches in 90% of cases strong headaches were present in close relatives of the patients while in other groups the familial factor was infrequent.