Submited on: 30 Nov 2012 05:51:45 AM GMT
Published on: 30 Nov 2012 08:33:17 PM GMT
 

  • What are the main claims of the paper and how important are they?

    This is a case report on orgasmic headache (OH) in a women. A 56 year old female with hemochromatosis (HC) developed new daily persistent headache (NDPH) following a single orgasm. HC causes excessive iron overload resulting in neurodegeneration in the brain. Since she exhibited none of the conditions (micro-bleeds, vasoconstriction, cerebral venous sinus stenosis or thrombosis) in NDPH, HC and idiopathic intracranial hypertension (IIH) were suggested to predispose her to develop an orgasmic headache.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    NA


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    The speculation of the cause of OH seems to be unclear.


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    NA


  • Other Comments:

    It is necessary more cases of OH with NDPH and IIH to say that the etiology is not relavant to initial hypertension.

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Capsaicin and pain

  • How to cite:  Hiura A .Post-orgasmic New Daily Persistent Headache in a Patient with Hemochromatosis and Idiopathic Intracranial Hypertension Without Papilledema[Review of the article 'Post-Orgasmic New Daily Persistent Headache In a Patient With Hemochromatosis and Idiopathic Intracranial Hypertension Without Papilledema ' by Jacome D].WebmedCentral 2012;3(12):WMCRW002368
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  • What are the main claims of the paper and how important are they?

    A woman with hemochromatosis develops a post-orgasmic new daily persistent headache who also has pseudotumor cerebri (without papilledema).


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    Yes


  • Are the claims properly placed in the context of the previous literature?

    Yes


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    NA


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    NA


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    NA


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    It is an interesting report.


  • Other Comments:

    This is an interesting report on a woman with hemochromatosis who developed new daily persistent headache following a single orgasm and was also found to have pseudotumor cerebri. The association of primary post-orgasmic new daily persistent headache, hemochromatosis and pseudotumor cerebri seems to be unique. As the author notes, there has been reported associations between hemochromatosis and cephagia, independent of orgasmic headaches. The reported meningioma is most likely incidental. I would like confirmation that the opening pressure (OP) on the lumbar puncture was taken in the standard lateral decubitus position. I would also have liked to actually see the MRV images. It is unclear to me if the patient actually did have additional pseudotumor cerebri as the OP was only measured once and there is no mention of any papilledema (in fact there was an absence of this), absent spontaneous venous pulsation, enlarged blind spot, transient visual obscurations, pulsatile tinnitus, etc. (also, the protein in the CSF tends to be low in this condition, not elevated as in the reported patient and as per the modified Dandy criteria the CSF composition should actually be normal) (please see: Case Report Otolaryngol. 2012;2012:814696. Epub 2012 Aug 9.) Nonetheless it's an interesting paper and the discussion sections raises some interesting possibilities.

  • Competing interests:
    No
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    General Neurology.

  • How to cite:  Rison R A.Post-Orgasmic New Daily Persistent Headache In a Patient With Hemochromatosis and Idiopathic Intracranial Hypertension Without Papilledema[Review of the article 'Post-Orgasmic New Daily Persistent Headache In a Patient With Hemochromatosis and Idiopathic Intracranial Hypertension Without Papilledema ' by Jacome D].WebmedCentral 2012;3(12):WMCRW002365
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