Caffeine-withdrawal headache induced by hemodialysis

• DOI: 10.1007/s10194-009-0119-1
• Publication Date: 2009-04-14T15:14:40Z
• Authors: Petar M. Nikić; Jasna Zidverc-Tra...; Branislav Andrić; Marija Milinković; Biljana Stojimirović
• Keywords: Pain Threshold; Ultrasonography, Doppler, Transcranial; Clinical Neurology; Headache; Case Report; Middle Aged; Coffee; Substance Withdrawal Syndrome; 3. Good health; 03 medical and health sciences; Anesthesiology and Pain Medicine; 0302 clinical medicine; Renal Dialysis; Caffeine; Cerebrovascular Circulation; Disease Progression; Humans; Central Nervous System Stimulants; Female; Kidney Diseases; Pain Measurement

Caffeine is the most widely used psychoactive substance, and caffeinated beverages enjoy immense popularity around the world. Temporal abstinence from caffeine in habitual users results in the well-characterized withdrawal syndrome, consisting mainly of headache, fatigue, tiredness and decreased alertness. The formal diagnostic criteria for caffeine-withdrawal headache (CWH) were given in the International Classification of Headache Disorders, 2nd edition (ICHD-II). According to these criteria, the headache is bilateral and/or pulsating, occurs when intake is interrupted or delayed in person with caffeine consumption of C200 g/day for [2 weeks, develops within 24 h after last caffeine intake and is relieved within 1 h by 100 mg of caffeine. The obligatory criterion, as for the other secondary headaches, is the improvement or resolution of headache after relief from the causative disorder, e.g. that this headache resolves within 7 days after total caffeine withdrawal. There is a comment on the possibility of this syndrome in patients on dialysis who consume large quantities of caffeine [1, 2]. We report a case of patient on hemodialysis (HD) with CWH. To our best knowledge, there is no published case report on that subject in medical literature.