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Munchausenís Syndrome Presenting as Cluster Headache
Lawrence Robbins, M.D.
Posted: January 2003  
Headache Quarterly 2002; 13:121-122

Background:   The patient was a 23-year old female with typical symptoms of cluster headache that began shortly after a cervical trigger point injection for radicular pain. She underwent multiple hospitalizations, was frequently seen in outpatient facilities, and was given a number of cluster and migraine medications. She became well-versed in the textbook presentation of cluster headache. The patient displayed a very dramatic presentation of pain, but could be easily distracted from the pain. While it was suspected that she was using artificial tears to simulate tearing, this was not definitely confirmed. In addition, despite the patient claiming to have severe nausea and vomiting, actual vomiting was never witnessed by medical personnel.

Conclusions:   Antiemetics were unsuccessful in relieving her nausea. The patient craved attention, and was very persistent in attempting to be hospitalized. Psychological testing revealed weak coping mechanisms, depression, low frustration tolerance, and low self esteem.