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Published on: June 2, 2014
[Treatment of cluster headache]
1Service de Neurologie, Hôpital Rangueil, Toulouse, France.
Revue Neurologique
|September 6, 2005
Summary
Recent advances offer new treatments for trigemino-autonomic cephalalgias. While current therapies for cluster headache include sumatriptan and oxygen, novel non-vasoconstrictive options are emerging, alongside established verapamil and lithium for prevention.
Area of Science:
- Neurology
- Pharmacology
Context:
- Trigemino-autonomic cephalalgias (TACs) represent a group of debilitating headache disorders.
- Cluster headache and SUNCT syndrome are primary examples of TACs with significant unmet treatment needs.
Purpose:
- To review recent therapeutic advancements in the management of TACs.
- To evaluate the efficacy and limitations of current and emerging treatments for cluster headache and SUNCT.
Summary:
- Current cluster headache attack treatment relies on sumatriptan and oxygen, with non-vasoconstrictive therapies on the horizon. Prophylaxis involves verapamil and lithium; anti-epileptic drug efficacy is unproven.
- Surgical interventions for TACs show limited success due to recurrence and adverse events. Hypothalamic stimulation is a promising breakthrough but requires further large-scale validation.
- Indomethacin remains the standard for paroxysmal hemicrania. Lamotrigine, topiramate, and gabapentin show potential for previously intractable SUNCT.
Impact:
- This review highlights the evolving landscape of TAC treatment, emphasizing the need for more effective and safer therapeutic options.
- The findings underscore the potential of novel approaches like hypothalamic stimulation and specific anti-epileptic drugs for refractory cases.
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