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[Cluster headache and chronic paroxysmal hemicrania: current therapy]
T Brandt1, W Paulus, W Pöllmann
1Neurologische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
Der Nervenarzt
|June 1, 1991
Summary
Acute cluster headache (CH) treatments include oxygen and local anesthetics. Newer drugs offer improved safety and efficacy for episodic and chronic CH, reducing the need for older therapies and surgical interventions.
Area of Science:
- Neurology
- Pharmacology
Context:
- Cluster headache (CH) presents unique challenges in acute attack management and long-term prevention.
- Traditional treatment guidelines for CH are evolving due to new therapeutic options.
Purpose:
- To review current and emerging pharmacological treatments for acute and preventive management of cluster headache.
- To highlight advancements in CH therapy, emphasizing reduced side effects and improved efficacy.
Summary:
- Acute CH attacks are managed with oxygen, ergotamine aerosol, or intranasal anesthetics.
- For episodic CH, steroids and verapamil are now first-line, with methysergide as second-line.
- Chronic CH treatment involves verapamil and lithium, with steroids as second-line; valproic acid and budipine are alternatives for resistant cases. Indomethacin is primary for chronic paroxysmal hemicrania.
Impact:
- Updated treatment strategies offer better outcomes and tolerability for cluster headache patients.
- The efficacy of new drugs diminishes the necessity for invasive surgical procedures in CH management.
- Advances simplify treatment decisions, reducing the emphasis on differentiating between episodic and chronic CH subtypes.