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Cluster headache: clinical features and therapeutic options.
Charly Gaul1, Hans-Christoph Diener, Oliver M Müller
1Klinik und Poliklinik für Neurologie, Westdeutsches Kopfschmerzzentrum,Universitätsklinikum Essen. Charly.Gaul@gmx.de
Deutsches Arzteblatt International
|September 14, 2011
Summary
Effective treatments for cluster headache, a severe neurological condition, include oxygen and triptans for acute attacks. Medications like verapamil and cortisone are used for prevention, with advanced options available for severe cases.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Cluster headache is a prevalent trigemino-autonomic headache affecting approximately 120,000 individuals in Germany.
- Characterized by severe unilateral periorbital pain, attacks average 90 minutes and include autonomic symptoms and restlessness.
- Episodic and chronic forms exist, with chronic cluster headache significantly impacting quality of life and often exhibiting circadian and seasonal patterns.
Purpose of the Study:
- To review current literature on cluster headache treatment.
- To outline effective acute and prophylactic therapies.
- To discuss advanced and invasive treatment options for refractory cases.
Main Methods:
- A selective literature review was conducted.
- Evidence for various treatment modalities was evaluated.
Main Results:
- Oxygen inhalation and triptans are effective for acute cluster headache attacks.
- Verapamil and cortisone are first-line prophylactic drugs; lithium and topiramate are alternatives.
- Invasive options like occipital nerve stimulation and deep brain stimulation are available for treatment-resistant patients.
Conclusions:
- Pharmacotherapy is effective for most patients with cluster headache, both for acute attacks and prophylaxis.
- For the minority unresponsive to drug treatment, invasive techniques offer potential relief.
- Further research is needed to definitively establish the value of newer invasive treatments.
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