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Cluster headache: present and future therapy.

Massimo Leone1, Alessandro Giustiniani2, Alberto Proietti Cecchini2

  • 1Department of Neurology and Headache Centre, Fondazione Istituto Nazionale Neurologico 'Carlo Besta', Via Celoria 11, 20133, Milan, Italy. leone@istituto-besta.it.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|May 21, 2017
PubMed
Summary
This summary is machine-generated.

Cluster headache involves severe, unilateral attacks needing rapid treatment. Current options include sumatriptan injections, preventative verapamil or carbolithium, and emerging CGRP monoclonal antibodies.

Keywords:
CGRPCluster headacheDrugsNeurostimulationTreatment

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Area of Science:

  • Neurology
  • Pain Medicine

Background:

  • Cluster headache presents as severe, unilateral orbital, supraorbital, or temporal pain attacks.
  • Attacks are accompanied by ipsilateral cranial autonomic symptoms like lacrimation and rhinorrhea.
  • The rapid pain escalation necessitates fast-acting abortive treatments.

Purpose of the Study:

  • To review current and emerging treatments for cluster headache.
  • To highlight acute, preventative, and neurostimulation strategies.

Main Methods:

  • Review of established and investigational therapies for cluster headache.
  • Discussion of pharmacological and neurostimulation approaches.

Main Results:

  • Sumatriptan injection is the gold standard for acute cluster headache treatment.
  • Verapamil and carbolithium are first-line preventative medications.
  • Topiramate, valproic acid, gabapentin, steroids, and CGRP monoclonal antibodies show promise.
  • Neurostimulation techniques are options for chronic intractable cases.

Conclusions:

  • Effective acute and preventative treatments exist for cluster headache.
  • Novel therapies like CGRP monoclonal antibodies and neurostimulation offer new hope.
  • Treatment choice depends on headache type (episodic vs. chronic) and severity.