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Cluster headache--acute and prophylactic therapy.
Headache. 2011 Feb; 51(2):272-86.H

Abstract

Cluster headache (CH) pain is the most severe of the primary headache syndromes. It is characterized by periodic attacks of strictly unilateral pain associated with ipsilateral cranial autonomic symptoms. The majority of patients have episodic CH, with cluster periods that typically occur in a circannual rhythm, while 10% suffer from the chronic form, with no significant remissions between cluster periods. Sumatriptan injection or oxygen inhalation is the first-line therapy for acute CH attacks, with the majority of patients responding to either treatment. The calcium channel blocker verapamil is the drug of choice for CH prevention. Other drugs that may be used for this purpose include lithium carbonate, topiramate, valproic acid, gabapentin, and baclofen. Transitional prophylaxis, most commonly using corticosteroids, helps to control the attacks at the beginning of a cluster period. Peripheral neural blockade is effective for short-term pain control. Recently, the therapeutic options for refractory CH patients have expanded with the emergence of both peripheral (mostly occipital nerve) and central (hypothalamic) neurostimulation. With the emergence of these novel treatments, the role of ablative surgery in CH has declined.

Authors+Show Affiliations

The Neurologic Group of Bucks/Montgomery County-Neurology, Doylestown, PA 18901, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21284609

Citation

Ashkenazi, Avi, and Todd Schwedt. "Cluster Headache--acute and Prophylactic Therapy." Headache, vol. 51, no. 2, 2011, pp. 272-86.
Ashkenazi A, Schwedt T. Cluster headache--acute and prophylactic therapy. Headache. 2011;51(2):272-86.
Ashkenazi, A., & Schwedt, T. (2011). Cluster headache--acute and prophylactic therapy. Headache, 51(2), 272-86. https://doi.org/10.1111/j.1526-4610.2010.01830.x
Ashkenazi A, Schwedt T. Cluster Headache--acute and Prophylactic Therapy. Headache. 2011;51(2):272-86. PubMed PMID: 21284609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cluster headache--acute and prophylactic therapy. AU - Ashkenazi,Avi, AU - Schwedt,Todd, PY - 2011/2/3/entrez PY - 2011/2/3/pubmed PY - 2011/4/1/medline SP - 272 EP - 86 JF - Headache JO - Headache VL - 51 IS - 2 N2 - Cluster headache (CH) pain is the most severe of the primary headache syndromes. It is characterized by periodic attacks of strictly unilateral pain associated with ipsilateral cranial autonomic symptoms. The majority of patients have episodic CH, with cluster periods that typically occur in a circannual rhythm, while 10% suffer from the chronic form, with no significant remissions between cluster periods. Sumatriptan injection or oxygen inhalation is the first-line therapy for acute CH attacks, with the majority of patients responding to either treatment. The calcium channel blocker verapamil is the drug of choice for CH prevention. Other drugs that may be used for this purpose include lithium carbonate, topiramate, valproic acid, gabapentin, and baclofen. Transitional prophylaxis, most commonly using corticosteroids, helps to control the attacks at the beginning of a cluster period. Peripheral neural blockade is effective for short-term pain control. Recently, the therapeutic options for refractory CH patients have expanded with the emergence of both peripheral (mostly occipital nerve) and central (hypothalamic) neurostimulation. With the emergence of these novel treatments, the role of ablative surgery in CH has declined. SN - 1526-4610 UR - https://www.unboundmedicine.com/medline/citation/21284609/Cluster_headache__acute_and_prophylactic_therapy_ L2 - https://doi.org/10.1111/j.1526-4610.2010.01830.x DB - PRIME DP - Unbound Medicine ER -