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Oxygen as an abortive therapy in cluster headache: a narrative review and clinical practice aspects

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Abstract

Cluster headache (International Classification of Headache Disorders third edition, ICHD-3 3.1) is a primary headache disorder affecting around 0.12% of individuals. It is characterized by severe headache attacks causing significant negative impact on the lives of patients. While administration of 100% oxygen is considered to be the first-choice acute treatment, undertreatment also exists. Reasons for undertreatment may entail problems with the correct prescription of oxygen, reimbursement issues or the practical implementation of home oxygen therapy. The aim of this manuscript is to review the scientific evidence on oxygen therapy for cluster headache and provide a practical guidance for both physicians and patients to optimize its use in an acute setting. The current evidence of the administration of 100% oxygen as a safe and effective treatment for cluster headache is strong. Based on several clinical trials and surveys, the recommended flow rates range between 12 and 15 L/min via a non-rebreathing mask, for at least fifteen minutes. The frequency of cluster headache attacks and thus the need for acute treatment can be very high. Fortunately, the Belgian social security system provides a full and lifetime reimbursement of oxygen therapy for cluster headache if the diagnosis and the need for this therapy has been certified by a neurologist, neurosurgeon or neuropsychiatrist.

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Acknowledgements

The authors would like to thank Lukas Nollet, resident Internal Medicine, for his appreciated contribution to this article.

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Authors and Affiliations

  1. Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium

    Julie Van Houtte, Nicolas Vandenbussche & Koen Paemeleire

  2. Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium

    Eric Derom

  3. Headache Research Unit, Department of Neurology, University of Liège, Liège, Belgium

    Jean Schoenen

  4. Department of Neurology, Brussels University Hospital, Jette, Belgium

    Jan Versijpt

Authors
  1. Julie Van Houtte
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  2. Nicolas Vandenbussche
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  3. Eric Derom
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  4. Jean Schoenen
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  5. Jan Versijpt
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  6. Koen Paemeleire
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Correspondence to Julie Van Houtte.

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Van Houtte, J., Vandenbussche, N., Derom, E. et al. Oxygen as an abortive therapy in cluster headache: a narrative review and clinical practice aspects. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02506-z

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