Current Neurology and Neuroscience Reports

, Volume 2, Issue 2, pp 114–121

New treatments in cluster headache

  • Todd D. Rozen


Cluster headache is the most severe headache syndrome known to humans. In most instances, this disorder is readily treatable when the correct medications are utilized at the correct dosages. Cluster treatment involves abortive, transitional, and preventive therapy strategies, all of which are discussed in this article.


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References and Recommended Reading

  1. 1.
    Kudrow L: Response of cluster headache attacks to oxygen inhalation. Headache 1981, 21:1–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Rozen TD, Niknam R, Shechter AL, Young WB, Silberstein SD: Gender differences in clinical characteristics and treatment response in cluster headache patients. Cephalalgia 1999,19:323.Google Scholar
  3. 3.
    Disabato F, Fusco BM, Pelaia P, Giacovazzo M: Hyperbaric oxygen therapy in cluster headache. Pain 1993, 52:245CrossRefGoogle Scholar
  4. 4.
    Ekbom K: Treatment of acute cluster headache with sumaptriptan. N Engl J Med 1991, 325:322–326.CrossRefGoogle Scholar
  5. 5.
    Ekbom K, Krabbe A, Micieli G, et al.: Cluster headache attacks treated for up to three months with subcutaneous sumatriptan (6mg) (Sumatriptan Long-Term Study Group). Cephalalgia 1995, 15:230–236.PubMedCrossRefGoogle Scholar
  6. 6.
    Gobel H, Lindner V, Heinze A, et al.: Acute therapy for cluster headache with sumatriptan: findings of a one-year long-term study. Neurology 1998, 51:908–911.PubMedGoogle Scholar
  7. 7.
    Hardebo JE, Dahlof C: Sumatriptan nasal spray (20mg/dose) in the acute treatment of cluster headache. Cephalagia 1998, 18:487–489.CrossRefGoogle Scholar
  8. 8.
    Hering-Hanit R: Alteration in nature of cluster headache during subcutaneous administration of sumatriptan. Headache 2000, 40:41–44.PubMedCrossRefGoogle Scholar
  9. 9.
    Andersson PG, Jespersen LT: Dihydroergotamine nasal spray in the treatment of attacks of cluster headache. Cephalalgia 1986, 6:51–54.PubMedCrossRefGoogle Scholar
  10. 10.
    Bahra A, Becker WJ, Blau JN: Efficacy of oral zolmitriptan in the acute treatment of cluster headache. Cephalalgia 1999, 19:457. First report of an oral triptan working in cluster headache.Google Scholar
  11. 11.
    Rozen TD: Olanzapine as an abortive agent for cluster headache. Headache 2001, 41:813–816. New possible abortive therapy for cluster headache patients who have contraindications to vasoconstrictive compounds and who have failed oxygen treatmentPubMedCrossRefGoogle Scholar
  12. 12.
    Kudrow L: Cluster Headache: Mechanisms and Management. London: Oxford University Press; 1980.Google Scholar
  13. 13.
    Anthony M, Daher BN: Mechanisms of action of steroids in cluster headache. In New Advances in Headache Research 2. Edited by Rose FC. London: Smith Gordon; 1992:271–274Google Scholar
  14. 14.
    Mather PJ, Silberstein SD, Schulman EA, et al.: The treatment of cluster headache with repetitive intravenous dihydroergotamine. Headache 1991, 31:525–532.PubMedCrossRefGoogle Scholar
  15. 15.
    Anthony M: Arrest of attacks of cluster headache by local steroid injection of the occipital nerve. In Migraine. Edited by Rose CF. Basel: Karger; 1985:169–173.Google Scholar
  16. 16.
    Mitsias PD, Norris L, Junn F: Greater occipital nerve block for intractable cluster headache. Cephalalgia 2001, 21:502.Google Scholar
  17. 17.
    Bussone G, Leone M, Peccarisi C: Double blind comparison of lithium and verapamil in cluster headache prophylaxis. Headache 1990, 30:411–417.PubMedCrossRefGoogle Scholar
  18. 18.
    Leone M, D’Amico D, Attanasio A, et al.: Verapamil is an effective prophylactic for cluster headache: results of a double blind multicenter study versus placebo. In In Cluster: Headache and Related Conditions. Edited by Oelsen J, Goadsby PJ. Oxford: Oxford University Press; 1999:296–299.Google Scholar
  19. 19.
    Steiner TJ, Hering R, Couturier EG, Davies PT, Whitmarsh TE: Double-blind placebo-controlled trial of lithium in episodic cluster headache. Cephalalgia 1997, 17:673–675.PubMedCrossRefGoogle Scholar
  20. 20.
    Curran DA, Hinterberger H, Lance JW: Methysergide. Res Clin Stud Headache 1967, 1:74–122.Google Scholar
  21. 21.
    Hering R, Kuritzky A: Sodium valproate in the treatment of cluster headache: an open clinical trail. Cephalalgia 1989, 9:195–198.PubMedCrossRefGoogle Scholar
  22. 22.
    Freitag FG, Diamond S, Diamond ML, Urban G, Peepr B: Divalproex sodium in the preventative treatment of cluster headache. Headache 2000, 40:408.Google Scholar
  23. 23.
    Wheeler S: Significance of migrainous features in cluster headache: divalproex responsiveness. Headache 1998, 53:234–236.Google Scholar
  24. 24.
    Wheeler S, Carrazana EJ: Topiramate-treated cluster headache. Neurology 1999, 53:234–236. Topiramate appears to be an exciting new preventive therapy for cluster headache. Dosages needed to prevent cluster appear to be less than dosages needed to prevent migraine.PubMedGoogle Scholar
  25. 25.
    Lainez MJ, Pascual J, Santonja JM, et al.: Topiramate in the prophylactic treatment of cluster headache. Cephalalgia 2001, 21:500.Google Scholar
  26. 26.
    Leone M, Damico D, Moschiano F, et al.: Melatonin versus placebo in the prophylaxis of cluster headache: a double blind pilot study with parallel groups. Cephalalgia 1996, 16:494–496.PubMedCrossRefGoogle Scholar
  27. 27.
    Mulder LJ, Spierings EL: Naratriptan in the preventive treatment of cluster headache. Cephalalgia 2001, 21:501.Google Scholar
  28. 28.
    Mathew NT, Hurt W: Percutaneous radiofrequency trigeminal gangliorhizolysis. Headache 1988, 328–331.Google Scholar
  29. 29.
    Taha JM, Tew JM: Long-term results of radiofrequency rhizotomy in the treatment of cluster headache. Headache 1995, 35:193–196.PubMedCrossRefGoogle Scholar
  30. 30.
    Pieper DR, Dickerson J, Hassenbusch SJ: Percutaneous retrogasserian glycerol rhizolysis for treatment of chronic intractable cluster headaches: long-term results. Neurosurgery 2000, 46:363–368.PubMedCrossRefGoogle Scholar
  31. 31.
    Jarrar RG, Dodick DW, Davis DH: Outcome of trigeminal nerve section in the treatment of chronic cluster headache. Cephalalgia 2001, 21:499.Google Scholar
  32. 32.
    Lovely TJ, Kotsiakis X, Jannetta PJ: The surgical management of chronic cluster headache. Headache 1998, 38:590–594.PubMedCrossRefGoogle Scholar
  33. 33.
    Ford RG, Ford KT, Swaid S, et al.: Gamma knife treatment of refractory cluster headache. Headache 1998, 38:1–9.CrossRefGoogle Scholar
  34. 34.
    Leone M. Franzini A, D’Amico D, Grazzi L: Intractable chronic cluster headache relieved by electrode implant to posterior hypothalamus. Cephalalgia 2001, 21:503. Very exciting new surgical technique for cluster headache based on the hypothalamic generator theory. It will need more scrutiny before it becomes mainstream therapy.Google Scholar
  35. 35.
    May A, Bahra A, Buchel C, et al.: Hypothalamic activation in cluster headache attacks. Lancet 1998, 352:275–278. Positron emission tomography scan investigation demonstrating hypothalamic activation during a nitroglycerin-triggered cluster attack. A very important headache study, it is helping us to better understand cluster pathogenesis.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2002

Authors and Affiliations

  • Todd D. Rozen
    • 1
  1. 1.Department of Neurology T33Cleveland Clinic FoundationClevelandUSA

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