Current Pain and Headache Reports

, Volume 9, Issue 2, pp 135–140

Cluster headache: Diagnosis and treatment

  • Todd D. Rozen
Article

Abstract

Cluster headache is a primary headache syndrome that is underdiagnosed and in many instances undertreated. The pain produced during a cluster headache is more severe than that generated by any other primary headache. Cluster headache is very stereotyped in its presentation and fairly easy to diagnose with an in depth headache history. Cluster headache is easy to treat in most individuals if the correct medications are used and the correct dosages are given. The following manuscript presents information on the clinical presentation of cluster headache and both medicinal and surgical interventions.

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References and Recommended Reading

  1. 1.
    Klapper JA, Klapper A, Voss T: The misdiagnosis of cluster headache: a nonclinic, population-based, Internet survey. Headache 2000, 40:730–735. This is an important study stating the magnitude of misdiagnosis of cluster headache in the United States.PubMedCrossRefGoogle Scholar
  2. 2.
    Vingen JV, Pareja JA, Sovner LJ: Quantitative evaluation of photophobia and phonophobia in cluster headache. Cephalalgia 1998, 18:250–256.PubMedCrossRefGoogle Scholar
  3. 3.
    Nappi G, Micieli G, Cavallini A, et al.: Accompanying symptoms of cluster headache: their relevance to the diagnostic criteria. Cephalagia 1992, 3:165–168.CrossRefGoogle Scholar
  4. 4.
    Kudrow L: Cluster headache: diagnosis and management. Headache 1979, 19:142–150.PubMedCrossRefGoogle Scholar
  5. 5.
    Ekbom K: Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991, 325:322–326.CrossRefGoogle Scholar
  6. 6.
    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
  7. 7.
    van Vliet JA, Bahra A, Martin V: Intranasal sumatriptan is effective in the treatment of acute cluster headache-a doubleblind placebo-controlled crossover study. Cephalagia 2001, 21:267–272.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.
    Kudrow L: Response of cluster headache attacks to oxygen inhalation. Headache 1981, 21:1–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Rozen TD, Niknam R, Shechter AL, et al.: Gender differences in clinical characteristics and treatment response in cluster headache patients. Cephalalgia 1999, 19:323.Google Scholar
  11. 11.
    Rozen TR: High oxygen flow rates for cluster headache. Neurology 2004, 63:593.PubMedGoogle Scholar
  12. 12.
    Disabato F, Fusco BM, Pelaia P, Giacovazzo M: Hyperbaric oxygen therapy in cluster headache. Pain 1993, 52:245.CrossRefGoogle Scholar
  13. 13.
    Ekbom K, Hardebo JE: Cluster headache: aetiology, diagnosis and management. Drugs 2002, 62:61–69.PubMedCrossRefGoogle Scholar
  14. 14.
    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 Cluster Headache and Related Conditions. Edited by Olesen J, Goadsby PJ. Oxford, UK: Oxford University Press; 1999:296–299.Google Scholar
  15. 15.
    Bussone G, Leone M, Peccarisi C: Double blind comparison of lithium and verapamil in cluster headache prophylaxis. Headache 1990, 30:411–417.PubMedCrossRefGoogle Scholar
  16. 16.
    Steiner TJ, Hering R, Couturier EG, et al.: Double-blind placebo-controlled trial of lithium in episodic cluster headache. Cephalagia 1997, 17:673–675.CrossRefGoogle Scholar
  17. 17.
    Freitag FG, Diamond S, Diamond ML, et al.: Divalproex sodium in the preventative treatment of cluster headache. Headache 2000, 40:408.Google Scholar
  18. 18.
    El Amrani M, Massiou H, Bousser MG: A negative trial of sodium valproate in cluster headache: methodological issues. Cephalalgia 2002, 22:205–208.PubMedCrossRefGoogle Scholar
  19. 19.
    Lainez MJ, Pascual J, Pascual AM, et al.: Topiramate in the prophylactic treatment of cluster headache. Headache 2003, 43:784–789. Topiramate is a newer antiepileptic compound that has shown efficacy in migraine headache; cluster headache; and short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) syndrome. The dosage needed to treat cluster headache appears to be lower than that needed to treat migraine.PubMedCrossRefGoogle Scholar
  20. 20.
    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
  21. 21.
    Peres MF, Rozen TD: Melatonin in the preventive treatment of chronic cluster headache. Cephalalgia 2001, 21:993–995.PubMedCrossRefGoogle Scholar
  22. 22.
    Pringsheim T, Magnoux E, Dobson CF, et al.: Melatonin as adjunctive therapy in the prophylaxis of cluster headache: a pilot study. Headache 2002, 42:787–792.PubMedCrossRefGoogle Scholar
  23. 23.
    Leone M, Franzini A, Broggi G, Bussone G: Hypothalamic deep brain stimulation for intractable chronic cluster headache: a 3-year follow-up. Neurol Sci 2003, 24(Suppl 2):S143-S145. This article details an exciting new surgical treatment option for cluster headache. It suggests that truly understanding pathogenesis can lead to new treatment approaches.PubMedGoogle Scholar
  24. 24.
    May A, Bahra A, Buchel C, et al.: Hypothalamic activation in cluster headache attacks. Lancet 2001, 352:275–278. This is an important article suggesting a hypothalamic generator for cluster headache.CrossRefGoogle Scholar

Copyright information

© Current Science Inc 2005

Authors and Affiliations

  • Todd D. Rozen
    • 1
  1. 1.Michigan Head-Pain and Neurological InstituteAnn ArborUSA

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