Understanding the enigma of cluster headaches

2021 ◽  
Vol 17 (1) ◽  
pp. 21-23
Author(s):  
Mark Greener
Keyword(s):  
Cluster Headache ◽  
Biological Basis ◽  
Oral Steroids ◽  
Cluster Headaches ◽  
Headache Patients

Cluster headache is one of the most painful disorders and one of the most enigmatic. Why the condition is intimately associated with sleep remains unclear, for instance. Most cluster headache patients are managed inadequately, although recent insights into the condition's biological basis have identified potential targets for innovative treatments. Meanwhile, a new study provides long-awaited evidence supporting the use of oral steroids. Mark Greener elaborates.

scholarly journals Clomiphene treatment may be effective in refractory episodic and chronic cluster headache

2017 ◽  
Vol 75 (9) ◽  
pp. 620-624 ◽  
Author(s):  
Maria Eduarda Nobre ◽  
Mario Fernando Prieto Peres ◽  
Pedro Ferreira Moreira Filho ◽  
Antonio José Leal
Keyword(s):  
Complete Remission ◽  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Free Time ◽  
Chronic Patients ◽  
Conventional Medication ◽  
Episodic Cluster Headache ◽  
Cluster Headaches ◽  
Headache Patients

ABSTRACT Objective To describe the evolution of 15 patients who were treated for difficult-to-control episodic and chronic cluster headaches with clomiphene. Methods Clomiphene treatment was used for seven chronic and eight episodic cluster headache patients. The chronic patients were refractory to the medication being used, and the episodic patients, in addition to being resistant to conventional medication, had longer cluster headache periods, exceeding the average time of previous cluster cycles. Our main analysis was of the time to pain-free, complete remission, and the length of pain-free time and complete remission. Results Clomiphene was used for 45-180 days. The average time to being pain-free was 15 days and cluster remission was up to 60 days. The average time between being pain-free until cluster remission was 26 days. Conclusions Clomiphene treatment was significantly efficient. It interrupted chronicity in all patients, suggesting the capability of changing the pattern of attacks. It proved to be safe and well tolerated.

Computerized tomography-guided sphenopalatine ganglion pulsed radiofrequency treatment in 16 patients with refractory cluster headaches: Twelve- to 30-month follow-up evaluations

Cephalalgia ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Luo Fang ◽  
Lu Jingjing ◽  
Shen Ying ◽  
Meng Lan ◽  
Wang Tao ◽  
...  
Keyword(s):  
Side Effects ◽  
Cluster Headache ◽  
Computerized Tomography ◽  
Sphenopalatine Ganglion ◽  
Pulsed Radiofrequency ◽  
Radiofrequency Treatment ◽  
Pulsed Radiofrequency Treatment ◽  
Cluster Headaches ◽  
Headache Patients

Background Sphenopalatine ganglion percutaneous radiofrequency thermocoagulation treatment can improve the symptoms of cluster headaches to some extent. However, as an ablation treatment, radiofrequency thermocoagulation treatment also has side effects. Objective To preliminarily evaluate the efficacy and safety of a non-ablative computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion in patients with refractory cluster headaches. Methods We included and analysed 16 consecutive cluster headache patients who failed to respond to conservative therapy from the Pain Management Center at the Beijing Tiantan Hospital between April 2012 and September 2013 treated with pulsed radiofrequency treatment of sphenopalatine ganglion. Results Eleven of 13 episodic cluster headaches patients and one of three chronic cluster headaches patient were completely relieved of the headache within an average of 6.3 ± 6.0 days following the treatment. Two episodic cluster headache patients and two chronic cluster headache patients showed no pain relief following the treatment. The mean follow-up time was 17.0 ± 5.5 months. All patients enrolled in this study showed no treatment-related side effects or complications. Conclusion Our data show that patients with refractory episodic cluster headaches were quickly, effectively and safely relieved from the cluster period after computerized tomography-guided pulsed radiofrequency treatment of sphenopalatine ganglion, suggesting that it may be a therapeutic option if conservative treatments fail.

Evaluation of interictal autonomic function during attack and remission periods in cluster headaches

Cephalalgia ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 37-43 ◽  
Author(s):  
Ozlem Altiokka ◽  
Belgin Mutluay ◽  
Ayhan Koksal ◽  
Beyza Ciftci-Kavaklioglu ◽  
Musa Ozturk ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Orthostatic Hypotension ◽  
Sympathetic Skin Response ◽  
Skin Response ◽  
The Face ◽  
Skin Responses ◽  
Cluster Headaches ◽  
Drug Free ◽  
Headache Patients ◽  
Sympathetic Skin Responses

Objective To investigate which part of the autonomic system is mainly involved and assess the sensitivity of face sympathetic skin response in cluster headache. Material and methods The study sample consisted of 19 drug-free cluster headache patients (16 males, three females) and 19 healthy volunteers. Demographic features and pain characteristics were thoroughly identified. Dysautonomic symptoms were evaluated during attack and remission periods of cluster headache patients. Orthostatic hypotension, R-R interval variation and sympathetic skin responses obtained from the face and four extremities were evaluated and the sensitivity of face sympathetic skin responses was assessed in contrast to extremity sympathetic skin responses. Results All sympathetic skin responses of face and extremities could be obtained during attack and remission periods. On the symptomatic side, mean latency of face sympathetic skin responses was longer compared to the asymptomatic side and controls (p = 0.02, p = 0.004). There were no differences in latency or amplitude of extremity sympathetic skin responses between symptomatic and asymptomatic sides and controls. No significant relationship was determined between sympathetic skin responses, R-R interval variation, orthostatic hypotension and cluster headache clinical features. Conclusion Sympathetic hypoactivity of the face seems to predominate the pathophysiology of cluster headache. Face sympathetic skin responses might be more sensitive compared to extremity sympathetic skin response in demonstrating dysautonomic symptoms in cluster headache patients.

Clinical profile of cluster headaches in Japan: Low prevalence of chronic cluster headache, and uncoupling of sense and behaviour of restlessness

Cephalalgia ◽  
2011 ◽  
Vol 31 (5) ◽  
pp. 628-633 ◽  
Author(s):  
Noboru Imai ◽  
Nobuyasu Yagi ◽  
Ryou Kuroda ◽  
Takashi Konishi ◽  
Masahiro Serizawa ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Age At Onset ◽  
Japanese Patients ◽  
Chronic Cluster Headache ◽  
Clinical Profile ◽  
Caucasian Patients ◽  
Cluster Headaches ◽  
Low Prevalence ◽  
Headache Patients

Introduction: This study examined the clinical profile of cluster headaches in Japan and the potential presence of features peculiar to Japan. Most previous studies of cluster headaches have focused on Caucasian populations. Methods: Subjects comprised 86 consecutive new cluster headache patients (68 males, 18 females; mean age, 38.4 ± 12.2 years; range, 17–73 years). Mean age at onset was 31.0 years and the ratio of males to females was 3.8:1. Results: Chronic cluster headache was observed in 3.5% of patients. More than half of patients (68.9%) reported feelings of restlessness during headache episodes and 42.9% reported restless behaviour. Patients with uncoupling of feelings of restlessness and restless behaviour forced themselves to keep still. Similar findings were reported in a Taiwanese study. Conclusion: Japanese patients in this study showed a relatively low prevalence of chronic cluster headaches, and uncoupling of a sense of restlessness and restless behaviour. These features of cluster headache may be more common in Japanese and Taiwanese patients than in Caucasian patients.

Increased Prevalence of Sensing Types in Men with Cluster Headaches

2000 ◽  
Vol 87 (2) ◽  
pp. 555-558 ◽  
Author(s):  
Loretta Mueller ◽  
R. Michael Gallahger ◽  
Robert A. Steer ◽  
Carman A. Ciervo
Keyword(s):  
Cluster Headache ◽  
Myers Briggs Type Indicator ◽  
Psychosomatic Symptoms ◽  
Psychological Types ◽  
Migraine Headaches ◽  
Type Indicator ◽  
Myers Briggs ◽  
Cluster Headaches ◽  
Headache Patients

To ascertain whether the percentage of men who suffer with cluster headaches and are classified as sensing types according to Jung's theory of psychological types was comparable to the percentage (74%) of Sensing types that was found by Gallagher, et al. among women who experience migraine headaches, the Myers-Briggs Type Indicator® was administered to 25 male cluster-headache patients. There were 19 (76%) male Sensing types, and this was comparable to the percentage of Sensing types for migrainous women. The results are discussed as supporting previous contentions that Sensing types may be prone to developing psychosomatic symptoms related to stress.

Old Age of Onset in Cluster‐Headache Patients

2005 ◽  
Vol 45 (5) ◽  
pp. 615-616 ◽  
Author(s):  
Marthe Fischera ◽  
Kerstin Anneken ◽  
Stefan Evers
Keyword(s):  
Cluster Headache ◽  
Old Age ◽  
Age Of Onset ◽  
Headache Patients

Somatosensory Evoked Potentials In Cluster Headache Patients Under Histamine Stimulation

Cephalalgia ◽  
1987 ◽  
Vol 7 (6_suppl) ◽  
pp. 347-348
Author(s):  
V. Gallai ◽  
C. Firenze ◽  
L. Mattelli ◽  
G. Mazzotta ◽  
F. Del Gatto
Keyword(s):  
Cluster Headache ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Histamine Stimulation ◽  
Headache Patients

scholarly journals Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

BMC Neurology ◽  
2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Delphine Magis ◽  
Marie-Aurélie Bruno ◽  
Arnaud Fumal ◽  
Pierre-Yves Gérardy ◽  
Roland Hustinx ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Fdg Pet ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Headache Patients
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