Cluster Headache

Clinical Description

Repetitive episodes of excruciating headache typically of short duration (up to 2 hours) in clusters for weeks to months at a time. Typically, the headache is of sudden onset, unilateral during the specific cluster, and quickly reaches a climax. Associated redness of the eye with lacrimation and rhinorrhea occurs.

Pharmacological

Oxygen inhalation may abort some episodes. Analgesics are ineffective in this indication.

To induce rapid remission in patients with episodic cluster headache:

• Prednisone, oral, 40 mg q24h for 5-10 days. Tapering is not necessary when the above duration is used.

Or

• Verapamil, oral, 40 to 80 mg 8 hourly

Complications and Referral Criteria

• When the is inadequate response to treatment.