Cluster headache

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By Peter J Goadsby MD PhD

Cluster headache is also known as or subsumes Ciliary neuralgia, Hemicrania periodic neuralgiform, Histaminic cephalalgia, Migrainous neuralgia, Sphenopalatine ganglion neuralgia, and Vidian neuralgia. -ed.

Key points

  • Cluster headache is a relatively common, very severe form of primary headache that belongs to the family of trigeminal autonomic cephalalgias.
  • Cluster headache involves dysfunction of central nervous system elements concerned with pain control and with links to circadian and circannual mechanisms.
  • Acute cluster headache can be treated with oxygen, intranasal triptans (sumatriptan and zolmitriptan), and injected sumatriptan.
  • Medicines or strategies useful in the preventive management of cluster headache include verapamil, lithium, methysergide, corticosteroids, topiramate, and melatonin.