Cluster Headaches

  • Medical Author:
    Danette C. Taylor, DO, MS, FACN

    Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

View the Headaches and Migraines Slideshow Pictures

Quick GuideHeadache Pictures Slideshow: Surprising Headache and Migraine Triggers

Headache Pictures Slideshow: Surprising Headache and Migraine Triggers

What is the treatment for cluster headaches?

The treatment of cluster headache can be divided into two distinct categories -- relief of the acute headache and prevention of future headaches. Oxygen delivered by face mask has been shown to help a majority of patients within a short period of time. However, this can be unwieldy, and most patients are unable or unwilling to transport oxygen canisters if they need to travel. Injectable sumatriptan has been shown to be beneficial in many of patients with cluster headache. This treatment is contraindicated in patients with cardiac disease or untreated hypertension. Nasal spray or oral versions of this medication have been less effective than the injectable. Dihydroergotamine, given intravenously, can be extremely effective in treating a cluster headache, but can be difficult to administer acutely and cannot be used if a patient has used sumatriptan in the preceding 24 hours. Intranasal lidocaine has been suggested as a treatment option, but must be administered in a specific manner and is ineffective if not given correctly.

Steroids can be extremely effective to decrease a headache cycle; these can be used infrequently and are for short-term use only as long-term use can lead to significant complications. Verapamil, lithium, valproic acid, topiramate, and melatonin can all be of benefit in reducing the frequency and severity of cluster cycles. In intractable cases, surgery has been suggested. Radiofrequency lesioning of the trigeminal ganglion can decrease cluster headache frequency, but is associated with significant side effects and nerve loss; gamma knife lesioning and deep brain stimulation are being studied as possible options with less risk of permanent nerve change.

Medically Reviewed by a Doctor on 2/2/2015
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