Cluster headache: state of the art in treatment

Frontiers in Pain Research

Pain Research

Agustín Melo-Carrillo¹  Silvia García²  Adriana Patricia Martínez-Mayorga³  Rubén Dario Vargas-García⁴  Erwin Chiquete⁵  Ildefonso Rodriguez-Leyva⁶  Marco Martinez-Gurrola⁷  Jorge Villareal-Careaga⁸  Maria-Karina Velez-Jimenez⁹  Daniel San-Juan^1,10  Alejandro Marfil^1,11  Paul David Uribe-Jaimes^1,12  Miguel Angel Collado-Ortiz^1,12  Juan Alberto Nader-Kawachi^1,13  Humberto Juárez-Jimenez^1,14  Manuel Gudiño-Castelazo^1,15 

[1] Anesthesia Department, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States;Clinical Research Department, Centro Médico Nacional “20 de Noviembre,” ISSSTE, Mexico City, Mexico;Departament of Neurophysiology, Universidad Autónoma de San Luis Potosí, San Luis Potosi, Mexico;Department of Neurology and Psychiatry, Clínica de Merida, Merida, Mexico City, Mexico;Department of Neurology and Psychiatry, National Institute of Medical Science and Nutrition “Salvador Zubirán,”, Mexico City, Mexico;Department of Neurology, Faculty of Medicine, Central Hospital “Dr. Ignacio Morones Prieto,”, Universidad Autónoma de San Luis Potosi, San Luis Potosi, Mexico;Department of Neurology, General Hospital 450 Durango, Mexico City, Mexico;Department of Neurology, General Hospital of Culiacan, Culiacan, Mexico;Department of Neurology, Hospital Angeles Lomas, Mexico City, Mexico;Epilepsy Clinic of the National Institute of Neurology and Neurosurgery Manuel Velazco Suarez, Mexico City, Mexico;Headache and Chronic Pain Clinic, Neurology Service, Hospital Universitario “Dr. J. E. González” of the Universidad Autónoma de Nuevo Leon, Monterrey, Mexico;Neurological Center, ABC Medical Center, Mexico City, Mexico;Neurology and Neurosurgery Center, Médica Sur Hospital, Mexico City, Mexico;Neurology, Médica Sur Hospital, Mexico City, Mexico;Star Medica Group, Star Medica Hospital Lomas Verdes, Mexico City, Mexico;

关键词: cluster headache;    treatment;    clinical trials;    drugs;    neuromodulation;   

DOI  :  10.3389/fpain.2023.1265540

 received in 2023-07-23, accepted in 2023-09-29,  发布年份 2023

来源: Frontiers

【 摘 要 】

Cluster headache (CH) is the most common and devastating autonomic headache with multiple and recent advances in treatment. However, it usually goes unrecognized and is found to have a delayed and inappropriate treatment. This paper aims to review the current therapeutic options for patients with CH. We conducted a narrative literature review on the treatments available for this condition using the American Academy of Neurology (AAN) classification of therapeutic evidence. We found effective and safe pharmacological and non-pharmacological therapies with heterogeneity of clinical trial designs for patients with CH, and they are divided into three phases, namely, transitional, acute, and preventive interventions. Prednisone (A) is the most studied treatment in the transitional phase; acute attacks are treated using triptans (A), oxygen (A), and non-invasive transcutaneous vagal nerve stimulation (A). Verapamil (A) and monoclonal antibodies (possible A) are considered the first options in preventive treatments, followed by multiple pharmacological and non-pharmacological options in prophylactic treatments. In conclusion, numerous effective and safe treatments are available in treating patients with episodic, chronic, and pharmacoresistant CH according to the clinical profile of each patient.

【 授权许可】

Unknown   
© 2023 Rodriguez-Leyva, Velez-Jimenez, García, Nader-Kawachi, Martínez-Mayorga, Melo-Carrillo, Juárez-Jimenez, Martinez-Gurrola, Gudiño-Castelazo, Chiquete, Villareal-Careaga, Marfil, Uribe-Jaimes, Vargas-García, Collado-Ortiz and San-Juan.