Cluster headache

Cluster headache

Clinical Features:-

1. Severe episodic unilateral periorbital (intense/sharp) pain; attacks lasting 15 minutes to 3

hours with spontaneous remission; worsened by alcohol and during night; men being 10 times

affected as compared to women.

2. P/E shows autonomic symptoms (e.g. ipsilateral horner syndrome; nasal stuffiness/rhinorrhea; eye reddening with lacrimation).

Treatment:-

A. Abortive therapy:- 

1. 100% of oxygen(1st line agents).

2. Triptans (e.g. intranasal sumatriptan 20 mg/ subcutaneous sumatriptan 20 mg) or Ergotamines.

B. Preventive therapy(Prophylaxis):- Verapamil (1st line therapy); Corticosteroids, Sodium

valproate, Lithium (2nd line therapy)

Figure:- ICHD-3 differential diagnosis - cluster headache