Current and Novel Therapies for Cluster Headache: A Narrative Review
Abstract Cluster headache (CH) is an excruciating and debilitating primary headache disorder. The prevalence is up to 1.3%, and the typical onset is around age 30. Often misdiagnosed as migraine, particularly in children, the diagnosis rate of CH has been increasing among women. CH is characterized...
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| Language: | English |
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Adis, Springer Healthcare
2024-11-01
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| Series: | Pain and Therapy |
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| Online Access: | https://doi.org/10.1007/s40122-024-00674-7 |
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| author | Bruna de Freitas Dias Christopher L. Robinson Maria Dolores Villar-Martinez Sait Ashina Peter J. Goadsby |
| author_facet | Bruna de Freitas Dias Christopher L. Robinson Maria Dolores Villar-Martinez Sait Ashina Peter J. Goadsby |
| author_sort | Bruna de Freitas Dias |
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| description | Abstract Cluster headache (CH) is an excruciating and debilitating primary headache disorder. The prevalence is up to 1.3%, and the typical onset is around age 30. Often misdiagnosed as migraine, particularly in children, the diagnosis rate of CH has been increasing among women. CH is characterized by intense unilateral pain and autonomic symptoms, significantly impacting patients’ quality of life, mental health, and productivity. Genetic associations suggest a familial risk for developing CH, with lifestyle factors also potentially playing a role. The pathophysiology involves alterations in both central and peripheral nervous system, with the hypothalamus, trigeminocervical complex, and neuropeptides such as calcitonin gene-related peptide (CGRP) being implicated. Nonpharmacological treatments focus on patient education and lifestyle modifications, while pharmacological treatments include acute therapies such as oxygen and subcutaneous or nasal sumatriptan, as well as preventive therapies like verapamil, lithium, and CGRP monoclonal antibodies. Transitional options include oral corticosteroids and greater occipital nerve injections. Emerging interventional procedures offer new avenues for managing refractory cases. Noninvasive vagal nerve stimulation and occipital nerve stimulation show promise for both acute and preventive treatment. Careful consideration of safety profiles is crucial in specific populations such as pregnant patients and children. Current treatments still leave patients highly burdened by limited efficacy and side effects. Future research continues to explore novel pharmacological targets, interventional procedures, and the potential role of psychedelics in CH management. Comprehensive, multifaceted treatment strategies are essential to improve the daily functioning and quality of life for individuals with CH. |
| format | Article |
| id | doaj-art-01e78e52e38b4b9f9873fc05bd96ec51 |
| institution | Kabale University |
| issn | 2193-8237 2193-651X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Adis, Springer Healthcare |
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| series | Pain and Therapy |
| spelling | doaj-art-01e78e52e38b4b9f9873fc05bd96ec512025-01-26T12:13:58ZengAdis, Springer HealthcarePain and Therapy2193-82372193-651X2024-11-0114111910.1007/s40122-024-00674-7Current and Novel Therapies for Cluster Headache: A Narrative ReviewBruna de Freitas Dias0Christopher L. Robinson1Maria Dolores Villar-Martinez2Sait Ashina3Peter J. Goadsby4Department of Psychiatry and Behavioral Sciences, Stanford UniversityDepartment of Anesthesiology, Perioperative, and Pain Medicine, Harvard Medical School, Brigham and Women’s HospitalInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolInstitute of Psychiatry, Psychology and Neuroscience, King’s College LondonAbstract Cluster headache (CH) is an excruciating and debilitating primary headache disorder. The prevalence is up to 1.3%, and the typical onset is around age 30. Often misdiagnosed as migraine, particularly in children, the diagnosis rate of CH has been increasing among women. CH is characterized by intense unilateral pain and autonomic symptoms, significantly impacting patients’ quality of life, mental health, and productivity. Genetic associations suggest a familial risk for developing CH, with lifestyle factors also potentially playing a role. The pathophysiology involves alterations in both central and peripheral nervous system, with the hypothalamus, trigeminocervical complex, and neuropeptides such as calcitonin gene-related peptide (CGRP) being implicated. Nonpharmacological treatments focus on patient education and lifestyle modifications, while pharmacological treatments include acute therapies such as oxygen and subcutaneous or nasal sumatriptan, as well as preventive therapies like verapamil, lithium, and CGRP monoclonal antibodies. Transitional options include oral corticosteroids and greater occipital nerve injections. Emerging interventional procedures offer new avenues for managing refractory cases. Noninvasive vagal nerve stimulation and occipital nerve stimulation show promise for both acute and preventive treatment. Careful consideration of safety profiles is crucial in specific populations such as pregnant patients and children. Current treatments still leave patients highly burdened by limited efficacy and side effects. Future research continues to explore novel pharmacological targets, interventional procedures, and the potential role of psychedelics in CH management. Comprehensive, multifaceted treatment strategies are essential to improve the daily functioning and quality of life for individuals with CH.https://doi.org/10.1007/s40122-024-00674-7Cluster headacheSumatriptanNeuromodulationOnabotulinum toxin ACalcitonin gene-related peptide monoclonal antibodies |
| spellingShingle | Bruna de Freitas Dias Christopher L. Robinson Maria Dolores Villar-Martinez Sait Ashina Peter J. Goadsby Current and Novel Therapies for Cluster Headache: A Narrative Review Pain and Therapy Cluster headache Sumatriptan Neuromodulation Onabotulinum toxin A Calcitonin gene-related peptide monoclonal antibodies |
| title | Current and Novel Therapies for Cluster Headache: A Narrative Review |
| title_full | Current and Novel Therapies for Cluster Headache: A Narrative Review |
| title_fullStr | Current and Novel Therapies for Cluster Headache: A Narrative Review |
| title_full_unstemmed | Current and Novel Therapies for Cluster Headache: A Narrative Review |
| title_short | Current and Novel Therapies for Cluster Headache: A Narrative Review |
| title_sort | current and novel therapies for cluster headache a narrative review |
| topic | Cluster headache Sumatriptan Neuromodulation Onabotulinum toxin A Calcitonin gene-related peptide monoclonal antibodies |
| url | https://doi.org/10.1007/s40122-024-00674-7 |
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