Cluster headache

G44.0


DESCRIPTION

Repetitive episodes of excruciating headache typically of short duration (up to 2 hours) in clusters for weeks to months at a time. Typically, the headache is of sudden onset, unilateral during the specific cluster, and quickly reaches a climax. Associated redness of the eye with lacrimation and rhinorrhoea occurs.

MEDICINE TREATMENT

  • Oxygen inhalation may abort some episodes.

Analgesics are ineffective.

To induce rapid remission in patients with episodic cluster headache:

  • Corticosteroids (intermediate-acting) e.g.:
  • Prednisone, oral, 40 mg daily for 5–10 days.
    • Tapering is not necessary when the above duration is used.

LoEIII [47]

Prophylaxis

  • Verapamil, oral, 40–80 mg 12 hourly.

REFERRAL

Inadequate response to treatment.