Cluster Headache: Acute and Prophylactic Therapy

The document reviewed various therapies for managing cluster headaches (CH), emphasizing both acute and prophylactic treatments. Sumatriptan, especially in injectable form, was effective for acute attacks, with 80% of 134 patients experiencing relief. Oxygen therapy also provided significant pain relief, with a study showing 78% efficacy in 109 patients. For prophylactic treatment, verapamil was the first-line option, reducing headache frequency in 80% of 30 patients. Lithium carbonate and topiramate were second-line therapies, while third-line options included methysergide and valproic acid. Invasive procedures like occipital nerve stimulation and deep brain stimulation showed promise for refractory cases, though they carried risks. The document highlighted the importance of individualized treatment plans based on patient response and comorbidities.