Treatment of episodic and chronic cluster headaches

Treatment of episodic and chronic cluster headaches is not designed to reduce the severity of individual attacks. Treatment is usually considered successful if the frequency and duration of headaches is reduced. For this reason, the main criterion for the effectiveness of therapy in cluster headaches is the lower frequency of their occurrence.

The use of nicotine and alcohol affects the course of cluster headaches. Thus, among patients with cluster headaches (N = 374), the number of smokers and daily drinking alcohol is higher than in the general population. In a recent study, 316 patients suffering from chronic cluster headaches, 87% of them at the time of the study were smoking or had previously suffered from nicotine addiction.

Interestingly, the development of cluster headaches in non-smoking adults is associated with long passive smoking in childhood. It is noteworthy that patients notice relief of cluster headaches after quitting smoking. However, an interactive survey of cluster headache patients revealed that, of the 74% of patients who stopped using nicotine, only 3% reported relief of headaches.

Alcohol consumption is an absolute factor provoking cluster headaches. That is why most patients try to avoid drinking alcohol during the cluster period.

The European Society for the Study of Headaches has published recommendations for the treatment of headaches, including indications for contacting a specialist in the treatment of headaches. These recommendations suggest that most cases of migraine and drug-induced headaches can be treated by general practitioners. Appeal to a specialist is indicated if:
• a secondary headache is suspected;
• the diagnosis is not clear;
• the patient complains of a prolonged aura (lasting more than 1 hour), manifested by motor weakness, which occurs regardless of a headache or when using oral contraceptives;
• there are comorbid diseases, including cardiovascular pathology;
• ineffective previous therapy;
• The patient was diagnosed with a puchal headache.

local_offerevent_note February 5, 2019

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