Treatment-Resistant Chronic Cluster Headache

2014 ◽  
pp. 163-171
Author(s):  
Nu Cindy Chai ◽  
Alan M. Rapoport
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Treatment Resistant

A case of cluster headache treated with rotigotine: Clinical and neurophysiological correlates

Cephalalgia ◽  
2013 ◽  
Vol 33 (15) ◽  
pp. 1272-1276 ◽  
Author(s):  
Cherubino Di Lorenzo ◽  
Gianluca Coppola ◽  
Francesco Pierelli
Keyword(s):  
Cluster Headache ◽  
Male Patient ◽  
Facial Pain ◽  
Therapeutic Option ◽  
Blink Reflex ◽  
Chronic Cluster Headache ◽  
Drug Resistant ◽  
Treatment Resistant ◽  
Remission Period ◽  
Nociceptive Blink Reflex

Background Chronic cluster headache (CCH) is characterized by recurrent bouts of facial pain lasting up to 180 minutes in the absence of a long remission period. Case We report the case of a 43-year-old male patient with treatment-resistant CCH, who improved with administration of transdermal rotigotine. We also evaluated the nociceptive blink reflex habituation that was reduced before the treatment (as is usual in CH patients) and normalized by transdermal rotigotine. Conclusions We suggest that rotigotine could represent a further therapeutic option in the treatment of drug-resistant CCH.

scholarly journals Long-term use of daily sumatriptan injections in severe drug-resistant chronic cluster headache: Table

Neurology ◽  
2015 ◽  
Vol 86 (2) ◽  
pp. 194-195 ◽  
Author(s):  
Massimo Leone ◽  
Alberto Proietti Cecchini
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Drug Resistant

TRIGEMINAL NERVE RADIOSURGICAL TREATMENT IN INTRACTABLE CHRONIC CLUSTER HEADACHE

Neurosurgery ◽  
2006 ◽  
Vol 59 (6) ◽  
pp. 1252-1257 ◽  
Author(s):  
Anne Donnet ◽  
Manabu Tamura ◽  
Dominique Valade ◽  
Jean Régis
Keyword(s):  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
High Rate ◽  
Long Term Results ◽  
Complete Relief ◽  
Term Evaluation ◽  
The One

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.

Efficacy and safety of 121 injections of the greater occipital nerve in episodic and chronic cluster headache

Cephalalgia ◽  
2012 ◽  
Vol 32 (8) ◽  
pp. 630-634 ◽  
Author(s):  
Andreas R Gantenbein ◽  
Nina J Lutz ◽  
Franz Riederer ◽  
Peter S Sándor
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Efficacy And Safety ◽  
Occipital Nerve ◽  
Greater Occipital Nerve

Outcome of trigeminal nerve section in the treatment of chronic cluster headache

Neurology ◽  
2003 ◽  
Vol 60 (8) ◽  
pp. 1360-1362 ◽  
Author(s):  
R.G. Jarrar ◽  
D.F. Black ◽  
D.W. Dodick ◽  
D.H. Davis
Keyword(s):  
Cluster Headache ◽  
Trigeminal Nerve ◽  
Chronic Cluster Headache ◽  
Nerve Section

scholarly journals Efficacy of transdermal rotigotine in chronic cluster headache: A case series

2018 ◽  
Vol 1 ◽  
pp. 251581631880969
Author(s):  
Cherubino Di Lorenzo ◽  
Lanfranco Pellesi ◽  
Gianluca Coppola ◽  
Vincenzo Parisi ◽  
Maurizio Evangelista ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Case Series ◽  
Chronic Cluster Headache ◽  
Drug Resistant ◽  
Transdermal Patch ◽  
Full Resolution ◽  
Episodic Cluster Headache ◽  
Monoaminergic System ◽  
Rotigotine Transdermal Patch ◽  
Effective Treatments

Cluster headache (CH) is one of the most severe forms of headache, but the number of effective treatments is still limited. Recently, we reported the case of a drug-resistant CH patient responsive to the rotigotine transdermal patch, which is used in the treatment of Parkinson’s disease. This report formed the basis for a case series where other drug-resistant CH patients were treated with rotigotine. Here are the results of this study. Twenty-two CH patients underwent the treatment. Eight were episodic cluster headache (ECH) patients and 14 were chronic cluster headache (CCH) patients. Of the eight ECH patients, four reported that their CH had been stopped by the treatment. Of the 14 CCH patients, 11 were considered responders to the treatment (5 experienced a full resolution of headache, and 6 had a headache reduction of at least 50% in terms of mean monthly number of attacks). Our case series confirms the previous observation that rotigotine could be helpful in the treatment of CH. It may even influence the monoaminergic system that has a key role in the pathogenesis of CH.

Vidian Neurectomy for Management of Chronic Cluster Headache

Neurosurgery ◽  
2018 ◽  
Vol 84 (5) ◽  
pp. 1059-1064 ◽  
Author(s):  
Shao-Cheng Liu ◽  
Ming-Chang Kao ◽  
Yun-Chen Huang ◽  
Wan-Fu Su
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Preliminary Evaluation ◽  
Sphenopalatine Ganglion ◽  
Attack Frequency ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Vidian Neurectomy ◽  
Headache Onset ◽  
Attack Intensity

Abstract BACKGROUND Management of chronic cluster headache (CCH) remains a challenging endeavor, and the optimal surgical approach for medically refractory CCH remains controversial. OBJECTIVE To conduct a preliminary evaluation of the efficacy and safety of vidian neurectomy (VN) in patients with medically refractory CCH. METHODS Between March 2013 and December 2015, 9 CCH patients, all of whom had failed to respond to conservative therapy, underwent VN with a precise nerve cut and maximal preservation of the sphenopalatine ganglion. Data included demographic variables, cluster headache onset and duration, mean attack frequency, mean attack intensity, and pain disability index measures pre- and through 12-mo postsurgery. RESULTS Seven of the 9 cases (77.8%) showed immediate improvement. Improvement was delayed by 1 mo in 1 patient, after which the surgical effects of pain relief were maintained throughout the follow-up period. One patient (11.1%) did not improve after surgery. One year after VN, patients’ mean attack frequency, mean attack intensity, and pain disability index decreased by 54.5%, 52.9%, and 56.4%, respectively. No patient experienced treatment-related side effects or complications. CONCLUSION VN is an effective treatment method for CCH patients. Precise Vidian nerve identification and maximal preservation of the sphenopalatine ganglion may achieve good surgical outcomes and dramatically improve quality of life among patients, without significant adverse events.

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