15. Cluster Headache.

IF 2.5 3区医学 Q2 ANESTHESIOLOGY

Pain Practice Pub Date : 2025-06-01 DOI:10.1111/papr.70050

Casper S Lansbergen, Rolf Fronczek, Leopoldine A Wilbrink, Steven P Cohen, Cecile C de Vos, Frank J P M Huygen

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引用次数: 0

Abstract

Introduction: Cluster headache is a rare primary headache disorder characterized by excruciating unilateral pain around the eye, lasting between 15 and 180 min, accompanied by ipsilateral cranial autonomic symptoms. Cluster headache is classified into two forms: episodic and chronic, with chronic cluster headache defined by pain-free intervals of less than 3 months between bouts. Both drug-based and invasive treatments are available for abortive and preventive purposes. Treatment selection depends on individual efficacy and tolerance, with invasive options considered when pharmacological treatments prove ineffective.

Methods: This narrative review summarizes the literature on common practice and the evidence in the treatment of cluster headache.

Results: Oxygen therapy and subcutaneous sumatriptan are the most effective abortive treatments for cluster headache. Oral corticosteroid tapering regimens can be used as bridging therapy. Verapamil, lithium, topiramate, and CGRP antagonists are potential preventive medication options. Greater occipital nerve (GON) injections and radiofrequency (RF) therapy can be used as preventive treatments, though their effects are often temporary. For refractory chronic cluster headache, occipital nerve stimulation (ONS) has proven to be effective. Deep brain stimulation (DBS) may also be considered if all other treatments have failed.

Conclusions: The management of cluster headache is complex due to the variable efficacy of treatments across different patients and limited evidence.

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15. 丛集性头痛。

丛集性头痛是一种罕见的原发性头痛疾病，其特征是眼睛周围单侧剧烈疼痛，持续15至180分钟，伴有同侧颅自主神经症状。丛集性头痛分为两种形式：发作性和慢性，慢性丛集性头痛的定义是两次发作之间的无痛间隔少于3个月。药物治疗和侵入性治疗都可用于流产和预防目的。治疗的选择取决于个人的疗效和耐受性，当药物治疗证明无效时考虑侵入性治疗。方法：对治疗丛集性头痛的临床实践及证据进行综述。结果：氧疗和皮下注射舒马匹坦是治疗丛集性头痛最有效的方法。口服皮质类固醇减量方案可作为桥接治疗。维拉帕米、锂、托吡酯和CGRP拮抗剂是潜在的预防药物选择。枕大神经（GON）注射和射频（RF）治疗可作为预防性治疗，尽管其效果通常是暂时的。对于难治性慢性丛集性头痛，枕神经刺激（ONS）已被证明是有效的。如果所有其他治疗都失败了，也可以考虑深部脑刺激（DBS）。结论：丛集性头痛的治疗是复杂的，因为不同患者的治疗效果不同，证据有限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain Practice ANESTHESIOLOGY-CLINICAL NEUROLOGY

CiteScore

5.60

自引率

3.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Pain Practice, the official journal of the World Institute of Pain, publishes international multidisciplinary articles on pain and analgesia that provide its readership with up-to-date research, evaluation methods, and techniques for pain management. Special sections including the Consultant’s Corner, Images in Pain Practice, Case Studies from Mayo, Tutorials, and the Evidence-Based Medicine combine to give pain researchers, pain clinicians and pain fellows in training a systematic approach to continuing education in pain medicine. Prior to publication, all articles and reviews undergo peer review by at least two experts in the field.