{"title":"Case report: Prophylactic administration of verapamil for cluster headache during the pre-episode symptoms phase.","authors":"Yajin Wu, Mingjie Zhang, Zhao Dong, Shengyuan Yu","doi":"10.1111/head.15008","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>As the first-line preventive treatment of cluster headache (CH), verapamil provides less relief in the initial stage of medication and takes 2-3 weeks to achieve optimal efficacy. Approximately one third of patients with CH have symptoms before the cluster period arrives, such as local pain, sensory abnormalities, and autonomic symptoms, which are called pre-episode symptoms (PES); however, no study has examined the role of prophylactic administration during this period.</p><p><strong>Case: </strong>Here, we report a patient with CH who was treated with verapamil at the beginning of the PES phase five times over 5 years to avoid the onset of CH. Unfortunately, CH recurred after the latest PES phase due to delayed treatment.</p><p><strong>Conclusion: </strong>Prophylactic treatment in the PES phase of CH might reduce the severity or prevent the onset of headache during the episode phase, suggesting the feasibility of initiating prophylactic treatment in the PES phase. A large clinical trial is necessary to verify this.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":"65 8","pages":"1492-1494"},"PeriodicalIF":4.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Headache","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/head.15008","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/15 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: As the first-line preventive treatment of cluster headache (CH), verapamil provides less relief in the initial stage of medication and takes 2-3 weeks to achieve optimal efficacy. Approximately one third of patients with CH have symptoms before the cluster period arrives, such as local pain, sensory abnormalities, and autonomic symptoms, which are called pre-episode symptoms (PES); however, no study has examined the role of prophylactic administration during this period.
Case: Here, we report a patient with CH who was treated with verapamil at the beginning of the PES phase five times over 5 years to avoid the onset of CH. Unfortunately, CH recurred after the latest PES phase due to delayed treatment.
Conclusion: Prophylactic treatment in the PES phase of CH might reduce the severity or prevent the onset of headache during the episode phase, suggesting the feasibility of initiating prophylactic treatment in the PES phase. A large clinical trial is necessary to verify this.
期刊介绍：
Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.
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