No abstract

Intractable chronic cluster headache (CCH) is a devastating, disabling condition that has traditionally been treated with cranially invasive or neurally destructive procedures. ONS offers a safe, effective option for some patients with CCH. More work is required to evaluate and understand this novel therapy.

LUSTER HEADACHE IS A STEREOtypical primary headache syndrome characterized by attacks of unilateral excruciating pain usually in the eye, periorbital region, and temple with associated cranial autonomic symptoms such as conjunctival injection, lacrimation, nasal blockage, rhinorrhea, ptosis, and eyelid edema. During attacks patients are often restless, agitated, or both. Attacks typically last for 15 to 180 minutes untreated and have a frequency of 1 every other day for up to 8 attacks a day. 1 Attacks usually occur in bouts, or clusters, lasting for weeks or months, separated by remissions lasting months or years. Episodic cluster headache is defined as bouts of attacks lasting 7 days up to a year with breaks of 1 month or more between bouts. Bouts are usually circannual, occurring once a year, with a mean bout duration of 8 weeks. 2 Chronic cluster headache is defined as occurring for more than a year without remission or with remissions lasting less than a month. Cluster headache attacks may also occur with clocklike regularity during the day and may be precipitated by sleep, 3 usually occurring 90 minutes after the onset of sleep. Cluster headache affects more men than women (male-female ratio of 2.5:1) and has an estimated prevalence of 0.3% in the general population. 4 Cluster headache is probably the most severe pain known to humans. Most female patients describe each attack as worse than childbirth.See also Patient Page.

No abstract

Considerable advances have been made in the diagnostic and therapeutic approaches to trigeminal autonomic cephalalgias and these are important for neurologists to consider.