Objective.-To describe the self-treatment of cluster headache with kudzu. Background.-Many cluster headache patients take over-the-counter (OTC) kudzu extract in the belief that it helps their cluster attacks. Kudzu's actual efficacy has not been studied.Methods.-A database of cluster headache patients was questioned about their use of various alternative remedies to treat their cluster headache. Of 235 patients identified, 16 had used kudzu, consented to interviews, and provided medical records.Results.-In total, 11 (69%) experienced decreased intensity of attacks, 9 (56%) decreased frequency, and 5 (31%) decreased duration, with minimal side effects.Conclusion.-Anecdotal evidence suggests that a component in OTC products labeled as kudzu may prove useful in managing cluster headache. This hypothesis should be tested with a randomized clinical trial.Key words: cluster headache, case series, kudzu (Headache 2009;49:98-105) Cluster headache is a rare disorder, generally considered to be the most painful of all types of headache.1 It occurs predominantly in men (0.4% vs 0.08% of women), typically beginning in the third decade, and is categorized as either episodic, occurring for periods interspersed with pain-free remissions, or chronic, in which the headaches occur constantly for more than a year with no remission longer than one month.2 Ten percent of episodic cluster headaches ultimately evolve into the chronic form, and these are termed secondary chronic. In standard descriptions of cluster headache, an "attack" refers to the actual paroxysm of pain, a "cluster period" to a period of time when attacks occur regularly, and a "remission period" to an interval during which no attacks occur.
3Cluster periods tend to recur at fixed intervals ranging from several months to several years, often occurring at the same time each year, and are marked by recurrent stabbing attacks that increase in intensity over 5 to 10 minutes, last 15 minutes to 3 hours, and then fade away. Attacks typically occur 1 to 3 times a day, usually at strikingly predictable times (often 2 hours after the patient falls asleep) but can sometimes occur as often as every 2 hours. The intensity of the pain is severe enough that patients have been known to commit suicide. 4 Standard care for cluster headache includes acute treatments such as triptans or high-flow oxygen taken at the onset of an attack, supplemented with prophylactic treatments such as verapamil or lithium, which are taken on a continuous basis once a cluster period has begun, or before sleep in order to prevent nocturnal attacks in the case of ergotamine.