European Academy of Neurology guidelines on the treatment of cluster headache

May, Arne; Evers, Stefan; Goadsby, PJ; Leone, Massimo; Manzoni, Gian Camillo; Pascual, Julio; Carvalho, Vanessa; Romoli, Michele; Aleksovska, Katina; Pozo‐Rosich, Patricia; Jensen, Rigmor Højland

doi:10.1111/ene.15956

Cited by 28 publications

(24 citation statements)

References 184 publications

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“…Dear Editor, We read with great interest the recently published European Academy of Neurology (EAN) guidelines for the treatment of cluster headache [1]. We applaud the careful and comprehensive analysis of the various acute and prophylactic treatment options.…”

Section: Occipital Nerve Stimulation In Medically Intractable Chronic...mentioning

confidence: 99%

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Occipital nerve stimulation in medically intractable chronic cluster headache

Lansbergen,

de Vos,

Brandt

et al. 2024

Euro J of Neurology

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Section: Occipital Nerve Stimulation In Medically Intractable Chronic...mentioning

confidence: 99%

“…The EAN guideline raised concerns about a poor safety profile of ONS based on studies conducted in the early stages of ONS development [1]. Hardware-related adverse events (e.g., lead migration or battery depletion) did occur in the early phase of the ICON trial.…”

Section: Occipital Nerve Stimulation In Medically Intractable Chronic...mentioning

confidence: 99%

Occipital nerve stimulation in medically intractable chronic cluster headache

Lansbergen,

de Vos,

Brandt

et al. 2024

Euro J of Neurology

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“…As a result, delayed diagnosis and incorrect treatment are common in clinical practice. 3 Once correctly diagnosed, treatment options are limited; Verapamil is the first choice prophylactic treatment, but verapamil is not efficacious in all patients with cluster headache [4][5][6] ; therefore, there is an unmet need for new diagnostic tools and treatment targets for CH.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Biomarkers in cluster headache: A systematic review

Søborg,

Jensen,

Barloese

et al. 2023

Headache

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ObjectiveTo systematically investigate previously examined biomarkers in blood, urine, cerebrospinal fluid, tear fluid, and saliva of patients with cluster headache.BackgroundCluster headache is a condition with extensive clinical challenges in terms of diagnosis and treatment. Identification of a biomarker with diagnostic implications or as a potential treatment target is highly warranted.MethodsWe conducted a systematic review including peer reviewed full text of studies that measured biochemical compounds in either blood, urine, cerebrospinal fluid, tear fluid, or saliva of patients with cluster headache diagnosed after the implementation of the International Classification of Headache Disorders (1988) written in English, Danish, Swedish, or Norwegian. Inclusion required a minimum of five participants. The search was conducted in PubMed and EMBASE, in September 2022, and extracted data were screened by two authors. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines for reporting systematic reviews were followed. The Newcastle–Ottawa Scale was used to assess the risk of bias in case–controlled studies.ResultsWe included 40 studies involving 832 patients with cluster headache and 872 controls, evaluating 80 potential biomarkers. The risk of bias for case–controlled studies was a median of 6 (range: 3–8) and 20 studies out of 40 (50%) were of fair or good quality. Most studies were identified within three groups: hypothalamic‐regulated hormones, inflammatory markers, and neuropeptides. Among the hypothalamic hormones, cortisol was the most frequently investigated (N = 7) and was elevated in cluster headache in most of the studies. The most frequently examined inflammatory marker was interleukin 1 (N = 3), but findings were divergent. Calcitonin gene–related peptide was the most investigated neuropeptide (N = 9) and all studies found increased levels during attacks.ConclusionBiomarker findings have been inconsistent and widely non‐specific for cluster headache, which explains why none of the previous studies succeeded in identifying a unique biomarker for cluster headache, but instead contributed to substantiating the underlying pathophysiologic mechanisms. Several of the examined biomarkers could hold promise as markers for disease activity but are unfit for a clear distinction from both controls and other headaches.

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“…For transition treatment, prednisolone and greater occipital nerve blockade are recommended. Verapamil, topiramate and lithium can be used for maintenance prophylaxis but require ECG (topiramate) or regular serum level monitoring (lithium) [ 7 , 8 ]. Many patients continue to experience inadequate relief [ 8 ], and a recent consensus statement has advocated the need for novel treatment modalities [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Ketamine as Treatment for Cluster Headache: A Systematic Review of Literature and a Case Series

Neumann,

Bornemann-Cimenti,

Rumpold-Seitlinger

et al. 2024

Pain Ther

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Introduction Cluster headache is a severe and debilitating neurological condition characterized by intense, excruciating pain with a significant impact on patients' wellbeing. Although different treatment options are available, many patients continue to experience inadequate relief. Therefore, experimental strategies are increasingly studied. One of the more promising approaches is the use of ketamine. We present the currently available evidence and our own data. Methods In this mixed-methods paper, we first summarize the available evidence of ketamine for treatment of cluster headache based on a systematic review of literature in MEDLINE, EMBASE and the Cochrane library of systematic reviews. As the level of evidence is quite limited, we report our own cohort study with ten patients treated with ketamine infusions for cluster headache. They were followed up to investigate the patients’ experience of treatment success and quality of life. Results The search and review of literature identified four reports with a total of 68 patients. All were uncontrolled case series. The current literature suggests that ketamine might decrease cluster headache. However, as the applied regimes and reported outcomes are highly heterogeneous, further analysis was futile. Our own data show high patient satisfaction with ketamine treatment. Conclusion Despite the limited evidence, ketamine might be considered a potential therapeutic approach for cluster headache. Therefore, further research including randomized controlled trials should be encouraged.

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European Academy of Neurology guidelines on the treatment of cluster headache

Cited by 28 publications

References 184 publications

Occipital nerve stimulation in medically intractable chronic cluster headache

Occipital nerve stimulation in medically intractable chronic cluster headache

Biomarkers in cluster headache: A systematic review

Ketamine as Treatment for Cluster Headache: A Systematic Review of Literature and a Case Series

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