Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache

Bennett, Michael H; French, Chris; Schnabel, Alexander; Wasiak, Jason; Kranke, Peter; Weibel, Stephanie

doi:10.1002/14651858.cd005219.pub3

Cited by 44 publications

(44 citation statements)

References 62 publications

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“…Wilson et al 15 showed a significant decrease in subjective pain in those who underwent HBO versus the control group of females with migraine with aura. Other studies by Eftedal et al 1,22,23 showed insignificant prophylactic measure against migraines with the use of HBO. It is important to note that these studies have limited sample sizes.…”

Section: Discussionmentioning

confidence: 89%

“…A Cochrane review on the usage of HBO to prevent migraines showed no evidence to suggest that HBO could prevent migraine attacks, reduce the incidence of nausea and vomiting, or reduce the requirement for rescue medication based upon 11 trials. 23 On the contrary, we present a patient who had a reduction in frequency, intensity, symptomatology, and need for rescue medications after HBO treatment. To truly judge the efficacy of HBO and take to into account the inherent variability in response to different treatments, larger studies are needed.…”

Section: Discussionmentioning

confidence: 90%

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Revisiting the expanded use of hyperbaric oxygen therapy for treatment of resistant migraines

Matera¹,

Smith²,

Lam³

2019

Med Gas Res

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There are currently 13 indications approved by the U.S. Food and Drug Administration for use of hyperbaric oxygen therapy. The European Consensus Conference on Hyperbaric Medicine has 28 indications approved for its use. However, neither includes the use of hyperbaric oxygen therapy for neurological conditions such as migraines with aura. Recent research has made the attempt to fully understand the use of hyperbaric therapy in treatment of neurological conditions, but results have so far been inconclusive. We report a 23-year-old female with an 11-year history of migraines with aura who has received inadequate pharmacological treatment for her migraines since she began having them. Migraines have led her to significant loss of function. The patient underwent treatment at 1.5 absolute atmospheres in a hyperbaric chamber Monday through Friday for 1 hour each day for a total of 40 sessions but reported missing a few sessions over the 8-week period. No more than 1 session during a given week was missed and the patient received no other treatments for her migraines throughout this time period. By her 24 th treatment, the patient had only experienced a single migraine with aura but without debilitating pain. The patient stated she had never had a migraine with such little intensity prior to initiation of hyperbaric treatment and did not have to take any days off from work or school. Follow-up at the end of her 40-day treatment period revealed a highly-satisfied patient who had only experienced the single episode of a mild migraine during the entire course of treatment. Thus, we believe that further research needs to be done to realize the full potential of hyperbaric oxygen therapy in the treatment of neurological conditions as this case highlights the potential for using hyperbaric oxygen therapy as prophylaxis against attacks in patients with treatment resistant migraines with aura.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 90%

Revisiting the expanded use of hyperbaric oxygen therapy for treatment of resistant migraines

Matera¹,

Smith²,

Lam³

2019

Med Gas Res

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“…In a trial of 204 ED patients with primary headache disorders (47% tension, 27% migraine, 1% cluster, and 25% undifferentiated headaches), oxygen therapy resulted in a significant improvement in pain scores, and had a lower requirement for rescue analgesics (8). A Cochrane analysis of 11 clinical trials involving 209 participants with migraine or cluster headache found that hyperbaric oxygen therapy was effective in relieving pain, but its high cost and poor availability are major limitations (9). The encouraging results of our trial should prompt further trials to determine the efficacy of high-flow oxygen inhalation (a relatively low-cost and widely available treatment) in patients with acute migraine.…”

Section: Discussionmentioning

confidence: 99%

“…Oxygen therapy is inexpensive, widely available, has an excellent safety profile, and can be self-administered at home. If truly effective, oxygen therapy may significantly impact the current-day management of migraine around the world (9).…”

Section: Introductionmentioning

confidence: 99%

High-flow oxygen therapy for treatment of acute migraine: A randomized crossover trial

Singhal

Maas²,

Goldstein

et al. 2016

Cephalalgia

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Background Impaired oxygen utilization and cerebrovascular dysfunction are implicated in migraine. High-flow oxygen is effective in cluster headache and has shown promise in animal models of migraine, but has not been adequately studied in patients with migraine. Methods In this randomized, crossover-design, placebo-controlled trial, adult migraineurs self-administered high-flow oxygen or medical air at 10-15 l/min via face mask in blinded fashion starting soon after symptom onset for 30 minutes, for a total of four migraine attacks. Participants recorded the severity of headache, nausea, and visual symptoms on visual analog scales periodically up to 60 minutes. Results We enrolled 22 individuals (mean age 36 years, 20 women) who self-treated 64 migraine attacks (33 oxygen, 31 air). The pre-specified primary endpoint (mean decrease in pain score from baseline to 30 minutes) was 1.38 ± 1.42 in oxygen-treated and 1.22 ± 1.61 in air-treated attacks ( p = 0.674). Oxygen therapy resulted in relief (severity score 0-1) of pain (24% versus 6%, p = 0.05), nausea (42% versus 23%, p = 0.08) and visual symptoms (36% versus 7%, p = 0.004) at 60 minutes. Exploratory analysis showed that in moderately severe attacks (baseline pain score <6), pain relief was achieved in six of 13 (46%) oxygen versus one of 15 (7%) air ( p = 0.02). Gas therapy was used per protocol in 91% of attacks. There were no significant adverse events. Conclusion High-flow oxygen may be a feasible and safe strategy to treat acute migraine. Further studies are required to determine if this relatively inexpensive, widely available treatment can be used as an adjunct or alternative migraine therapy.

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“…However, two trials found no improvement with hyperbaric oxygen (11.38, 0.77 to 167.85; P=0.08) in 29 patients with cluster headache. 37 Given the lack of availability of hyperbaric oxygen therapy, it is difficult to recommend this treatment to patients with migraine.…”

Section: Other Treatmentsmentioning

confidence: 99%

Complementary and integrative medicine in the management of headache

Millstine

Chen

Bauer

2017

BMJ

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Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs). The overall quality of the evidence for CIM in headache management is generally low and occasionally moderate. Available evidence suggests that traditional Chinese medicine including acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches. Spinal manipulation, chiropractic care, some supplements and botanicals, diet alteration, and hydrotherapy may also be beneficial in migraine headache. CIM has not been studied or it is not effective for cluster headache. Further research is needed to determine the most effective role for CIM in patients with headache.

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Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache

Cited by 44 publications

References 62 publications

Revisiting the expanded use of hyperbaric oxygen therapy for treatment of resistant migraines

Revisiting the expanded use of hyperbaric oxygen therapy for treatment of resistant migraines

High-flow oxygen therapy for treatment of acute migraine: A randomized crossover trial

Complementary and integrative medicine in the management of headache

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