Response of Cluster Headache Attacks to Oxygen Inhalation

Abstract

SYNOPSIS Fifty‐two randomly selected patients diagnosed as having either active episodic or chronic cluster headaches were evaluated for symptomatic response to oxygen inhalation. At the onset of attacks, 100% oxygen was administered through a facial mask at a rate of 7 liters per minute, for 15 minutes. Each patient self‐treated ten attacks, and timed the rated reduction of pain. A successful treatment result required complete or almost complete reduction of pain in seven of ten attacks, within 15 minutes.In a second (crossover) trial involving an additional 50 patients, sublingual ergotamine tartrate (ErgomarÒ) was compared to oxygen inhalation for symptomatic relief of cluster attacks. Each patient treated ten attacks with either preparation in accordance with the crossover design. Oxygen was administered as described above. Sublingual ergotamine was used every five minutes, to a maximum of three tablets, if necessary.In the first trial 3952 (75%) of patients obtained significant relief from cluster pain. The greatest benefit (92.9%) was found among episodic patients under 50 years of age. The least benefit (57%), was found among chronic patients over 49 years of age. In the second trial, results among oxygen users were better (82%) than those of ergotamine users (70%), but not significantly. Rapidity of relief was similar in both groups.The results of both series indicate that oxygen inhalation is an efficacious symptomatic treatment for cluster attacks. It is superior to ergotamine since there are neither complications nor contraindications to its use. Ergotamine, however, has the advantage of convenience.

Chronic cluster headache: a review

“…More patients with ECH than with CCH had success with oxygen: 78.8% vs. 68.4% [19]. The greatest difference was found when comparing ECH patients under 50 years of age (92.9%) with CCH patients over 49 years of age (57.1%).…”

A Case Report: Cluster Headache in Childhood

“…In all of them the first or secondline medication always turn out to be effective. According to these data, the most effective symptomatic treatments are oxygen and sumatriptan [6]. Prophylactic treatments tried in literature are methysergide, prednisone/prednisolone, verapamil, and flunarizine [7].…”

Evidence for Oxygen Use in the Hospitalized Patient: Is More Really the Enemy of Good?

“…109 His treatment for these subjects was alcohol injections around the supraorbital and infraorbital nerve. Horton first described the use of oxygen for the treatment of CH in 1952, 110 and was brought to the forefront by Kudrow in 1981. 111 This first systematic study compared oxygen by mask at 7 L/ min for 15 min versus sublingual ergotamine.…”