{"id":19122,"date":"2024-05-16T11:14:00","date_gmt":"2024-05-16T09:14:00","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=clinical_pattern&#038;p=19122"},"modified":"2024-05-17T12:28:21","modified_gmt":"2024-05-17T10:28:21","slug":"cluster-headache","status":"publish","type":"clinical_pattern","link":"https:\/\/www.physiotutors.com\/clinical-patterns\/cluster-headache\/","title":{"rendered":"Cluster Headache"},"featured_media":14858,"template":"","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":""},"tracking_tag":[2190],"class_list":["post-19122","clinical_pattern","type-clinical_pattern","status-publish","has-post-thumbnail","hentry","tracking_tag-headneck"],"acf":{"free_access":"unfree","app_link":"https:\/\/app.physiotutors.com\/add-ons\/a8d5ef54-ba7d-4cf2-852a-97eecbe5083f","sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":14858,"background_image_alt_text":"Cluster Headache"},"heading":"Cluster Headache","subheading":"Head\/Neck","content_editor":"","button_type":"internal_link","button_label":"","button_style":"button-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null,"label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Introduction","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Clinical Picture","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Treatment","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"References","button_internal_link":null,"button_anchor":"section-number-7","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"","button_style":"button-link-one","button_internal_link":"","button_anchor":"","button_url":"","button_file":null},"button_description":""},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Introduction<\/h2>"},"column_right":{"content_editor":"<ul data-pm-slice=\"3 3 []\">\r\n \t<li>\r\n<p data-pm-slice=\"1 1 [&quot;bulletList&quot;,null,&quot;listItem&quot;,null]\">Cluster headaches are a primary type of headache, distinguished by intensely painful attacks.<\/p>\r\n<\/li>\r\n \t<li>\r\n<p data-pm-slice=\"1 1 [&quot;bulletList&quot;,null,&quot;listItem&quot;,null]\">Lifetime prevalence is approximately 0.12%, with a 1-year prevalence of 53 per 100,000 persons. The male-to-female ratio is about 4.3:1. In a Swedish cohort, the 1-year prevalence among the working-aged population was reported as 0.054%.<\/p>\r\n<\/li>\r\n<\/ul>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Clinical Presentation<\/h2>"},"column_right":{"content_editor":"<ul>\r\n \t<li data-pm-slice=\"2 4 [&quot;bulletList&quot;,null]\"><em>Diagnostic Criteria (ICHD-III):<\/em>\r\n<ul>\r\n \t<li><em>A. <\/em>Must have at least five attacks that fulfill criteria B-D.<\/li>\r\n \t<li><em>B.<\/em> Severe or very severe unilateral orbital, supraorbital, and\/or temporal pain lasting 15-180 minutes if untreated.<\/li>\r\n \t<li><em>C. <\/em>Accompanied by at least one of the following symptoms ipsilateral to the headache: conjunctival injection\/lacrimation, nasal congestion\/rhinorrhea, eyelid edema, forehead\/facial sweating, miosis\/ptosis, or a sense of restlessness\/agitation.<\/li>\r\n \t<li><em>D.<\/em> Frequency of attacks ranges from once every other day to 8 per day.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>"}},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">Treatment<\/h2>"},"column_right":{"content_editor":"<ul data-pm-slice=\"3 3 []\">\r\n \t<li><em>Acute Attack Management:<\/em>\r\n<ul>\r\n \t<li>100% Oxygen Therapy: A level A recommendation for cluster headaches, effective in about 66% of patients, taking effect in less than ten minutes.<\/li>\r\n \t<li>Triptans: Subcutaneous sumatriptan or nasal spray zolmitriptan are level A-indicated therapies.<\/li>\r\n \t<li>Alternatives: Octreotide, ergotamine, and intranasal lidocaine, although medication resistance occurs in 10-20% of severe cases.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><em>Preventive Treatment:<\/em>\r\n<ul>\r\n \t<li>Suboccipital Blockade: The only level A recommended preventive method, with minimal side effects.<\/li>\r\n \t<li>Verapamil: The most commonly prescribed prophylactic medication, starting at 240 mg once daily. Regular ECGs are recommended due to cardiac side effects.<\/li>\r\n \t<li>Glucocorticoids: For short-term use in episodic cluster headaches, with a high response rate but significant long-term side effects.<\/li>\r\n \t<li>Other Medications: Lithium, valproic acid, melatonin, and intranasal capsaicin have been used for prevention.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><em>Surgical and Neuromodulation Therapies:<\/em>\r\n<ul>\r\n \t<li>Electrical Stimulation: Of the sphenopalatine ganglion, occipital, and vagus nerve. Deep brain stimulation of the hypothalamus has shown effectiveness in drug-resistant cases.<\/li>\r\n \t<li>Vagus Nerve Stimulation: A non-implanted device option for patients.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><em>Physiotherapy:<\/em> Currently, there are no established physiotherapy interventions for cluster headache patients, with only case studies exploring the combination of endogenous neurostimulation and physiotherapy.<\/li>\r\n<\/ul>"}},{"acf_fc_layout":"cta-big","heading":"Download the new Physiotutors App","subheading":"PHYSIOTUTORS APP","content_editor":"Are you ready for a learning revolution?\r\n\r\nExperience the Physiotutors content you love in our new app.","form_toggle":false,"form":"92","number_of_buttons":"one","button_1":{"button_1_button_type":"internal_link","button_1_button_label":"DOWNLOAD NOW","button_1_button_style":"button-two","button_1_button_internal_link":16662,"button_1_button_anchor":"","button_1_button_url":"","button_1_button_file":null},"button_2":{"button_2_button_type":"internal_link","button_2_button_label":"","button_2_button_style":"button-one : 1","button_2_button_internal_link":null,"button_2_button_anchor":"","button_2_button_url":"","button_2_button_file":null},"image":17728,"image_alt_text":"","overlay":false},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"<h2 class=\"heading-four\">References<\/h2>"},"column_right":{"content_editor":"<p data-pm-slice=\"1 1 []\">Ekbom, K., &amp; Hardebo, J. E. (2002). Cluster headache: aetiology, diagnosis and management.\u00a0Drugs,\u00a062, 61-69.<\/p>\r\nFischera, M., Marziniak, M., Gralow, I., &amp; Evers, S. (2008). The incidence and prevalence of cluster headache: a meta-analysis of population-based studies.\u00a0Cephalalgia,\u00a028(6), 614-618.\r\n\r\nFontaine, D., Lanteri-Minet, M., Ouchchane, L., Lazorthes, Y., Mertens, P., Blond, S., \u2026 &amp; Lemaire, J. J. (2010). Anatomical location of effective deep brain stimulation electrodes in chronic cluster headache.\u00a0Brain,\u00a0133(4), 1214-1223.\r\n\r\nGoadsby, P. J., de Coo, I. F., Silver, N., Tyagi, A., Ahmed, F., Gaul, C., \u2026 &amp; Ferrari, M. D. (2018). Non-invasive vagus nerve stimulation for the acute treatment of episodic and chronic cluster headache: a randomized, double-blind, sham-controlled ACT2 study.\u00a0Cephalalgia,\u00a038(5), 959-969.\r\n\r\nLeone, M., D\u2019amico, D., Frediani, F., Moschiano, F., Grazzi, L., Attanasio, A., &amp; Bussone, G. (2000). Verapamil in the prophylaxis of episodic cluster headache: a double-blind study versus placebo.\u00a0Neurology,\u00a054(6), 1382-1385.\r\n\r\nManzoni, G. C., Camarda, C., Genovese, A., Quintana, S., Rausa, F., Taga, A., &amp; Torelli, P. (2019). Cluster headache in relation to different age groups.\u00a0Neurological Sciences,\u00a040, 9-13.\r\n\r\nMatharu, M. S., Levy, M. J., Meeran, K., &amp; Goadsby, P. J. (2004). Subcutaneous octreotide in cluster headache: Randomized placebo\u2010controlled double\u2010blind crossover study.\u00a0Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society,\u00a056(4), 488-494.\r\n\r\nMay, A., Leone, M., Afra, J., Linde, M., S\u00e1ndor, P. S., Evers, S., &amp; Goadsby, P. J. (2006). EFNS guidelines on the treatment of cluster headache and other trigeminal\u2010autonomic cephalalgias.\u00a0European Journal of Neurology,\u00a013(10), 1066-1077.\r\n\r\nMir, P., Alberca, R., Navarro, A., Montes, E., Mart\u00ednez, E., Franco, E., \u2026 &amp; Lozano, P. (2003). Prophylactic treatment of episodic cluster headache with intravenous bolus of methylprednisolone.\u00a0Neurological Sciences,\u00a024, 318-321.\r\n\r\nNavarro-Fern\u00e1ndez, G., de-la-Puente-Ranea, L., Gand\u00eda-Gonz\u00e1lez, M., &amp; Gil-Mart\u00ednez, A. (2019). Endogenous neurostimulation and physiotherapy in cluster headache: a clinical case.\u00a0Brain Sciences,\u00a09(3), 60.ISO 690\r\n\r\nObermann, M., Holle, D., Naegel, S., Burmeister, J., &amp; Diener, H. C. (2015). Pharmacotherapy options for cluster headache.\u00a0Expert opinion on pharmacotherapy,\u00a016(8), 1177-1184.\r\n\r\nOlesen, J. (2018). International classification of headache disorders.\u00a0The Lancet Neurology,\u00a017(5), 396-397."}}]},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Cluster Headache | Clinical Pattern | All physio info at one glance<\/title>\n<meta name=\"description\" content=\"Learn about the diagnosis, prognosis, and treatment of Cluster Headache in our Clinical Pattern for Physiotutors Members\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.physiotutors.com\/clinical-patterns\/cluster-headache\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cluster Headache | Clinical Pattern | All physio info at one glance\" \/>\n<meta property=\"og:description\" content=\"Learn about the diagnosis, 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