Cluster headache treatment dilemmas: the experts respond.
When conventional treatment approaches to cluster headache are unsuccessful, expert recommendations are relevant but may not be easily accessible to treating clinicians. We conducted a study of expert recommendations in response to standardized vignettes. Ten expert headache clinicians were asked what treatment they would recommend for a hypothetical 55-year-old male cluster headache patient in the following five situations: 1) known coronary artery disease with response only to sumatriptan; 2) strictly unilateral headaches unresponsive to preventive treatment; 3) effective abortive treatment not covered by insurance; 4) patient request to obtain methysergide from Canada; and 5) headaches responsive only to steroid treatment.
Loder
Elizabeth
E
1153 Centre Street, Boston, MA 02130, USA. eloder@partners.org
Rizzoli
Paul
P
McGeeney
Brian
B
Ward
Thomas
T
Levin
Morris
M
Shapiro
Robert E
RE
Tepper
Stewart
S
Newman
Larry
L
Sheftell
Fred
F
Rapoport
Alan
A
Markley
Herbert
H
D000700:Analgesics / Q000627:therapeutic use; D003027:Cluster Headache / Q000628:therapy*; D004599:Electric Stimulation Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010102:Oxygen Inhalation Therapy; D010818:Practice Patterns, Physicians'; D019233:Retreatment; D017211:Treatment Failure
D000700:Analgesics