title: High-dose intravenous methylprednisolone for the prophylactic treatment of cluster headache.
abstract: BACKGROUND
  Triptans are effective for immediate relief of episodic cluster headache (CH) but do not reduce the frequency of attacks. Intravenous bolus injection of corticosteroids like methylprednisolone (MP) has been reported to decrease the frequency of CH attacks. We validated the prophylactic efficacy of MP pulse therapy by monitoring CH recurrence over several years following treatment of six consecutive male patients (mean age: 38.8 years, range: 26-54 years) afflicted by frequent (often daily) CH attacks.
  
  
  RESULTS
  Total MP dose per infusion was 250-500 mg for five patients and 125 mg for the sixth (a diabetic). High-dose MP was administered for 2 or 3 consecutive days in hospital for the first two patients treated. The next four patients received a single bolus injection at presentation, and in some cases a second injection days later at an outpatient clinic. The first two cases treated were also prescribed daily oral prednisolone for at most 6 months while the latter four cases were not. The frequency of CH attacks was markedly reduced in all patients, with intervals between attacks ranging from 4 to 23 months. We noted no apparent adverse events following MP administration.
  
  
  CONCLUSIONS
  High-dose MP therapy reduced CH attack frequency and improved patient quality of life.
authors.affiliation: Department of Neurology, Okayama Kyokuto Hospital, 567-1 Kurata, Naka-ku, Okayama, 703-8265 Japan.
authors.forename: Sanami
authors.initials: S
authors.lastname: Kawada
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kashihara
authors.forename: Takaki
authors.initials: T
authors.lastname: Imamura
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohno
keywords: Cluster headache; Methylprednisolone; Steroid pulse therapy