TREATMENT OF CLUSTER HEADACHE AND ITS VARIANTS

In cluster headache, subcutaneous administration of sumatriptan has be en established as an efficient, safe and well tolerated treatment for acute attacks. For prophylatic treatment, capsaicin (intranasal admini stration) and leuprolide (a synthetic slow-release gonadotrophin-relea sing hormone) seem to be promising. Hyperbaric oxygen therapy seems to be effective in acute attacks, but it is of interest mostly because o f its apparent interruption of the cluster period in some patients. In chronic paroxysmal hemicrania, which clinically resembles cluster hea dache, indomethacin is still necessary for diagnosis, and it is the tr eatment of choice in most patients. However, because of its potential side effects, alternative treatments should be sought.