ANTIHISTAMINE RESPONSIVE CLUSTER HEADACHE IN A TEENAGED GIRL

Episodic cluster headache is a well-recognized entity usually starting in the second decade of life. Uncommonly, the first typical symptoms may present in the first decade of life, but are rarely recognized as such during childhood. We report a 12-year-old girl who presented with a 1-year history of bouts of right-sided hemicrania with ipsilateral, clearly demarcated, redness and itching of the skin of the face, tast ing from 15 minutes to 2 hours per day. The episodes recurred up to se veral times daily for a few days and were followed by remissions lasti ng up to 2 months. Thorough investigations failed to prove any definit e cause. Antihistamine prophylaxis, first with astemizole and then wit h loratadine, proved to be very effective. During the followup period of more than 3 years, such a prophylactic regimen provided excellent r elief, with only two relapses due to noncompliance. We suggest that in a sequential treatment trial for cluster headache during childhood, a ntihistamines should have their place, especially in those cases where clinical evidence may suggest histamine involvement.