neurologic disorders
Cluster Headache
Key Points
Typically, cluster headache causes excruciating unilateral periorbital or temporal pain, with ipsilateral ptosis, lacrimation, rhinorrhea, and/or nasal congestion, in men aged 20 to 40 years. Usually, patients experience ≥ 1 attack/day for 1 to 3 months, followed by remission for months to years. Diagnose cluster headache based on clinical findings. To abort attacks, give a parenteral triptan ordihydroergotamineand/or 100% oxygen by a nonrebreathing face mask. To prevent attacks, useprednisoneor a greater occipital nerve block for short-term relief andverapamil,lithium,topiramate, and/orgalcanezumabfor long-term relief. 