Diagnosis, pathophysiology, and management of cluster headache
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Diagnosis, pathophysiology, and management of cluster headache. / Hoffmann, Jan; May, Arne.
In: LANCET NEUROL, Vol. 17, No. 1, 01.2018, p. 75-83.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Diagnosis, pathophysiology, and management of cluster headache
AU - Hoffmann, Jan
AU - May, Arne
N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Cluster headache is a trigeminal autonomic cephalalgia characterised by extremely painful, strictly unilateral, short-lasting headache attacks accompanied by ipsilateral autonomic symptoms or the sense of restlessness and agitation, or both. The severity of the disorder has major effects on the patient's quality of life and, in some cases, might lead to suicidal ideation. Cluster headache is now thought to involve a synchronised abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system. The hypothalamus appears to play a fundamental role in the generation of a permissive state that allows the initiation of an episode, whereas the attacks are likely to require the involvement of the peripheral nervous system. Triptans are the most effective drugs to treat an acute cluster headache attack. Monoclonal antibodies against calcitonin gene-related peptide, a crucial neurotransmitter of the trigeminal system, are under investigation for the preventive treatment of cluster headache. These studies will increase our understanding of the disorder and perhaps reveal other therapeutic targets.
AB - Cluster headache is a trigeminal autonomic cephalalgia characterised by extremely painful, strictly unilateral, short-lasting headache attacks accompanied by ipsilateral autonomic symptoms or the sense of restlessness and agitation, or both. The severity of the disorder has major effects on the patient's quality of life and, in some cases, might lead to suicidal ideation. Cluster headache is now thought to involve a synchronised abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system. The hypothalamus appears to play a fundamental role in the generation of a permissive state that allows the initiation of an episode, whereas the attacks are likely to require the involvement of the peripheral nervous system. Triptans are the most effective drugs to treat an acute cluster headache attack. Monoclonal antibodies against calcitonin gene-related peptide, a crucial neurotransmitter of the trigeminal system, are under investigation for the preventive treatment of cluster headache. These studies will increase our understanding of the disorder and perhaps reveal other therapeutic targets.
KW - Anesthetics, Local
KW - Cluster Headache
KW - Humans
KW - Lidocaine
KW - Oxygen
KW - Tryptamines
KW - Journal Article
KW - Review
U2 - 10.1016/S1474-4422(17)30405-2
DO - 10.1016/S1474-4422(17)30405-2
M3 - SCORING: Review article
C2 - 29174963
VL - 17
SP - 75
EP - 83
JO - LANCET NEUROL
JF - LANCET NEUROL
SN - 1474-4422
IS - 1
ER -