Greater Occipital Nerve Injection versus Oral Steroids for Short Term Prophylaxis of Cluster Headache: A Retrospective Comparative Study

Wei, Jerry; Robbins, Matthew S.

doi:10.1111/head.13334

Cited by 17 publications

(19 citation statements)

References 23 publications

(58 reference statements)

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“…Alternative therapies include oral NSAIDS, neuroleptics, triptans, and use of any available neuromodulation devices 27 . Oral corticosteroids may be superior to nerve blocks for the remission of status migrainosus within 24 hours (31% of patients compared to 24% 29 respectively) as well as a transitional treatment for cluster headache, 30 however, should be used cautiously given the Center for Disease Control’s warning that corticosteroids may prolong viral replication in SARS‐CoV2, as was observed in MERS‐CoV 31…”

Section: Impact Of Covid‐19 On Patients With Headache Disorders and Omentioning

confidence: 99%

COVID‐19 and Headache: A Primer for Trainees

Bobker

Robbins

2020

Headache

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Objective To summarize for the trainee audience the possible mechanisms of headache in patients with COVID‐19 as well as to outline the impact of the pandemic on patients with headache disorders and headache medicine in clinical practice. Background COVID‐19 is a global pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2, of which a large subset of patients features neurological symptoms, commonly headache. The virus is highly contagious and is, therefore, changing clinical practice by forcing limitations on in‐person visits and procedural treatments, more quickly shifting toward the widespread adaptation of telemedicine services. Design/Results We review what is currently known about the pathophysiology of COVID‐19 and how it relates to possible mechanisms of headache, including indirect, potential direct, and secondary causes. Alternative options for the treatment of patients with headache disorders and the use of telemedicine are also explored. Conclusions Limited information exists regarding the mechanisms and timing of headache in patients with COVID‐19, though causes relate to plausible direct viral invasion of the nervous system as well as the cytokine release syndrome. Though headache care in the COVID‐19 era requires alterations, the improved preventive treatment options now available and evidence for feasibility and safety of telemedicine well positions clinicians to take care of such patients, especially in the COVID‐19 epicenter of New York City.

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Section: Impact Of Covid‐19 On Patients With Headache Disorders and Omentioning

confidence: 99%

COVID‐19 and Headache: A Primer for Trainees

Bobker

Robbins

2020

Headache

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“…A PRISMA flow diagram that summarized the process of study selection is presented in Figure 1. After an initial review of 3488 citations (following removal of duplicates), a total of 56 studies 18–72 were selected for inclusion. These studies included 45 published RCTs, four RCTs that were available only in clinical trial registries, 57,61–63 and seven observational studies, 66–72 with publication dates from 1978 to 2021.…”

Section: Resultsmentioning

confidence: 99%

Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

et al. 2022

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Background: Cluster headache is the most common primary headache disorder of the trigeminal autonomic cephalalgias, and it is highly disabling.Objective: We undertake a scoping review to characterize therapies to prevent and acutely treat cluster headache, characterize trial methodology utilized in studies, and recommend future trial "good practices." We also assess homogeneity of studies and feasibility for future network meta-analyses (NMAs) to compare acute and preventive treatments for cluster headache. Methods:A priori protocol for this scoping review was registered and available on Open Science Forum. We sought studies that enrolled adult patients with cluster headache as identified by accepted diagnostic criteria. Both randomized controlled trials (RCTs) and observational studies (with a control group) were included. The interventions of interest were medications, procedures, devices, surgeries, and behavioral/psychological interventions, whereas comparators of interest were placebo, sham, or other active treatments.Outcomes were predefined; however, we did not exclude studies lacking these outcomes.A systemic search was conducted in Ovid Medline, Embase, and Cochrane. We performed a targeted search for conference abstracts from journals prominent in the field. Results:We identified 56 studies: 45 RCTs, four studies only available in clinical trial registries, and seven observational studies. Of the 45 RCTs, 20 focused on acute therapies and 25 on preventive therapies. Overall, we determined that it is feasible to pursue a NMA for acute therapy focusing on 15 or 30-min headache reduction for acute trials, as we identified 11 trials in the combined population of patients with either episodic or chronic cluster headache (2 trials in populations with chronic cluster headache were also found). For preventive therapy of cluster headache, we identified trials with common outcomes that may be considered for NMA, however, as these trials had differences in treatment effect modifiers that could not be corrected, NMAs appear infeasible for this indication. We identified new studies looking at noninvasive vagal nerve stimulation, sphenopalatine ganglion stimulation, prednisone, and oxygen published since the most recent systematic review in the field, although these acute treatments were previously identified as effective. However, for calcitonin gene-related Rationale for this workThere are few evidence-based treatments available in CH, 3,4 as it is a condition that has been under studied. 1 The current scoping review was designed to expand upon past reviews in several ways. First, we sought to identify new studies published since the prior reviews were completed. 3,4 Second, with the data gathered in this scoping review, we aimed to assess the feasibility of pursuing network metaanalyses (NMAs) 5,6 to inform comparisons of multiple treatments based on available direct and indirect evidence in the field. We planned to systematically evaluate study and population features to establish the potential for rigorous N...

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“…30 For cluster headache prevention, only 1 treatment received a Level A recommendation: occipital nerve injection with steroid, which is conceptualized as a bridge treatment akin to an oral steroid course. 31 Verapamil, the most commonly used preventive therapy, 32 still only has a Level C recommendation despite its widespread use in practice because of the lack of clinical trials in the modern era. This debilitating disease also has a high proportion of patients who have the chronic subform (chronic cluster headache), which is particularly intractable.…”

Section: Neuromodulation For Cluster Headachementioning

confidence: 99%

Neuromodulation for the Acute and Preventive Therapy of Migraine and Cluster Headache

2019

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Headache disorders are among the most common and disabling medical conditions worldwide. Pharmacologic acute and preventive treatments are often insufficient and poorly tolerated, and the majority of patients are unable to adhere to their migraine treatments due to these issues. With improvements in our understanding of migraine and cluster headache pathophysiology, neuromodulation devices have been developed as safe and effective acute and preventive treatment options. In this review, we focus on neuromodulation devices that have been studied for migraine and cluster headache, with special attention to those that have gained food and drug administration (FDA) clearance. We will also explore how these devices can be used in patients who might have limited pharmacologic options, including the elderly, children, and pregnant women.

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Greater Occipital Nerve Injection versus Oral Steroids for Short Term Prophylaxis of Cluster Headache: A Retrospective Comparative Study

Abstract: Our single-center, retrospective data suggest the majority of patients with cluster headache responded to both prednisone and GON injections for transitional treatment, with a higher response to oral steroids. Our results may inform study design for a randomized trial, which is warranted.

Cited by 17 publications

References 23 publications

COVID‐19 and Headache: A Primer for Trainees

COVID‐19 and Headache: A Primer for Trainees

Effects of acute and preventive therapies for episodic and chronic cluster headache: A scoping review of the literature

Neuromodulation for the Acute and Preventive Therapy of Migraine and Cluster Headache

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