High-Flow Oxygen for Treatment of Cluster Headache

Abstract

LUSTER HEADACHE IS A STEREOtypical primary headache syndrome characterized by attacks of unilateral excruciating pain usually in the eye, periorbital region, and temple with associated cranial autonomic symptoms such as conjunctival injection, lacrimation, nasal blockage, rhinorrhea, ptosis, and eyelid edema. During attacks patients are often restless, agitated, or both. Attacks typically last for 15 to 180 minutes untreated and have a frequency of 1 every other day for up to 8 attacks a day. 1 Attacks usually occur in bouts, or clusters, lasting for weeks or months, separated by remissions lasting months or years. Episodic cluster headache is defined as bouts of attacks lasting 7 days up to a year with breaks of 1 month or more between bouts. Bouts are usually circannual, occurring once a year, with a mean bout duration of 8 weeks. 2 Chronic cluster headache is defined as occurring for more than a year without remission or with remissions lasting less than a month. Cluster headache attacks may also occur with clocklike regularity during the day and may be precipitated by sleep, 3 usually occurring 90 minutes after the onset of sleep. Cluster headache affects more men than women (male-female ratio of 2.5:1) and has an estimated prevalence of 0.3% in the general population. 4 Cluster headache is probably the most severe pain known to humans. Most female patients describe each attack as worse than childbirth.See also Patient Page.

Evidence for Oxygen Use in the Hospitalized Patient: Is More Really the Enemy of Good?

“…Cohen et al evaluated the effectiveness of using 12-15 L/min oxygen for treatment of CH. 115 While headache relief was comparable to studies using lower flows, no rebound CH were reported.…”

Effect of intermittent normobaric hyperoxia for treatment of neuropathic pain in Chinese patients with spinal cord injury

“…The most important one is low participant number and inability. Most studies on oxygen therapy in treatment with pain ranged from 15 to 70 min, [14][15][16] and most studies of InHO in neuroscience designated 4 h per day for six consecutive days (almost a week) as their treatment. 21,22,34 We regarded daily term (1 h per day, 2 h per day and 4 h per day) and weeks (1 week, 2 weeks and 4 weeks) of InHO therapy as factors.…”

“…Recent researches have reported that oxygen therapy appears to be effective in the pain management and show same effectiveness as hyperbaric oxygen. [14][15][16] Though studies have revealed the analgesic effect of hyperbaric oxygen in both rats and human with neuropathic pain, 13,[17][18][19] costs and poor availability limit the use of hyperbaric oxygen. These prompt us to investigate the effect of intermittent normobaric hyperoxia (InHO) in the treatment of neuropathic pain.…”

Headache, Primary Headaches and Their Treatment

“…For acute attack, High-flow oxygen (10-12 L/ min for 15-20 min) or sumatriptan (6 mg SC or 20 mg nasal spray) is effective. 30 Deep-brain stimulation of the posterior hypothalamic gray matter is successful for refractory cases as is the less-invasive approach of occipital nerve stimulation. Hemicrania continua is a continuous, strictly unilateral headache that waxes and wanes .…”