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Cluster and other trigeminal autonomic cephalalgias 

Cluster and other trigeminal autonomic cephalalgias
Chapter:
Cluster and other trigeminal autonomic cephalalgias
Author(s):

Gennaro Bussone

and Massimo Leone

DOI:
10.1093/med/9780199545148.003.0012
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date: 22 October 2019

The first step in management is to reassure the patient that the condition is benign and to provide accurate information about it.

There are two pharmacological approaches: acute and prophylactic.

For cluster headache, the first choice acute treatment is the selective 5-HT1B/1D receptor agonist sumatriptan.

A number of different drug options are available for prophylaxis.

The choice of prophylactic drug is influenced by previous response, previous side-effects, contraindications, duration of symptoms, and the age and lifestyle of the patient.

If a severe attack occurs notwithstanding prophylaxis, acute medications should be employed.

Patients with chronic trigeminal autonomic cephalalgias who do not respond to, or have major contraindications to, prophylactic treatments may be candidates for surgical approaches.

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