Acute treatments
Migraine Ireland
Acute treatments are used to treat an attack once it has begun, to try to stop or abort the attack. They include:
Triptans
- Sumatriptan (Imigran/Imitrex) is the most widely used Triptan for Cluster Headache. It is delivered via subcutaneous injection and has shown that it works very quickly in a high proportion of sufferers.
- Zolmitriptan (Zomig) may help with episodic Cluster Headache, but may not be as fast-acting as either Sumatriptan or Oxygen therapy.
Oxygen Therapy
Breathing in pure oxygen (100%) at a rate of between 10 to 15 litres per minute is relatively fast at providing pain relief in most sufferers. It should be inhaled continuously for 15 – 20 minutes using a non-re-breathing mask (the one without the holes).
GammaCore’ Device
The ‘gammaCore’ device is a non-invasive hand held device that produces a mild electrical signal that is transmitted to the vagus nerve through the skin. It’s not certain how it works on prevention of Cluster Headache but it is thought that it works on reducing the amount of ‘glutamate’ that is released in the body.
http://gammacore.com/en/patients/
**’gammaCore’ is only available with a prescription and authorisation form signed by your physician.
Preventative medicinal treatments
Migraine medications may be acute or preventative, and patients with frequent or severe headaches may require both approaches. Acute treatment attempts to relieve or stop the progression of an attack or to abort it once it has begun. Preventative treatment is used in an attempt to reduce the frequency and severity of anticipated attacks. However, these drugs are unlikely to prevent attacks altogether and will not cure the underlying cause.
Short term treatments
- Corticosteroids
- Ergotamine
- DHE (Dihydroergotamine) infusion.
Long term treatments
- Verapamil
- Lithium
Surgery
There are two possible surgery options available. Occipital Nerve Stimulation (ONS) and Deep Brain Stimulation (DBS).
ONS
ONS is minimally invasive and involves the implantation of a battery pack in either the shoulder or abdominal area with wires extending to the back of the skull. It emits a pulse which helps to stop the pain and reduce the frequency and severity of the attacks.
DBS
DBS is more invasive as it involves implantation of a battery on the posterior hypothalamus area under the brain. Surgery is much more complicated due to the location.