Guías Fisterra : Cefalea en racimos

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¿De qué hablamos?







¿Cómo se diagnostica?








International Headache Classification


 Tabla 1. Diagnóstico diferencial de la cefalea en racimos (Schindler EAD, 2022; Law S, 2013; Lipton RB, 2005; IHS, 2018).
Características Cefalea en racimos Hemicránea Migraña
Sexo 3:1 1:1 3:1
Gravedad +++ +++ ++
Frecuencia crisis 1-8/diarios >5/diarios 8-15/mes
Duración crisis 15-180 minutos 2-30 minutos 4 horas-72 horas
Desencadenantes Alcohol Alcohol Patrón de sueño u horario de comida irregulares
Sedentarismo
Alimentos
Respuesta oxígeno 78% Sin efecto Efectivo como alternativa
Respuesta sumatriptan 75% 20% Efectivo >80%
Respuesta indometacina Sin efecto 100% Sin efecto

¿Cómo se trata?








Tratamiento agudo

Oxigenoterapia.

Triptanes. 





Tratamiento preventivo









galcanezumabmelatonina


Bibliografía

  • Beck E, Sieber WJ, Trejo R. Management of cluster headache. Am Fam Physician. 2005;71(4):717-24. PubMed PMID: 15742909
  • Bennett MH, French C, Schnabel A, Wasiak J, Kranke P, Weibel S. Normobaric and hyperbaric oxygen therapy for the treatment and prevention of migraine and cluster headache. Cochrane Database Syst Rev. 2015;(12):CD005219. PubMed PMID: 26709672Texto completo
  • Bussone G, Leone M, Peccarisi C, Micieli G, Granella F, Magri M, et al. Double blind comparison of lithium and verapamil in cluster headache prophylaxis. Headache. 1990;30(7):411-7. PubMed PMID: 2205598
  • Cohen AS, Burns B, Goadsby PJ. High-flow oxygen for treatment of cluster headache: a randomized trial. JAMA. 2009;302(22):2451-7. PubMed PMID: 19996400Texto completo
  • Cohen AS, Matharu MS, Goadsby PJ. Electrocardiographic abnormalities in patients with cluster headache on verapamil therapy. Neurology. 2007;69(7):668-75. PubMed PMID: 17698788
  • Diener HC, May A. Drug Treatment of Cluster Headache. Drugs. 2022;82(1):33-42. PubMed PMID: 34919214. Texto completo
  • Fischera M, Marziniak M, Gralow I, Evers S. The incidence and prevalence of cluster headache: a meta-analysis of population-based studies. Cephalalgia. 2008;28(6):614-8. PubMed PMID: 18422717
  • Francis GJ, Becker WJ, Pringsheim TM. Acute and preventive pharmacologic treatment of cluster headache. Neurology. 2010;75(5):463-73. PubMed PMID: 20679639
  • Goadsby PJ, Dodick DW, Leone M, Bardos JN, Oakes TM, Millen BA, et al. Trial of Galcanezumab in Prevention of Episodic Cluster Headache. N Engl J Med. 2019;381(2):132-41. PubMed PMID: 31291515Texto completo
  • Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211. doi: 10.1177/0333102417738202. PubMed PMID: 29368949. Texto completo
  • Kano H, Kondziolka D, Niranjan A, Flickinger JC, Lunsford LD. γ knife stereotactic radiosurgery in the management of cluster headache. Curr Pain Headache Rep. 2011;15(2):118-23. PubMed PMID: 21181562
  • Koppen H, Stolwijk J, Wilms EB, Van Driel V, Ferrari MD, Haan J. Cardiac monitoring of high-dose verapamil in cluster headache: An international Delphi study. Cephalalgia. 2016;36(14):1385-8. PubMed PMID: 26868817
  • Law S, Derry S, Moore RA. Triptans for acute cluster headache. Cochrane Database Syst Rev. 2013;(7):CD008042. PubMed PMID: 24353996Texto completo
  • Leone M, D’Amico D, Frediani F, Moschiano F, Grazzi L, Attanasio A, et al. Verapamil in the prophylaxis of episodic cluster headache: a double-blind study versus placebo. Neurology. 2000;54(6):1382-5. PubMed PMID: 10746617
  • Lipton RB, Bigal ME. Migraine: epidemiology, impact, and risk factors for progression. Headache. 2005;45 Suppl 1:S3-13. PubMed PMID: 15833088
  • Malu OO, Bailey J, Hawks MK. Cluster Headache: Rapid Evidence Review. Am Fam Physician. 2022;105(1):24-32. PubMed PMID: 35029932
  • Manzoni GC, Maffezzoni M, Lambru G, Lana S, Latte L, Torelli P. Late-onset cluster headache: some considerations about 73 cases. Neurol Sci. 2012;33 Suppl 1:S157-9. PubMed PMID: 22644193
  • Matharu MS, Levy MJ, Meeran K, Goadsby PJ. Subcutaneous octreotide in cluster headache: randomized placebo-controlled double-blind crossover study. Ann Neurol. 2004;56(4):488-94. PubMed PMID: 15455406
  • Morgan A, Jessop V. Best BETs from the Manchester Royal Infirmary. BET 2: should intranasal lidocaine be used in patients with acute cluster headache? Emerg Med J. 2013;30(9):769-70. PubMed PMID: 23943642
  • Narouze SN. Role of sphenopalatine ganglion neuroablation in the management of cluster headache. Curr Pain Headache Rep. 2010;14(2):160-3. PubMed PMID: 20425206
  • Obermann M, Nägel S, Ose C, Sonuc N, Scherag A, Storch P, et al. Safety and efficacy of prednisone versus placebo in short-term prevention of episodic cluster headache: a multicentre, double-blind, randomised controlled trial. Lancet Neurol. 2021;20(1):29-37. PubMed PMID: 33245858
  • Pascual J, Láinez MJ, Dodick D, Hering-Hanit R. Antiepileptic drugs for the treatment of chronic and episodic cluster headache: a review. Headache. 2007;47(1):81-9. PubMed PMID: 17355498
  • Robbins MS, Starling AJ, Pringsheim TM, Becker WJ, Schwedt TJ. Treatment of Cluster Headache: The American Headache Society Evidence-Based Guidelines. Headache. 2016;56(7):1093-106. PubMed PMID: 27432623Texto completo
  • Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache. 2012;52(1):99-113. PubMed PMID: 22077141
  • Schindler EAD, Burish MJ. Recent advances in the diagnosis and management of cluster headache. BMJ. 2022;376:e059577. PubMed PMID: 35296510. Texto completo
  • Schürks M, Kurth T, De Jesus J, Jonjic M, Rosskopf D, Diener HC. Cluster headache: clinical presentation, lifestyle features, and medical treatment. Headache. 2006;46(8):1246-54. PubMed PMID: 16942468
  • Waung MW, Taylor A, Qualmann KJ, Burish MJ. Family History of Cluster Headache: A Systematic Review. JAMA Neurol. 2020;77(7):887-96. PubMed PMID: 32310255. Texto completo
  • Weaver-Agostoni J. Cluster headache. Am Fam Physician. 2013;88(2):122-8. PubMed PMID: 23939643

Más en la red

  • Malu OO, Bailey J, Hawks MK. Cluster Headache: Rapid Evidence Review. Am Fam Physician. 2022;105(1):24-32. PubMed PMID: 35029932
  • Robbins MS. Diagnosis and Management of Headache: A Review. JAMA. 2021;325(18):1874-85. PubMed PMID: 33974014
  • Schindler EAD, Burish MJ. Recent advances in the diagnosis and management of cluster headache. BMJ. 2022;376:e059577. PubMed PMID: 35296510. Texto completo

Autoras

  • Begoña Aldamiz-Echevarría Iraúrgui
Médico Especialista en Medicina Familiar y Comunitaria (1)
  • Carmen Costa Ribas
Médico Especialista en Medicina Familiar y Comunitaria (2)
(1) Unidad de Hospitalización a Domicilio. Hospital Marítimo de Oza. Servizo Galego de Saúde. A Coruña. España.
(2) Centro de Salud de Vila. Ibiza, Illes Balears. España.