Work

Transient side shift of cluster headache attacks after unilateral greater occipital nerve injection

Year: 2023

Type: article

Abstract: Attacks of cluster headache (CH) are usually side-locked in most, but not all, patients. In a few patients, the side may alternate between or, rarely, within cluster episodes. We observed seven cases in whom the side of CH attacks temporarily shifted immediately or shortly after unilateral injection of the greater occipital nerve (GON) with corticosteroids. In five patients with previously side-locked CH attacks and in two patients with previously side-alternating CH attacks, a side shift for several weeks occurred immediately (N = 6) or shortly (N = 1) after GON injection. We concluded that unilateral GON injections might cause a transient side shift of CH attacks through inhibition of the ipsilateral hypothalamic attack generator causing relative overactivity of the contralateral side. The potential benefit of bilateral GON injection in patients who experienced a side shift after unilateral injection should be formally investigated.

Source: Headache The Journal of Head and Face Pain

DOI: 10.1111/head.14587

Authors: Roemer B. Brandt, Willemijn C. Naber, Rosa‐Lin H. Ouwehand, Joost Haan, Michel D. Ferrari, Rolf Fronczek

Institutions: Leiden University, Leiden University Medical Center, Alrijne Ziekenhuis

Language: English

Topic: Migraine and Headache Studies

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,950