Cluster Headache: Treatment

General measures

  • Nicotine restriction (abstaining from tobacco use) – smokers have significantly longer cluster headache periods and higher attack frequencies compared to non-smokers
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day) or alcohol restriction (abstaining from alcohol) Note:
    • Alcohol consumption can trigger cluster headache attacks.
    • During an active cluster period, alcohol consumption should be completely avoided.
  • Review of permanent medication due topossible effect on the existing disease.
  • Avoidance of psychosocial stress:
    • Stress
  • Travel medical recommendations
    • Avoidance of high altitudes
    • Avoidance of time zone shifts

Conventional non-surgical therapy methods

  • Subcutaneous occipital neurostimulation (pain reduction by occipital nerve stimulation) – can be effective in the prophylaxis of chronic cluster headache. However, revision interventions due to electrode dislocations, electrode fractures, or infections are very common. This clinical experience is not supported by controlled studies. Approval status: off-label use
  • Stimulation of the sphenopalatine ganglion (SPG): for this purpose, a microstimulator is inserted on the lateral maxilla via a gingival margin incision; in a small study (43 patients), 68% of those treated experienced a significant reduction in pain (sham stimulation: approximately 7%); one year after the procedure, 61% continued to have a relevant clinical effect (reduction in pain attacks by at least 50%).

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
    • Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
    • Avoid foods that lead to increased histamine release, such as strawberries, chocolate, citrus fruits, tomatoes, since histamine is also a possible cause of cluster headache
  • Selection of appropriate foods based on the nutritional analysis.
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Psychotherapy