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Cluster Headache: Potential Options for Medically Refractory Patients (When All Else Fails)

Authors


  • Conflict of Interest:

    Stewart J. Tepper, MD

    Grants/Research Support (no personal compensation, all paid to Cleveland Clinic, and not tied to salary): ATI (active), Boston Scientific (active), GSK (active), MAP (active), Merck (active), NuPathe (active), OptiNose (active), Valkee (active), Zogenix (active)

    All personal compensation <$10,000 per company:

    Consultant: Allergan (active), ATI (active), Impax (active), MAP (active), Merck (active), Nautilus (active), NuPathe (active), Zogenix (active)

    Speakers Bureau: Allergan (active), ATI (active), Impax (active), Merck (active), Nautilus (active), Zogenix (active)

    Advisors Board: Allergan (active), ATI (active), Merck (active), MAP (active), Nautilus (active), NuPathe (active), Pfizer (active), USWorldMeds (active), Zogenix (active)

    Stock options: ATI (active)

    Royalties (all active and <$10,000/year): University of Mississippi Press, Peoples Publishing House of Peking, Springer

    Mark J. Stillman, MD

    Grants/Research Support (no personal compensation, all paid to Cleveland Clinic, and not tied to my salary): ATI (active), Boston Scientific (active), GSK (active), MAP (active), Merck (active), NuPathe (active), OptiNose (active), Valkee (active), Zogenix (active)

Address all correspondence to S. Tepper, Headache Center, Neurological Center for Pain, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.

Abstract

The most evidence exists for mixed anesthetic/steroid occipital nerve blocks (which are also useful in non-refractory patients), deep brain stimulation, sphenopalatine ganglion (SPG) blocks, SPG radiofrequency ablation, and SPG stimulation with the Autonomic Technologies, Inc (ATI) SPG Neurostimulator, the latter approved in the European Union and reimbursed in several countries.

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