Get access

Single high-dose steroid treatment in episodic cluster headache

Authors

  • F Antonaci,

    Corresponding author
    1. Department of Neurological Sciences, IRCCS C. Mondino, University of Pavia
    2. University Centre for Adaptive Disorders and Headache (UCADH), Varese
    Search for more papers by this author
  • A Costa,

    1. Department of Neurological Sciences, IRCCS C. Mondino, University of Pavia
    2. University Centre for Adaptive Disorders and Headache (UCADH), Pavia, Italy
    Search for more papers by this author
  • E Candeloro,

    1. Department of Neurological Sciences, IRCCS C. Mondino, University of Pavia
    Search for more papers by this author
  • O Sjaastad,

    1. Department of Neurology, St. Olavs Hospital, Norwegian University of Technology and Science, Trondheim, Norway
    Search for more papers by this author
  • G Nappi

    1. Department of Neurological Sciences, IRCCS C. Mondino, University of Pavia
    2. University Centre for Adaptive Disorders and Headache (UCADH), Pavia, Italy
    3. Department of Neurology and Otorhinolaringology, La Sapienza University, Rome, Italy
    Search for more papers by this author

F. Antonaci, Department of Neurological Sciences, University of Pavia, Via Ferrata 6, 27100 Pavia Italy. Fax +39 02 700445466, e-mail neuronet@libero.it

Abstract

Corticosteroids appear to be the most rapid-acting of the prophylactic drugs used in the treatment of cluster headache (CH). These agents are frequently employed as a short-term regimen to induce clinical remission. In this study, we assessed in an open fashion the effect of high dose methylprednisolone (MPD) in a group of 13 patients with episodic CH (3 females and 10 males). On the 8th day of the active period, MPD was administered intravenously at the dose of 30 mg/kg body weight, as a 3-h infusion in saline. The attack frequency was followed for 7 days. The mean daily attack frequency before MPD administration was statistically different from that reported after treatment (respectively: 1.38 ± 0.42 and 0.83 ± 0.78; P = 0.05 Student's t-test). The mean interval between MPD administration and the occurrence of the first subsequent attack was 3.8 ± 2.2 days (range: 2–7 days). Only 3 (23%) of 13 patients experienced a complete headache remission. No significant side-effects were noted after MPD administration. These data further demonstrate that in most patients with episodic CH, high-dose systemic steroid administration may invariably interrupt attack recurrence for a few days, but is ineffective in maintaining complete clinical remission. This study also suggests that MPD administered as a solitary dose does not provide any advantage above prednisone in CH treatment.

Ancillary