The Treatment of Cluster Headache With Repetitive Intravenous Dihydroergotamine




We reviewed our experience with 54 cluster headache patients (23 episodic, 31 chronic) admitted to our headache center 54 tines over the past five years and treated with repetitive intravenous dihydroergotamine (IV DHE).

DHE therapy was initiated on admission and prophylactic medication regimens were started or adjusted.

All 54 patients had complete relief of their cluster headache, usually within two days. Most (82.8%) had no side effects. The average length of hospitalization was 6.7 days.

At the three month followup, 92.9% of the episodic cluster patients were headache-free and 7.1% had a 50-74% improvement; at six months, all wore headache-free.

Of the chronic cluster patients, 44.4% wore headache-free at three months and 52.8% had at least 50% improvement. At six months, 75% were headache-free and 22.2% wore at least 75% improved, probably as a result of continued prophylactic medication. Repetitive IV DHE safely, rapidly, and effectively controls cluster headache.