Oral Steroids Perform Better Than Injection in Short-Term Cluster Headache Mgmt.

According to the retroactive study, published recently in Headache that oral steroids perhaps more effective than occipital nerve injections of cluster headache for the short term prophylaxis.

During cluster headache phases, transitional therapies are usually administered for long period prophylactic medications being titrated. However, data are very limited about efficacy of injected vs oral steroids.

Investigators analyzed the medical charts of the patient seen at Montefiore Headache center. Verdict of cluster headache had been prepared by using the International classification of disorders in headache.

What is cluster Headache?

Cluster headache is known as a primary headache disorder which is characterized by the multiple phases of extreme pain along with autonomic features.

During the attacks of cluster headache, transitional therapies are very much useful whereas prophylactic dosage are increased or initiated. There are only limited data available to compare efficacy of injected transitional treatments versus oral steroids.

Transitional therapy was categorized and analyzed through providing partial, complete and last no response.

So, what’re they, let’s have a look.

Complete Response

The complete response to transitional therapy was perfectly defined as a termination of headache phases by 1^st week of treatment.

Partial Response

Partial response defined as a deduction in frequency of phases by 1^st week of treatment or simply return of headache phases after initial cessation.

No response

No response defined as either worsening of headaches phases or no change.

Forty three patients were involved in the analysis and 140 transitional therapy clash were analyzed.

• Oral steroids were managed in 81 of the encounters
• Greater occipital nerve injections managed in 59 of the encounters.

Of the study group

• 24 patients undergo only 1 type treatment.
• While, 16 patients get both the options.

The higher percentage of patients are in which oral steroids were managed than greater occipital nerve injection resulted with partial response (82.7% vs 64.4%) and complete response (50.6% vs 35.6%).

About 16 patients have received both the treatments, in which

• 50% well responded to both options.
• 5% responded to the oral steroids.
• And only 6.3% responded to greater occipital nerve injection.

Moreover, no negative effects were documented through any of the treatment.

Ideally, a future study inscribed transitional therapy for the cluster headache can be a randomized, prospective and placebo controlled clinical trial for better discover to optimal dosage and treatment.

However, the oral prednisone is far better as compared to the injected steroids for any transitional treatment of the cluster headache.

The author wrote that, due to lack of this data, most of the study suggests both injected steroids and oral to be much effective in transitional therapy of cluster headache. But the author concluded that the oral steroids is potentially more beneficial than injected steroids.

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