09 December 2009

Oxygen therapy for cluster headache

High-flow oxygen appears to be an effective treatment for cluster headaches, British researchers have found.


High-flow oxygen appears to be an effective treatment for cluster headaches, British researchers have found.

People with cluster headaches can have as many as eight per day in bouts that last for weeks or months. The current treatment is injection with the drug sumatriptan, but frequent use of the drug isn't recommended because of the risk of adverse effects. High-flow oxygen is also used to treat cluster headaches, but its use is limited because of a lack of good quality controlled studies.

How the study was done

This new study included 76 adult patients, aged 18 to 70, with either episodic cluster headache (57) or chronic cluster headache (19). During four cluster headache episodes, the patients alternatively received high-flow oxygen (inhaled oxygen at 100%, 12 litres per minute, delivered by face mask, for 15 minutes at the start of the attack) or placebo (high-flow air).

The study found that 78% of patients reported being pain-free or having adequate relief within 15 minutes of receiving high-flow oxygen, compared with 20% of patients after they received high-flow air. High-flow oxygen also provided better pain relief at 30 and 60 minutes.

No serious harmful side effects were reported after high-flow oxygen treatment, according to the report published in the Journal of the American Medical Association.

"To our knowledge, this is the first adequately powered trial of high-flow oxygen compared with placebo, and it confirms clinical experience and current guidelines that inhaled oxygen can be used as an acute attack therapy for episodic and chronic cluster headache," wrote Anna S. Cohen, of the National Hospital for Neurology and Neurosurgery in London, and colleagues.

"This work paves the way for further studies to optimise the administration of oxygen and its more widespread use as an acute attack treatment in cluster headache, offering an evidence-based alternative to those who cannot take triptan agents," they concluded. - (HealthDay News, December 2009)


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Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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