Objective: There is very little literature surrounding the prophylactic use of zonisamide in cluster headaches. The study aims to evaluate the effectiveness of zonisamide for prophylaxis of cluster headache in patients with chronic or episodic cluster headache.
Background: Both chronic and episodic cluster headaches are debilitating disorders which are often refractory to multiple prophylactic medication regimens. There is a scarcity of research in this area, and current prophylactic options for patients are fairly limited, which is troublesome for affected patients. Zonisamide is an established antiepileptic with a multifactorial mechanism of action which has shown to be useful in other headache disorders such as migraine.
Methods: Twenty cluster headache patients, both episodic (n = 12; ICHD 3.1.1) and chronic (n = 8; ICHD 3.1.2), who had been or currently were treated with zonisamide, were retrospectively evaluated. Effectiveness of the medication was assessed and identified as headache remission or a reduction in severity or frequency of cluster headache of greater than 50%. Responder status, side effects, and dosage were recorded.
Results: Fourteen (70%) patients responded to zonisamide treatment, while 6 (30%) did not. Recorded effective plasma zonisamide levels ranged from 10.2 to 31.9 μg/mL. Of the 6 non-responders, 2 stopped the medication due to ineffectiveness, while 4 discontinued the medication secondary to intolerable side effects ranging from gastrointestinal upset to malaise. No more serious adverse events occurred. Eight patients total experienced weight loss/anorexia which many perceived as a positive effect; they lost an average of 10.5% of their body weight in the first 6 months of therapy.
Conclusions: Zonisamide appears to be an effective prophylactic treatment for patients with chronic and episodic cluster headache disorders. Further research in this area is clearly warranted.
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http://dx.doi.org/10.1111/head.13546 | DOI Listing |
Schmerz
January 2025
Neurologische Klinik und Poliklinik, LMU Klinikum, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, München, Deutschland.
Cluster headache is a severe primary headache disorder, which can be associated with a substantial impairment for sufferers. The Cluster Headache Impact Questionnaire (CHIQ) is a short questionnaire for measuring the cluster headache-specific impairment. A 5-stage severity grading from "no to low impairment" to "'extreme impairment" was established based on the results of an English-speaking patient collective.
View Article and Find Full Text PDFBMC Med Educ
January 2025
Public Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Background: Self- medication leading to wastage of limited resources in developing countries, prolonged suffering, increase resistance to drugs and may result in significant medical complications such as adverse drug responses and dependence. Self-medication is extensively used by health professionals. Undergraduate medical students as being the future physicians representing a main pillar in health care system thus have special significance.
View Article and Find Full Text PDFGac Med Mex
January 2025
Private practice, Guadalajara, Jalisco, Mexico.
Background: In developed countries, most of the neurologists use pericranial nerve blocks to treat headache patients, nevertheless, the knowledge and use patterns of this technique in developing countries are unknown.
Objective: Evaluate the knowledge and use patterns of pericranial nerve blocks in headache treatment by Mexican neurologists.
Material And Methods: We did a cross-sectional study, 90 Mexican neurologists completed a 26-question survey including data about sociodemographics, knowledge and patterns of use of pericranial nerve blocks.
Curr Pain Headache Rep
January 2025
Northwell Health Department of Neurology, New York, NY, USA.
Purpose Of Review: Exploration of the potential of serotonergic psychedelic drugs, such as psilocybin and LSD, as potential treatments for headache disorders. This review addresses the need for well-informed physician guidelines and discusses mechanisms, safety, and efficacy of these treatments. Further research, including the consideration of combination with psychotherapy, is needed.
View Article and Find Full Text PDFJ Headache Pain
January 2025
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, Latina, Italy.
Background: Neuroimaging studies have shown that hypothalamic/thalamic nuclei and other distant brain regions belonging to complex cerebral networks are involved in cluster headache (CH). However, the exact relationship between these areas, which may be dependent or independent, remains to be understood. We investigated differences in resting-state functional connectivity (FC) between brain networks and its relationship with the microstructure of the hypothalamus and thalamus in patients with episodic CH outside attacks and healthy controls (HCs).
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