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Cluster-status migrainosus with a weekly periodicity responsive to high-flow oxygen: A case report.

Authors :
Seav SM
Schuster NM
Source :
Cephalalgia : an international journal of headache [Cephalalgia] 2019 Jan; Vol. 39 (1), pp. 157-160. Date of Electronic Publication: 2018 Jul 18.
Publication Year :
2019

Abstract

Background: There are cases in the headache literature described as "cluster-migraine," but none of stereotyped cases of cluster headache evolving into status migrainosus. We believe this is the first documented case of "cluster-status migrainosus".<br />Case: A 54 year-old female hospital administrator presented with headaches with a unique periodicity and semiology that were acutely responsive to high-flow oxygen. She experienced cluster headache attacks every Thursday morning at 3-4 am, which would evolve into status migrainosus lasting through Sunday evening. These attacks were preceded by prodromal depressed mood changes and fluid retention, and later followed by postdromal euphoria and auto-diuresis. These attacks initially occurred every other week and progressed to weekly attacks for 1.5 years. These headaches did not respond to trials of propanolol, sodium valproate, topiramate, amitriptyline, gabapentin, and carbamazepine for preventive treatment or to oral sumatriptan and butalbital-acetaminophen-caffeine for acute treatment. We started her on high-flow 100% oxygen for cluster headache, which successfully aborted greater than 80% of her weekly cluster headache attacks and prevented them from evolving into status migrainosus.<br />Conclusion: We believe this is the first case of "cluster-status migranosus" described in the medical literature. High-flow oxygen both aborted the cluster headaches and prevented the ensuing status migrainosus.

Details

Language :
English
ISSN :
1468-2982
Volume :
39
Issue :
1
Database :
MEDLINE
Journal :
Cephalalgia : an international journal of headache
Publication Type :
Academic Journal
Accession number :
30019592
Full Text :
https://doi.org/10.1177/0333102418787263