Transient side shift of cluster headache attacks after unilateral greater occipital nerve injection

Attacks of cluster headache (CH) are usually side-locked in most, but not all, patients. In a few patients, the side may alternate between or, rarely, within cluster episodes. We observed seven cases in whom the side of CH attacks temporarily shifted immediately or shortly after unilateral injection...

Full description

Saved in:
Bibliographic Details
Published in:Headache 2023-09, Vol.63 (8), p.1193-1197
Main Authors: Brandt, Roemer B, Naber, Willemijn C, Ouwehand, Rosa-Lin H, Haan, Joost, Ferrari, Michel D, Fronczek, Rolf
Format: Article
Language:English
Subjects:
Clusters
Corticoids
Corticosteroids
Headache
Hypothalamus
Injection
Nerves
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Attacks of cluster headache (CH) are usually side-locked in most, but not all, patients. In a few patients, the side may alternate between or, rarely, within cluster episodes. We observed seven cases in whom the side of CH attacks temporarily shifted immediately or shortly after unilateral injection of the greater occipital nerve (GON) with corticosteroids. In five patients with previously side-locked CH attacks and in two patients with previously side-alternating CH attacks, a side shift for several weeks occurred immediately (N = 6) or shortly (N = 1) after GON injection. We concluded that unilateral GON injections might cause a transient side shift of CH attacks through inhibition of the ipsilateral hypothalamic attack generator causing relative overactivity of the contralateral side. The potential benefit of bilateral GON injection in patients who experienced a side shift after unilateral injection should be formally investigated.
ISSN:0017-8748
1526-4610
DOI:10.1111/head.14587