Botulinum toxin type A therapy in cluster headache: A case report

Kwon, So Young; Moon, Dong Eon; Kim, Young Hoon; Lee, Sung Hyun; Ryu, Keon Hee

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2012;7(1):12-15.
Published online January 31, 2012.

Botulinum toxin type A therapy in cluster headache: A case report

So Young Kwon, Dong Eon Moon, Young Hoon Kim, Sung Hyun Lee, Keon Hee Ryu

Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. demoon@catholic.ac.kr

Abstract

Cluster headache is a severe pain syndrome with a piercing, tearing sensation, nicknamed the suicide headache. It is associated with an autonomic symptom. No effective therapy is available in approximately 4-15% of patients with cluster headache. One of the treatment methods is occipital nerve block. It is conventionally performed with local anaesthetics, and in this case we used the botulinum toxin type A. Botulinum toxin is an effective therapeutic agent for various disorders, and has recently been discovered to be an effective treatment for chronic migraine. The efficacy of Botulinum toxin in headache invokes possible neurogenic effects that may reduce or even prevent sensitization of both the peripheral and central nervous system. Therefore, we describe a case of a 45-year-old male with a cluster headache that could not be controlled with conventional therapy. We performed botulium toxin type A therapy. Cluster headache VAS showed improvement after occipital nerve block using the botulinum toxin A.

Key Words: Botulinum toxin type A, Cluster headache, Occipi tal nerve block