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. 2023 Sep;63(8):1193-1197.
doi: 10.1111/head.14587. Epub 2023 Jun 26.

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

Roemer B Brandt  1 , Willemijn C Naber  1 , Rosa-Lin H Ouwehand  1 , Joost Haan  1   2 , Michel D Ferrari  1 , Rolf Fronczek  1
Affiliations

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

Roemer B Brandt et al. Headache. 2023 Sep.

Abstract

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.

Keywords: case series; cluster headache; greater occipital nerve injection; side switch.

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References

REFERENCES

    1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38:1-211.
    1. Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17:75-83.
    1. Meyer EL, Laurell K, Artto V, et al. Lateralization in cluster headache: a Nordic multicenter study. J Headache Pain. 2009;10:259-263.
    1. May A, Bahra A, Buchel C, Frackowiak RS, Goadsby PJ. Hypothalamic activation in cluster headache attacks. Lancet. 1998;352:275-278.
    1. Bahra A, May A, Goadsby PJ. Cluster headache: a prospective clinical study with diagnostic implications. Neurology. 2002;58:354-361.

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