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Managing cluster headache
  1. Diana Y Wei1,
  2. Modar Khalil1,2,
  3. Peter J Goadsby1,3
  1. 1 Headache Group, Department of Basic and Clinical Neuroscience, King’s College London, London, UK
  2. 2 Department of Neurology, Hull Royal Infirmary, Hull, UK
  3. 3 NIHR-Wellcome Trust King’s Clinical Research Facility, SLaM Biomedical Research Centre, King’s College Hospital, London, UK
  1. Correspondence to Professor Peter J Goadsby, Wellcome Foundation Building, King's College Hospital, London, SE5 9PJ, UK; peter.goadsby{at}


Cluster headache is a neurological disorder that presents with unilateral severe headache associated with ipsilateral cranial autonomic symptoms. Cluster headache attacks often occur more than once a day, and typically manifesting in bouts. It has a point prevalence of 1 in 1000 and is the most common trigeminal autonomic cephalalgia. This article aims to guide general neurologists to an accurate diagnosis and practical management options for cluster headache patients.

  • cluster headache
  • management
  • neuromodulation

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  • Contributors DYW, PJG: conception, outline of article and final revisions. DYW, MK: first draft and revisions of manuscript.

  • Funding This paper represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests PJG reports, over the last 36 months, grants and personal fees from Amgen and Eli-Lilly and Company, and personal fees from Alder Biopharmaceuticals, Allergan, Autonomic Technologies Inc., Biohaven Pharmaceuticals Inc., Dr Reddy's Laboratories, Electrocore LLC, eNeura, Impel Neuropharma, MundiPharma, Novartis, Teva Pharmaceuticals, Trigemina Inc., WL Gore, and personal fees from MedicoLegal work, Massachusetts Medical Society, Up-to-Date, Oxford University Press, and Wolters Kluwer; and a patent magnetic stimulation for headache assigned to eNeura without fee.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned. Externally peer reviewed by Nicola Giffin, Bath, UK and Alexandra Sinclair, Birmingham, UK.

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