Clomiphene treatment may be effective in refractory episodic and chronic cluster headache

Maria Eduarda Nobre; Mario Fernando Prieto Peres; Pedro Ferreira Moreira Filho; Antonio José Leal

doi:10.1590/0004-282X20170119

Arquivos de Neuro-Psiquiatria, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(09): 620-624
DOI: 10.1590/0004-282X20170119

ARTICLES

Clomiphene treatment may be effective in refractory episodic and chronic cluster headache

Tratamento de 15 casos episódicos e crçnicos de cefaleia em salvas de difícil controle com clomifeno

Maria Eduarda Nobre

¹Universidade Federal Fluminense, Departamento de Neurologia, Niterói RJ, Brasil;

,

Mario Fernando Prieto Peres

²Hospital Albert Einstein, Departamento de Neurologia, São Paulo SP, Brasil;

,

Pedro Ferreira Moreira Filho

¹Universidade Federal Fluminense, Departamento de Neurologia, Niterói RJ, Brasil;

,

Antonio José Leal

³Universidade Federal do Rio de Janeiro, Departamento de Epidemiologia, Rio de Janeiro RJ, Brasil.

› Institutsangaben

Abstract

ABSTRACT

Objective To describe the evolution of 15 patients who were treated for difficult-to-control episodic and chronic cluster headaches with clomiphene.

Methods Clomiphene treatment was used for seven chronic and eight episodic cluster headache patients. The chronic patients were refractory to the medication being used, and the episodic patients, in addition to being resistant to conventional medication, had longer cluster headache periods, exceeding the average time of previous cluster cycles. Our main analysis was of the time to pain-free, complete remission, and the length of pain-free time and complete remission.

Results Clomiphene was used for 45-180 days. The average time to being pain-free was 15 days and cluster remission was up to 60 days. The average time between being pain-free until cluster remission was 26 days.

Conclusions Clomiphene treatment was significantly efficient. It interrupted chronicity in all patients, suggesting the capability of changing the pattern of attacks. It proved to be safe and well tolerated.

RESUMO

Objetivo Descrever a evolução de 15 casos de cefaleia em salvas de difícil controle, episódicos e crçnicos, tratados com clomifeno.

Métodos Foram tratados 7 casos crçnicos e 8 episódicos. Os crçnicos, refratários aos medicamentos preventivos em uso e os episódicos, além de refratários, apresentaram salva mais longa que as anteriores. Foram analisados o tempo para a ausência das crises, fim da salva e o tempo entre os dois parâmetros.

Resultados O clomifeno foi usado por 45 a 180 dias. A média de tempo para a remissão das crises foi de 15 dias e da salva foi de 60 dias. A média entre o fim das crises e da salva foi de 26 dias.

Conclusão O clomifeno foi eficaz em ambos os padrões. Foi capaz de interromper a cronicidade em todos os casos, o que sugere uma ação neuromodulatória capaz de mudar o padrão das crises. Mostrou-se seguro e bem tolerado.

headache - therapeutics - testosterone - clomiphene - hypothalamus

cefaleia - terapêutica - testosterona - clomifeno - hipotálamo

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Referenzen

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