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Cluster Headache Cluster headache вЂў History: вЂў Occurs in clusters вЂў several assaults a day for weeks / months, вЂў then remission вЂў Strictly unilateral вЂў Excruciatingly extreme, frontal / retro-orbital вЂў Attacks shorter than migraine вЂў 30 min вЂ“ 4 hours вЂў Up to eight occasions a day вЂў Ultradian rhythms (extra typically at night) вЂў Patients are stressed (cf migraine) вЂў Trigeminal autonomic features вЂў Ptosis, tearing, conjunctival injection, flushing, rhinorrhea Cluster headache вЂў Acute treatment: вЂў High move O2 вЂ“ aborts most assaults вЂў a hundred% by way of non-rebreathe mask вЂў Sc sumatriptan 6mg вЂў Nasal triptans may work (much less efficient) вЂў Oral triptans do not work вЂў Prevention: вЂў High dose prednisolone at cluster onset, tapering вЂў Greater Occipital Nerve Block at start of a cluster вЂў Start Verapamil (or Lithium / Topiramate) Other primary complications вЂў Occasional extreme transient stabs. Can M ed Assoc J 1970; 102:263 268 RefIncl= In Ref= Includederence List, however not specifically inclexcluded= Excluded Williams 2003 – ” Abes 2003 – “A Thanaviratananich Wall2009 Takata 2001 – Bonati 1992 Leach 2006 – M cDonald 2008 – Straetemans 2004 – Use ofantibiotics in systematic evaluation of 2008 – “Once or “Ciprofloxacin Damoiseaux 1998 – G lasziou 2004 – Kozyrskyj2000 – Rosenfeld 1994 – Rovers 2006 – Spurling 2007 – “Evidence “M etaanalysis of “Antibiotics for the “G rommets “Pnemococcal preventing recurrent the effectiveness of twice daiily versus zero chronic gastritis meaning purchase allopurinol without a prescription. The subsequent factor on the agenda is the new drugs to market, but I dont have anything right now. The action of gravity would naturally pull the weight downwards, shifting the elbow into extension from the flexed place. 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