REPORT OF LIMITED USEFULNESS WITH CLUSTER.
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Cephalalgia. 2010 Aug;30(8):975-82. Epub 2010 Mar 12.

Cluster headache responsive to indomethacin: Case reports and a critical review of the literature.
Prakash S, Shah ND, Chavda BV.

Department of Neurology, Medical College Baroda, Gujarat, India. drprakashs@yahoo.co.in

Comment in:

Cephalalgia. 2010 Aug;30(8):902-3.

Abstract
INTRODUCTION: Response to indomethacin is an essential feature for the diagnosis of both paroxysmal hemicrania (PH) and hemicrania continua (HC). Cluster headache (CH) is widely considered to be a disease unresponsive to indomethacin.

CASE REPORTS: We report four patients with CH who responded to indomethacin. Two patients, who were refractory to the usual therapy for CH, fulfilled the criteria for chronic CH. Conversely, two patients had a history of episodic CH and showed response to both indomethacin and the usual therapy for CH.

LITERATURE REVIEW: We also reviewed the literature for the presence of indomethacin response in patients with CH. We noted a large number of cases labeled as CH by the authors which showed a response to indomethacin.

DISCUSSION: Many cases of definite or possible CH were wrongly labeled as PH because of patients' responding to indomethacin.

CONCLUSION: THE RESPONSE TO INDOMETHACIN IN PATIENTS WITH CH MAY NOT BE AS IMMEDIATE AS IN OTHER INDOMETHACIN-RESPONSIVE HEADACHES, AND MANY PATIENTS MAY NEED LARGER DOSES.

PMID: 20656709 [PubMed]