Posted by drummer (209.105.135.2) on July 01, 1999 at 07:15:49:
I asked my Neurologist to send something to the Medical Director of my Health Insurance company so that oxygen will be covered for cluster headaches. (Notice Dr. Goadsby's name on the first enclosed reference).
Here is the deal:
Letter from my Neurologist to my Health Insurance Company:
“You have requested any documentation of oxygen for treatment of cluster headaches. There are many, many articles on the use of oxygen for cluster headaches. It is now in the textbooks that are used for headache management. I’ve enclosed copies from two textbooks on the clinical management of headache disorders”.
Enclosed:
HEADACHE IN CLINICAL PRACTICE – Stephen D. Silberstein, Richard B. Lipton and Peter J. Goadsby. ISIS Medical Media.
Oxygen inhalation, a standard abortive treatment for cluster headache, was first used by Horton. Given via a non-breathing mask at a flow rate of 7-10L/min, it is effective in approximately 70% of patients, usually within 5 minutes. In some patients oxygen may delay rather than abort the attack, and pain may return. In a placebo-controlled study, hyperbaric oxygen (2 atm) for 30 minutes aborted an acute attack of cluster within 5-13 minutes in six of seven patients, while none of the placebo group had relief. Long-term, three patients reported complete and three patients partial interruption of their cluster cycle. Other authors have reported similar benefit of hyperbaric oxygen.
HANDBOOK OF HEADACHE MANAGEMENT – A Practical Guide to Diagnosis and Treatment of Head, Neck and Facial Pain – Joel R. Saper, M.D./Stephen Silberstein, M.D./C. David Gordon, M.D./Robert L. Hamel, P.A.-C.
Oxygen (100%) inhalation should be administered via a face mask at 7 liters/min for 10-15 minutes at a time, preferably given at the onset of the attack.