Prophylactic treatment of episodiccluster headache with intravenous bolus ofmethylprednisolone

Abstract. We evaluated the efficacy of intravenous boluses ofmethylprednisolone followed by prednisone as a prophylactictreatment for episodic cluster headache. Fourteen male patients(mean age, 42.54 years) with episodic cluster headache weretreated with 250-mg boluses of methylprednisolone on 3consecutive days, followed by prednisone (90 mg/day orally) withgradual tapering in four weeks. Headache parameters of theactive phases treated with methylprednisolone were compared withthose of previous active phases in the same patients treatedwith other prophylactic medications. The primary efficacycriterion was decrease in the frequency of attacks during thefirst month of treatment. The statistical differences werecalculated using Wilcoxons test. The attacks were significantlyless frequent in the active phases treated withmethylprednisolone boluses than those treated with othermedications (p<0.05). Thistreatment seems to be more effective than the usual prophylactictreatments for episodic cluster headache.