Lancet Neurology: Safety and effective with placebo short-term prevention of plexual plexual headaches: a multi-center, double-blind, randomized controlled trial

Congset headache is a primary headache disease, which occurs without precursor and is characterized by severe pain on the side and head, and generally lasts 15-180 minutes accompanied by trigeminal neurodegenerative symptoms.
attacks range from once the next day to eight times a day, each going on for a week to a few months.
headaches in patients with plexual cluster headaches, asymptomatic intervals lasting from 3 months to several years occur, usually following circadian and annual rhythms.
treatment of plexual plexual headaches, in addition to preventive medications such as verapami, includes treatment at the onset (e.g. high-flow oxygen or lidocain), which reduces the number of seizures and may terminate the current seizure.
is commonly used in the initial short-term treatment of plexual cluster headaches before using preventive drugs such as verapami, but this strategy has not been proven in large randomized trials.
this article aims to explore the safety and effectiveness of this treatment.
study, patients with plexual cluster headaches were between the ages of 18 and 65 and had a current pain onset for no more than 30 days.
118 patients participated in the study.
two patients withdrew and 116 patients were randomly assigned (57 patients were treated with pernisone and 59 patients were treated with a placebo).
they were treated with 100 mg of oral pernisone for 5 days (a gradual reduction of 20 mg every 3 days) or with a placebo that matched them (for a total of 17 days).
all patients were given oral Verapami for long-term prevention, starting at 40 mg three times a day and increasing to 120 mg three times a day on the 19th day;
the main endpoint of the study was the average number of headache attacks in the first week of Pernisson's treatment compared to a placebo.
the seizure is defined as a one-sided headache with a moderate to severe intensity of at least 5 on the digital scale.
compared to 9.5 seizures in the placebo group (standard deviation 6.0), subjects in the Pernieson group had an average of 7.1 seizures in the first week (standard deviation 6.5) (95% confidence interval was -4.8 to -0.03; p=0.002).
adverse events (severe deterioration of groin palate and congestive headache) occurred in the placebo group.
In summary, oral pernisone 100 mg for 5 consecutive days, and then gradually reduce 20 mg every 3 days is an effective, rapid, short-term preventive treatment for plexual plexus headache, which can be used to reduce early congestive seizures until long-term prevention is fully effective.
patients with no co-existing health problems may consider using pernisone therapy on the basis of long-term prevention in Verapami.
Obermann, Mark et al. Safety and efficacy of prednisone versus placebo in short-term prevention of episodic cluster headache: a multicentre, double-blind, randomised controlled trial. The Lancet Neurology, Volume 20, Issue 1, 29 - 37 Network Source: Web Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Met Medical" or "Source: MedSci Original" are owned by Mays Medical, are not authorized, may not be reproduced by any media, website or individual, and must be reproduced with the words "Source: Mets Medicine".
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