Abstract

PADILLA DEL REY, M L; BENITEZ JIMENEZ, M; CANUEL, J F  and  DIAZ-ALEJO MARCHANTE, C. NMDA antagonism in the treatment of cluster headache. Rev. Soc. Esp. Dolor [online]. 2019, vol.26, n.4, pp.247-250.  Epub Mar 23, 2020. ISSN 1134-8046.  https://dx.doi.org/10.20986/resed.2019.3710/2018.

Standard treatment for cluster headache consists of abortive treatment with oxygen, triptans, ergot alkaloids and/or topical nasal local anesthetic during acute episodes and preventive treatment such as steroid injections, calcium channel blockers and lithium. Although the exact pathophysiology of cluster headache is not well understood, reduced serum levels of kynurenine metabolites with anti-NMDA (N-methyl-D-aspartate) properties have been demonstrated. Ketamine and magnesium, which both have potent anti-NMDA receptor activity, have been used in multiple refractory pain syndromes. We describe a case of cluster headache that was non-responsive to standard therapy and treated effectively with intravenous infusion of magnesium and ketamine.

Keywords : NMDA; ketamine; magnesium sulfate; cluster headache.

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