Subcutaneous injection and nasal spray of sumatriptan are known to be useful for the treatment of acute phase of cluster headache. Although nasal spry of zolmitriptan is not available in Japan, it is also reported to be effective for the acute phase of cluster headache. In addition, high flow oxygen is also reported to abort the attack of cluster headache. For preventive treatment of cluster headache, calcium channel blocker (verapamil) and steroids are recommended. In addition to these medications, some of refractory chronic cluster headache patients are reported to be respond to the occipital nerve block, deep brain stimulation, vagus nerve stimulation and occipital nerve stimulation. Furthermore, recent report revealed that stimulation of the sphenopalatine ganglion is effective for acute pain relief and attack prevention. This review will introduce the recent treatment for cluster headache including these nerve stimulations.
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