Relief of cluster headache and cranial neuralgias. Promising prophylactic and symptomatic treatments.

When a patient presents with persistently unilateral head or face pain, cluster headache and trigeminal neuralgia should be considered. Diagnosis is based on the patient's history; anatomical studies are performed only to rule out problems other than tumor or stroke. A patient who presents with pain in the pharynx, tonsils, and ear--particularly if it is initiated by swallowing, yawning, or eating--may have glossopharyngeal neuralgia. Treatment with carbamazepine is indicated; if the patient does not respond to this drug, the diagnosis is doubtful. Several effective treatments are available for these conditions. Oxygen, drug therapy, or surgery may be indicated depending on the course of the disease.