Table 5.

Suggested alternative treatments for trigeminal autonomic cephalalgias

	Cluster headache	Paroxysmal hemicrania	Hemicrania continua	Short-lasting unilateral neuralgiform headache attacks
Oral treatments	Melatonin: 12–16 mg daily Gabapentin: 3600 mg daily Baclofen: 90 mg daily Levitracetam: 2–3 g daily	COX-2 inhibitors (celecoxib: 400 mg daily; etoricoxib 900 mg daily) Topiramate: 400 mg daily Verapamil: 960 mg daily Flunarazine: 10 mg daily	Celecoxib: 400 mg daily Topiramate: 400 mg daily Gabapentin: 3600 mg daily Melatonin: 15–16 mg daily Verapamil: 960 mg daily	Oxcarbazepine: 1500 mg daily Carbamazepine: 1200 mg daily Topiramate: 400 mg daily Gabapentin: 3600 mg daily Mexiletine: 1200 mg daily
Nerve blocks	GONBa MCNBb	GONBa MCNBb	GONBa MCNBb	GONBa MCNBb
Surgery	ONS DBS SPG	ONS DBS	ONS DBS	MVD ONS DBS

COX cyclooxygenase, GONB greater occipital nerve block, MCNB multiple cranial nerve block, ONS occipital nerve stimulation, DBS deep brain stimulation, SPG sphenopalatine ganglion stimulation, MVD microvascular decompression

^aGONB: 2 ml 2 % lidocaine and 80 mg methylprednisolone

^bMCNB: greater occipital nerve 80 mg methylprednisolone, 1 ml bupivocaine 0.5 %, and 1 ml lidocaine 2 %; lesser occipital nerve supraorbital, supratrochlear, and auriculotemporal 50:50 mix lidocaine 2 % and bupivocaine 0.5 %