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Cluster headache — DipIMC MCQ

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HardMedical EmergenciesCluster headacheDipIMC

A 57-year-old with a confirmed history of cluster headache has an attack identical to previous episodes, with unilateral orbital pain, lacrimation and no neurological deficit. Which acute non-drug treatment is appropriate?

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Correct answer: A — Give oxygen at 12 L/min or more through a non-rebreathing mask

The best answer is “Give oxygen at 12 L/min or more through a non-rebreathing mask”. NICE recommends 100% oxygen at a flow rate of at least 12 litres per minute through a non-rebreathing mask for an acute cluster-headache attack, with an ambulatory supply arranged when appropriate. This is a disease-specific therapy rather than correction of hypoxaemia, so normal pulse oximetry does not remove the indication. Lower-flow devices may not deliver the required inspired oxygen concentration.

Reference: NICE CG150, Headaches: https://www.nice.org.uk/guidance/cg150/chapter/recommendations