Cluster headache

The objective of follow-up visits is to monitor response of cluster attacks to current therapy and adjust as necessary to achieve complete relief, as well as to monitor for adverse effects.

All patients with suspected cluster headache should be seen by a neurologist, and all patients with atypical attacks or in whom first-line treatment is ineffective should be referred to a headache specialist.

ECG is checked after every verapamil dose increase to look for abnormal conduction. Thyroid function, renal function, and electrolytes are monitored periodically in patients taking lithium.