Table 4 Opinions of Brazilian experts on the treatment of cluster headaches

Do you routinely request imaging studies in the first bout?

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Even with a typical clinical picture?

Yes

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

Do you request imaging for a patient with previous bouts, without previous imaging, but with you for the first time?

No

No

No

No

No

Yes

Yes

No

Yes

No

Patient with previous bouts seen by you, with a new bout with atypical features. Do you request imaging?

Yes

Yes

Yes

No

No

No

Yes

Yes

Yes

No

Do you use bridge therapy routinely? Point the first and second options

Yes

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

 steroid

1st

1st

1st

1st

1st

1st

1st

1st

1st

1st

 blockade Greater Occipital Nerve, supraorbital or following the pain

2nd

2nd

2nd

2nd

2nd

No

2nd

No

2nd

No

Do you routinely combine bridge, prevention and acute treatments?

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Do you use long-acting triptans twice a day routinely?

No

No

No

No

No

No

Yes

No

Yes

No

What is your acute treatment in order of preference?

 injectable sumatriptan as needed

1st

1st

1st

1st

1st

1st

1st

1st

1st

1st

 nasal sumatriptan

No

No

No

No

No

No

No

No

3rd

No

 other triptans

No

No

No

No

No

No

No

No

No

No

 100% Oxygen

2nd

2nd

2nd

2nd

2nd

2nd

2nd

2nd

2nd

2nd

 NSAID, narcotics or others

No

No

No

No

No

No

No

No

No

No

Do you combine acute treatments?

Yes

Yes

Yes

No

Yes

Yes

No

Yes

Yes

Yes

Limitations or as needed regardless of number of attacks?

limitations

limitations

limitations

limitations

limitations

as needed

limitations

limitations

limitations

as needed

Questions

Expert 1

Expert 2

Expert 3

Expert 4

Expert 5

Expert 6

Expert 7

Expert 8

Expert 9

Expert 10

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

What is your preventive treatment in order of preference?

 Verapamil

2nd

2nd

2nd

1st

1st

1st

1st

1st

1st

2nd

 Lithium

3rd

3rd

3rd

3rd

3rd

3rd

3rd

2nd

Don`t use

3rd

 Divalproate

7th

7th

7th

7th

7th

7th

2nd

4th

Don`t use

Don`t use

 Topiramate

5th

5th

5th

5th

5th

5th

4th

Don`t use

Don`t use

Don`t use

 Combinations

4th

4th

4th

4th

4th

4th

5th

3rd

Don`t use

4th

 onabotuliumtoxinA

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

8th

Don`t use

Don`t use

Don`t use

 galcanezumab

1st

1st

1st

2nd

2nd

2nd

6th

Don`t use

Don`t use

1st

 Melatonin

6th

6th

6th

6th

6th

6th

7th

Don`t use

Don`t use

Don`t use

 Others

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

Don`t use

After how long should he/she return? (weeks)

3

5

4

2

3

4

2

2

2

4

How many patients have already been evaluated and treated?

230

197

97

100

20

100

30

84

30

98

What is the percentage of men?

85

84

81

80

80

82

90

81

70

80

What is the average age of men (years)?

32

36

34

33

38

39

30

51

30

36

What is the percentage of women?

15

16

19

20

20

18

10

19

30

20

What is the average age of women (years)?

32

31

29

27

33

39

25

38

32

32

How many with chronic cluster headache?

5

6

2

2

0

4

5

1

0

2

Treatment mostly used for chronic

V/L

V/L

V/L

V/L

V

V/L

V/L

V/L

V

V

Did you refer patients to procedures?

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Yes

No

What is the percentage of referrals?

2.0

1.0

0.8

1.0

0.5

2.0

10.0

0.0

< 10.0

0.0

How many patients < 18 years old

3

1

0

0

0

3

2

0

0

1

Drugs used for this population

I/V/L

I

Not available

Not available

Not available

steroid

V

No

No

V