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Case Reports in Neurological Medicine
Volume 2018, Article ID 3901619, 5 pages
Case Report

Oral High-Dose Thiamine Improves the Symptoms of Chronic Cluster Headache

1Università Cattolica di Roma, Largo Agostino Gemelli, Roma, Italy
2Centro Polispecialistico Giovanni Paolo I, Viterbo, Italy
3Department of Neurological Rehabilitation, The “Villa Immacolata” Clinic, Viterbo, Italy

Correspondence should be addressed to Costantini Antonio; ti.orebil@atateparac

Received 9 November 2017; Revised 3 February 2018; Accepted 25 February 2018; Published 18 April 2018

Academic Editor: Chin-Chang Huang

Copyright © 2018 Costantini Antonio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Cluster headache is a rare painful primary disorder occurring in either episodic or chronic patterns. Several authors found that the hypothalamus, the brain region regulating endocrine function and autonomic system, is involved in the pathophysiology of cluster headache. Some authors have found in patients affected by this disease abnormality in glucose metabolism. Considering the role of thiamine in brain function, in energetic metabolism, and in pain modulation, we treated a patient affected by cluster headache with oral high-dose thiamine. We report a 41-year-old man suffering from primary chronic cluster headache since the age of 15 years. The patient began oral therapy with high-dose thiamine in December 2016. Oral thiamine supplementation led to a dramatic improvement of the symptoms. The therapy was effective in reversing all the symptoms of the disease. Our observation suggests that a thiamine deficiency due to enzymatic abnormalities or to dysfunction of the circulation of thiamine in the intracellular space could cause a neuronal selective impairment in the centers that are involved in this disease and could have an important role in the pathogenesis of the symptoms of cluster headache.