O R A L P R E S E N T A T I O N Open Access
O045. Cluster headache improvement during
Cherubino Di Lorenzo
, Gianluca Coppola
, Giulio Sirianni
, Paolo Rossi
, Francesco Pierelli
From Abstracts from the 1st Joint ANIRCEF-SISC Congress
Rome, Italy. 29-31 October 2015
Ketogenic diet (KD) is a valid treatment for drug-resistant
epilepsy, recently proposed as effective also in migraine.
Hitherto, no data are available about KD effects on cluster
headache (CH), a severe form of primary headache, char-
acterized (similarly to migraine) by a trigemino-vascular
activation. Prophylaxis drug-resistant patients have a great
need for care and could seek help in invasive treatments
and/or alternative drugs, such as illegal substances. Here
we performed a prospective observational study of the
potential beneficial ketogenesis-induced effects on CH,
studying a group of consecutive drug-resistant CH
We recruited 12 CH drug-resistant patients (7 chronic,
CCH) that accepted to undergo a 3-month trial with KD
in order to try to treat their headache. Patients received a
ketogenic “modified Atkins diet”or “Classic Diet”charac-
terized by a 3:1 ratio (75% fat, 25% non-fat macronutri-
ents). During ketogenesis, patients underwent medical
supervision and standard laboratory blood tests. At the
end of the KD, patients were free to decide whether to
prolong ketogenesis or revert to their standard diet (SD).
Out of 5 episodic CH (ECH) patients, all fully responded
to the diet at the end of the first month (three became
headache free in a couple of weeks, the other two reported
to have had “shadows”and mild attacks up to the end of
first month). All of them, at the end of KD period reverted
to a standard diet and, since out of active phase of disease,
have not had bouts as yet. Out of 7 CCH patients, six
reported a progressive reduction of bouts in terms of
number and intensity (three during the first 4-week
period, one during the second 4-week period, one during
the third 4-week period). At the end of the 3-month KD
period, four patients reported not yet having had attacks,
one reported only ‘shadows’and one reported having 2-3
attacks per week. One of patients that responded in the
first month of diet decided to revert to SD and CH
recurred after 7 weeks.
Drug-resistant CH is one of the greatest challenges in
headache medicine, and new therapeutic options are
welcome. Our observation suggests that ketogenesis can
also help CH patients other than migraineurs, maybe by
modulation of cortical excitability, or by dampening
neural-inflammation. It is interesting to note that both CH
and migraine are headache forms that involve the trigemi-
novascular system, maybe the real target of ketogenesis in
Written informed consent to publication was obtained
from the patient(s).
Don Carlo Gnocchi Onlus Foundation, Milan, Italy.
G.B. Bietti Foundation-
IRCCS, Department of Neurophysiology of Vision and Neuro-ophthalmology,
Wellness and Dietary Medicine, Krom Genetics Institute, Rome,
Headache Clinic, INI, Grottaferrata (RM), Italy.
for Adaptive Disorders and Head pain (UCADH), Pavia, Italy.
Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome,
IRCCS - Neuromed, Pozzilli (IS), Italy.
Published: 28 September 2015
Cite this article as: Di Lorenzo et al.: O045. Cluster headache
improvement during Ketogenic Diet. The Journal of Headache and Pain
2015 16(Suppl 1):A99.
* Correspondence: firstname.lastname@example.org
Don Carlo Gnocchi Onlus Foundation, Milan, Italy
Full list of author information is available at the end of the article
Di Lorenzo et al.The Journal of Headache and Pain 2015, 16(Suppl 1):A99
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