The clinical features and treatment of cluster headaches are reported in two patients, a boy aged 8 and a girl 10 years, evaluated at the Department of Neurology, University of North Carolina at Chapel Hill. Indomethacin 25 mg bid produced immediate and complete relief. The headaches were sharp, unilateral, localized to the temporal region, and associated with lacrimation, nasal congestion, and photophobia. They occurred several times a day for 3 to 4 weeks, sometimes early morning, and lasted 10 minutes to 1 to 2 hours. Clusters were followed by a 2- to 3-week headache-free period. Trials of propanolol, amitryptyline, and biofeedback were unsuccessful. [1]

COMMENT. Cluster headaches are rare in children and are frequently atypical. Although remarkably effective in the two patients reported, indomethacin toxicity may limit chronic usage. Dietary factors in etiology might be considered.