Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the initial treatment for cluster headaches?

1. Oxygen therapy

2. Ibuprofen

3. Sumatriptan only

4. Topiramate

The correct answer is: Oxygen therapy

Oxygen therapy is recognized as one of the most effective initial treatments for cluster headaches. This condition is characterized by severe, unilateral pain that can occur in clusters or bouts. Administering 100% oxygen at a flow rate of 7-10 liters per minute can provide rapid relief of symptoms for many individuals experiencing an attack. The mechanism is not entirely understood, but it may involve vasoconstriction or other effects on the body's pain pathways. Other options, while they may play a role in the overall management of headaches, are not typically considered first-line treatments for acute cluster headache attacks. For instance, ibuprofen is generally more suited for tension-type headaches or migraines but lacks the necessary effectiveness for the severe pain associated with cluster headaches. Sumatriptan is useful but is often combined with oxygen therapy for maximum benefit during an attack rather than being the only treatment. Topiramate, although effective as a preventative medication, is not used for acute relief in cluster headaches. Overall, the use of oxygen therapy stands out as a rapidly acting and preferred first-line treatment option for those experiencing an acute cluster headache episode.