Treatment of Persistent Posttraumatic Headache with the Anti-CGRP Receptor Antibody Erenumab: a Case Report

Abstract

AbstractCalcitonin gene-related peptide (CGRP) has only recently emerged as a potential target in posttraumatic headache. To our knowledge, this is the first description of a patient with persistent posttraumatic headache following severe traumatic head injury who has been treated with the CGRP receptor monoclonal antibody erenumab. A 56-year-old man presented with a 30-year history of frequent migraine-like posttraumatic headaches following a high-voltage head injury that he treated with an excessive intake of peripheral analgesics. Although amitriptyline was reasonably effective, it had to be discontinued when the patient developed restless legs syndrome in the second year of treatment. Under therapy with erenumab, he achieved a rapid and stable reduction in his symptoms down to only 2–3 headache days per month without adverse events. This case demonstrates that the inhibition of the CGRP-receptor with erenumab could be an effective treatment option in migraine-like posttraumatic headache even decades after the traumatic event.