Cluster headache history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saumya Easaw, M.B.B.S.[2]

History and symptoms

Cluster headache sufferers typically experience very severe headaches of a piercing quality near one eye or temple that last for fifteen minutes to three hours with some lasting days (rarely more than three days). The headaches are typically unilateral and rarely change sides during the same cycle (see episodic).

Pain

Persons who have experienced both cluster headaches and other painful conditions (childbirth, migraines) report that the pain of cluster headaches is far worse, significantly more severe than a migraine.[1] The pain has been described as akin to having an ice pick piercing the eye slowly but in a constant manner. Acid being poured in the head through a hole in the ear may be a better description.[2] A hot poker inserted in the eye, although gruesome, may well be the best description.[3] It has been described in medical journals as one of the most severe pain syndromes suffered by human beings.[4]

Other Symptoms

A person experiencing a cluster headache may find problems sitting still and may pace or even become severely agitated. Cluster headaches are frequently associated with Horner's syndrome:[5] ptosis (drooping eyelids), conjunctival injection (which results in red, watery eyes), lacrimation (tearing), miosis (constricted pupil), eyelid edema, nasal congestion, rhinorrhea (runny nose), and sweating on the affected side of the face. The neck is often stiff or tender in association with cluster headaches afterwards, and jaw and teeth pain are sometimes reported. Photophobia (sensitivity to light) is more typical of a migraine, as is vomiting, but both can be present in some sufferers of cluster headache, although rare.

Cyclical Recurrence and Regular Timing

Cluster headaches are occasionally referred to as "alarm clock headaches", because of the regularity of its timing and its ability to wake a person from sleep. Thus it has been known to strike at the same time each night or at a certain period after falling asleep, or at precisely the same time during the day a week later. This has prompted researchers to speculate an involvement of the brain's "biological clock" or circadian rhythm. In some cases, cluster headaches remain "steady" without cyclical ups and downs for days.

Episodic or Chronic

In episodic cluster headache, these attacks occur once or more daily, often at the same times each day, for a period of several weeks, followed by a headache-free period lasting weeks, months, or years. Approximately 10–15% of cluster headache sufferers are chronic; they can experience multiple headaches every day for years.

Cluster headaches occurring in two or more cluster periods lasting from 7 to 365 days with a pain-free remission of one month or longer between the clusters are considered episodic. If the attacks occur for more than a year without a pain-free remission of at least one month, the condition is considered chronic.[6] Chronic clusters run continuously without any "remission" periods between cycles.[7] The condition may change from chronic to episodic and from episodic to chronic. Remission periods lasting for decades before the resumption of clusters have been known to occur.

References

  1. Charlotte E. Grayson and The Cleveland Clinic Neuroscience Center (October 2004). "Cluster Headaches". WebMD. Retrieved 2006-09-22.
  2. Brian D. Loftus (2005). "Cluster Headache and Chronic Paroxysmal Hemicrania Overview". Retrieved 2006-09-22.
  3. Goldstein, Michael. "Cluster Headache". New Atlantean Press. 1999.
  4. Arne May, Anish Bahra, Christian Büchel, Richard S J Frackowiak, Peter J Goadsby; University Department of Clinical Neurology (May, Bahra, Goadsby), and Wellcome Department of Cognitive Neurology (Büchel, Frackowiak), Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London UK (1998 July 25;352(9124):275-8). "Hypothalamic activation in cluster headache attacks". The Lancet. Check date values in: |date= (help)
  5. Graff JM, Lee AG (February 21, 2005). "Horner's Syndrome (due to Cluster Headache): 46 y.o. man presenting with headache and ptosis". Ophthalmology Grand Rounds. The University of Iowa. Retrieved 2006-09-22.
  6. http://www.w-h-a.org/wha2/Newsite/resultsnav.asp?color=C2D9F2&idContentNews=751
  7. http://www.paralumun.com/headachecluster.htm



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