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Cluster Headaches

This is a specific classification of painful headaches that typically occur in moments or episodes of frequent attacks. These episodes are why it is called clusters.

The location of this headache varies between individuals, but most commonly, it occurs with intense pain around one eye on one side of the head.  The pain can be severe enough to wake you from your sleep—but again, this doesn’t happen in all patients.

The cluster phase can last from weeks to months. They might stop for a short period, then return.

This rare condition is often confused with migraines or reoccurring headaches. The term is also commonly used within the community to describe a regular headache that lasts for a few days. Cluster headaches are more insidious and painful.

Causes

Currently, the cause of cluster headaches is unknown. There might be a pattern of association with the hypothalamus – known as the body’s biological clock.

Symptoms

–  Fast-acting headache that comes on quickly
–  No warning the headache will occur
–  Some people might have an aura-like occurrence – similar to migraines
–  Sharp and stabbing pain behind or around one eye
–  One cluster usually stays on one side of the head. Another cluster can attack the opposite side.
–  Forehead or facial swelling
–  Swelling around the eye
–  Drooping around the eyelid
–  Stuffy nose on the side that hurts
–  Eye redness on side that  hurts

What is a Cluster Period

The timeframe for this headache is usually weeks to months. They may start around the same time of the year and can last about the same length of time.

Remission is the time period between clusters. It can be around 3 months or so – potentially longer between clusters.

If the cluster period last longer than 1 year – the headache becomes known as a Chronic Cluster Headache

The headache lasts 15 minutes to 3 hours – daily. The attacks often come at the same time of the day. If the headache occurs at night – often it is 1-2 hours after bedtime.

Potential Risk Factors

1.)  Sex – More often seen in men
2.)  Family history – increase likelihood if a close family member gets them.
3.)  Age – Typically seen in ages 20-50
4.)  Smoking – many people are smokers. Quitting smoking usually does not stop the attacks.
5.)  Alcohol – for those with Cluster Headaches – Alcohol increases the risk of an attack.

When to see a doctor?

If you’ve just started having cluster headaches, you should see a doctor.

If there is a serious change in your headaches from previous.

When the pain becomes too intense to bare.

If added symptoms of neck pain, neck stiffness, vision changes, etc.

If the headache does not resolve over a period of time – longer than your normal Cluster period.

Treatment

1.) Medications to prevent headaches

.    Galcanezumab – injection to treat migraines and Cluster Headaches.
.    Other meds to treat depression, blood pressure, seizures, etc
.    Others

2.) Pain medications during the attack

.    Sumatriptan
.    Steroids
.    Dihydroergotamine injections
.    100% oxygen

3.)  Alternative Treatment options

–  Acupuncture
–  Manipulation – spinal
–  Vagus Nerve stimulator
–  Physical Therapy or Physiotherapy
–  Others

*** – NSAIDS like IBU are not effective medications to treat Cluster Headaches.