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Cluster headache (migrainous neuralgia, chronic cluster headache): Treatment, symptoms, advice and help

About cluster headache (migrainous neuralgia, chronic cluster headache)

Cluster headache is quite a rare disorder characterised by severe episodes of headache which has a typical pattern of occurrence. The cause of cluster headache is not exactly clear and thus its management is not definitive and specific.

Cluster headache (migrainous neuralgia, chronic cluster headache): Incidence, age and sex

Custer headache is a disorder which is seldom encountered in the general population. It seems to have a preponderance for adults in the middle age with a gender bias towards men. The episodes of cluster headache usually occur during spring or fall.

Signs and symptoms of cluster headache (migrainous neuralgia, chronic cluster headache): Diagnosis

The predominant symptom of cluster headache is the sudden onset of excruciating pain around one eye and forehead and head on same side. The pain is typically stabbing or burning in nature and usually worsens as time passes. The onset of this headache is seen around 2 hours after falling asleep in most of the individuals. This is the time when the individual is in REM sleep which is deep sleep wherein dreams occur. The headache may be accompanied by red eye on same side and running nose. This severe pain may last for few minutes to several hours and usually deteriorate with passing time. The affected individual may sometimes feel very agitated or even violent.

This pain may occur same time each day for several weeks in row and then stop abruptly, to recure again after a few weeks or months. Such episodes of relapse and remission are typical of a cluster headache.

A history eliciting typical pattern of episodic occurrence along with intense unilateral headache is diagnostic of cluster headache. Some imaging modalities like MRI scans or CT scans may be needed to rule out other causes of clinical symptoms before establishing a sure shot diagnosis of cluster headache.

Causes and prevention of cluster headache (migrainous neuralgia, chronic cluster headache)

The exact cause of cluster headache is not clear. It has been postulated that some neurotransmitter disturbance in the brain may lead to this phenomenon. However there are some risk factors which may trigger this headache in individuals who are prone to cluster headache. Such triggering factors include smoking, alcohol, bright light, disturbance in normal sleep patters or even emotional stress.

Cluster headache (migrainous neuralgia, chronic cluster headache): Complications

Cluster headache is a functional problem and does not result in any serious health concerns. However, it may be extremely distressing for the affected individual and cause disruption in workplace and personal life.

Cluster headache (migrainous neuralgia, chronic cluster headache): Treatment

Unfortunately cluster headache has no definitive and effective treatment. However some medications like sumatriptan, verapamil (calcium channel blocker) and steroids may be prescribed for alleviating the symptoms. These drugs can be given via various routes like by mouth or as nasal sprays or even in injectible form. In fact, the most effective treatment in most individuals is inhaling 100% pure oxygen via mask, especially in the early stage of headache. Individuals who are more prone to cluster headaches are advised to avoid any triggering factors which may result in the relapse of episode.