| General Illness Information |
Common Name: |
Headache,
Cluster |
|
Medical Term:
|
Same |
| Description: |
|
* Constant one-sided
headache over and behind the eye, with onset occurring
usually within 3-4 hours of falling asleep.
|
|
* 80% of these affected
are males.
|
|
* Pain recurs nightly
for several weeks or month, followed by no symptoms for
months or years.
|
|
| Causes: |
|
* Unknown.
|
|
* Thought to be related
to changes in blood flows to the brain, and to disturbances
in RAM (rapid eye movement) sleep.
|
|
| Prevention: |
* During cluster periods, avoid bright light or
glare, alcohol, excessive anger, stressful activity or excitement.
These will precipitate attacks. |
| Signs
& Symptoms |
|
|
* Sudden onset of
headache often at night while sleeping.
|
|
* Headache reaches
crescendo within 15 minutes and lasts about 2 hours.
|
|
* Pain is unilateral
around the eye.
|
|
* Severe, piercing
or boring pain.
|
|
* Teary eyes.
|
|
* Slow heartbeat.
|
|
* Nausea.
|
|
* Perspiration.
|
|
* Restless, active,
violent (sometimes).
|
|
* Episodes of
headaches occur at same time on consecutive days, with
clusters of these days, separated by attack-free weeks
or months.
|
|
|
Risk Factors
|
* Male, age over 30.
|
|
* Possible relationship to previous
head injury or surgery.
|
|
* Prior history of migraine frequent
(significant in females).
|
|
|
|
| Diagnosis & Treatment |
|
* Diagnosis is usually determined
by the patient's history of the headache patterns and
symptoms.
|
|
* Therapy may involve medications
and lifestyle changes.
|
|
* During cluster periods, avoid
bright light or glare, alcohol, excessive anger,
stressful activity or excitement. These will
precipitate attacks.
|
|
* Avoid smoking, since nicotine
may make cluster unresponsive to drug treatment.
|
|
|
|
| General
Measures: |
|
As above. |
|
|
|
| Medications: |
|
|
* Sumatriptan , or other triptans,subcutaneous
(injected under the skin) or orally, may help
during an acute attack. Follow all prescription
instructions carefully.
|
|
* Ergotamine aerosol may be used
during an attack and also as a preventive. Follow
prescription instructions carefully, especially if you
take more than one medication.
|
|
* Several medications are available
that can help suppress headaches during a cluster period
(prednisone, lithium, ergotamine, verapamil,
indomethacin, and methysergide).
|
|
|
| Activity:
Avoid any activities that cause you to injure
yourself during attacks |
|
|
|
Diet:
|
* During clusters, avoid alcohol
as it can precipitate attacks.
|
|
* Rarely, specific foods
(chocolate, eggs, dairy products) trigger attacks.
|
|
|
|
|
| Possible
Complications : |
|
|
* Self-injury during attack.
|
|
* Side effects of drugs.
|
|
|
| Prognosis |
|
No cure is available, but treatment can
help control the pain and shorten the cluster period.
|
|
Prolonged remissions.
|
|