Cluster Headaches The Worst Pain Known To Man
What are Cluster Headaches?
Cluster headaches, also called Horton headaches, are a debilitating type of headache disorder. They are characterized by excruciating pain, usually felt around one eye or one side of the head. They followed by remission periods without headaches. During a cluster period, headaches may occur once every other day, or even several times a day, always at the same time of day. Most headache attacks last between 15 minutes to 3 hours if not treated.
Symptoms
The most common symptoms of a Cluster Headache attack include:
- Severe or excruciating stabbing or burning pain around one eye or temple area that comes on rapidly. The pain is often described as the worst pain known.
- Redness of the eye on the same side as the pain, with tearing, eyelid droop, and nasal congestion.
- Restlessness or agitation during attacks as the pain is difficult to endure without moving around.
- Attacks are usually brief, rarely lasting more than 3 hours.
- They most often occur at the same time each day, typically in the evening or early morning hours.
- Attacks are often preceded by other symptoms like fatigue, sweating or cranial autonomic changes.
- Patient may pace back and forth due to severity of pain.
Causes and Triggers
The exact cause of headaches is unknown, but it is believed they involve abnormal activity in the hypothalamus - the area of the brain that controls body temperature, sleep cycles and hormones. Some potential triggers that can bring on a cluster headache include:
- Alcohol consumption, especially beer and red wine.
- Strong odors like perfumes, smoke from cigarettes, fireplaces and marijuana.
- Stress, lack of sleep, skipped meals.
- Nitrates in foods like hot dogs, bacon and rocket.
- Bright lights or loud sounds.
- Changes in weather or barometric pressure.
Diagnosis
To diagnose cluster headaches, a neurologist will take a detailed medical history of headache characteristics like timing, duration and intensity of attacks. Physical and neurological exams may be performed to rule out other conditions. There are no specific blood tests or imaging scans to diagnose headaches. Diagnosis is based on the distinct clinical features of the condition. Doctors make a diagnosis based on the symptoms meeting the diagnostic criteria outlined by the International Classification of Headache Disorders.
Treatment
Currently, there is no cure for headaches. The goal of treatments is to abort attacks quickly and prevent future attacks. Common acute or abortive treatments to stop an attack midway include:
- Oxygen therapy via mask at a rate of 7-12 liters per minute can abort attacks within 15 minutes in over 80% cases.
- Triptans like sumatriptan injections, tablets or nasal sprays are effective treatments and can stop attacks within 15 minutes for many.
- Intranasal lidocaine or other numbing medications may provide rapid relief.
- Some may use ergotamine or dihydroergotamine for relief.
For preventive treatment during a cluster period to stop attacks from occurring, options include:
- Verapamil, a calcium channel blocker, is first-line preventive treatment.
- Lithium is also commonly used as a preventive.
- Steroids like prednisone provide rapid cluster period suppression.
- Melatonin supplements may help some by regulating circadian rhythms.
- Glucocorticoids injected around Trigeminal nerve branches can abort active periods.
- Neurosurgeries like gamma knife radiosurgery are sometimes considered for refractory cases.
Prognosis
With proper acute and preventive treatment, cluster headache symptoms can usually be managed effectively. The prognosis is generally good. The cluster periods spontaneously remit in most people. However, cluster periods may recur yearly in about 90% of those afflicted. There is no cure presently, but good management provides significant relief for many sufferers. Advancements in understanding disease mechanisms could lead to more targeted therapies in the future.
Cluster headaches, though rare, are among the most painful conditions known to afflict mankind. Their distinctive, excruciating symptoms involve recurrent attacks of unilateral pain around the eye or head. While the exact cause remains unclear, triggers and management strategies have been identified. With prompt treatment of individual attacks and prophylaxis during active periods, quality of life can be much improved. Further research may uncover causes and lead to novel preventive treatments.
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About Author:
Alice Mutum is a seasoned senior content editor at Coherent Market Insights, leveraging extensive expertise gained from her previous role as a content writer. With seven years in content development, Alice masterfully employs SEO best practices and cutting-edge digital marketing strategies to craft high-ranking, impactful content. As an editor, she meticulously ensures flawless grammar and punctuation, precise data accuracy, and perfect alignment with audience needs in every research report. Alice's dedication to excellence and her strategic approach to content make her an invaluable asset in the world of market insights.
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