Signs and Symptoms of Cluster Headache
- Occurs in males between the age thirties to fifties.
- Pain occurs in the forehead, the temple and behind the eye, and they practically never change the side.
- They often occur every day or usually at night at the same time.
- On the side of the headache the eye and the pupil gets smaller, the eye becomes red and tears, the nose becomes congested or runs, the forehead is sweating (as can be the whole head or the upper part of the body) and may become red.
- The pain is so strong that the patient cannot bear lying down, but has to get up and run about, banging his head.
- The pain can last upto two hours. After a month or two the period of pain fades away and may recur a few months or even years later.
- It is usually very acute in the beginning and of relatively short duration. Cluster headache is rare but it may become chronic.
There is no known positive diagnosis of a cluster headache. However, with a normal blood sedimentation rate is used to distinguish it from a Horton’s arthritis.
Treatment of Cluster Headache
In most cases of cluster headache there is an effective therapy. In the pain free interval no measures whatsoever can or should be taken. Red wine is a powerful trigger for the pain (as are sometimes also nuts, cheese and seafood) it should be avoided. Because of the very specific medication cluster headache should be treated only under close medical supervision.
The standard therapy is Methysergide or psychic side effects can occur. The medicament should not be given longer than three months, perhaps with a pause, because of the possibility of fibrosis.
Since the pain in cluster headache builds up very fast and the duration of the pain itself is mostly as short as less than half hour an oral application of any drug doesn't make sense at all. Instead the medicament should be taken subcutaneously or should be inhaled. Both ways are applicable by the patients himself.