Cluster pain how to treat. Causes and symptoms of cluster headache

Date of: 08.03.2020

Cluster (bundle) headache is infrequent in comparison with ordinary headache and migraine. This disease is not too common. several people per thousand, and it has certain symptoms that distinguish it from other types of headache.

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The strongest piercing sharp pain localized in one part of the head, usually in the area around the eye and immediately behind it.

Many patients cannot identify the clear reasons why this pain occurred, but there are still a number of factors that trigger cluster headache attacks. About this and not only we will tell you below.

Most often, the first bouts of this pain occur at the age of from 20 to 40 years old, but can occur in people of a younger or older age.

Symptoms of cluster headache

1 Pain occurs suddenly, often for no apparent reason, most often at the same time of the day or night. It happens that an attack can occur 1 or several times a day. Some people confuse cluster pain with migraines, but this is not right. Below we will talk about the differences between these types of pain. After all, bundle pain has a completely different nature, and it needs to be treated differently. According to patients, the pain is really unbearable - this is the main symptom of this particular type of pain.

2 Another distinctive symptom is that the patient cannot lie in bed, like those who suffer from migraines. On the contrary, the patient is too excited and inflated, he rushes about the room, cannot find a place for himself. Bundle pain is also called "suicidal" headache, as there are known cases of suicidal outcome in patients with this severe pain.

3 Most often, the localization of pain does not change from time to time, but after a while with the next episode of pain, it can change the side of the head.

4 Peak pain happens very quickly. Already after 10-15 minutes the pain rises to a maximum and brings the patient trying to get rid of her, almost to despair.

5 The eye from the side of the localization of pain turns red and begins to water, the eyelid drops. On the same side, the nose may be blocked or transparent discharge may appear.

6 This painful pain lasts on average from 30 to 60 minutes, but in some patients it may not pass for 3 hours in a row.

What is the difference between cluster headache and migraine

Below we provide a table of differences between migraine and beam headache, with which you can determine what type of pain is tormenting you.

Ipsilateral - located on one side (eye, nostril, cheek)

Types of Cluster Pain

Let's look at what types of cluster pain are. It happens:

episodic;
chronic

Moreover, it can flow from a temporary state to a chronic one and vice versa. Most often, it is episodic attacks of cluster headache that torment patients. Such pain occurs every day at about the same time over a period of time. This period of time is called an episode. After the episode ends, the bouts of pain also stop. On average, episodes last from 6 to 12 weeks. For some patients, however, cluster pain can only bother for 2-3 weeks, for others, relief comes only after six months.

In the chronic course of the disease, episodes usually occur at the same time of the year, most often spring or fall. There is a group of patients in whom episodes occur more often - 2-3 times a year, while other patients may not experience cluster headache for several years. Between episodes, these people consider themselves to be completely healthy and lead a normal life. Chronic cluster headache lasts a lifetime, tormenting the patient every day with severe bouts of pain. 1 patient out of 10 patients with this diagnosis has chronic attacks.

What causes a cluster headache attack

Beam headaches are pretty poorly understood. It is unlikely that anyone will be able to name a specific reason, because of which these pains can occur. According to studies, more often than others, this disease suffers heavy smokers, including those who quit. For some, the trigger for an onset of an episode is alcohol.

Also, due to the fact that this type of pain appears most often at a certain time of the year, there is a hypothesis that it is associated with the biological clock of the human body. A special part of the brain, the hypothalamus, is responsible for the biological clock of a living organism. Changes were detected in the hypothalamus of patients with cluster pain attacks.

What tests will help identify the disease

Many patients ask these questions, visit a variety of specialists who direct them to take all kinds of tests and undergo the necessary examinations. However, practice shows that to identify cluster pain, you do not need to undergo special examinations. This pain is easily recognized by a specialist and the patient can quickly make this diagnosis. The most important thing in the correct diagnosis is that the patient can correctly and reliably describe all the symptoms of a headache, the processes that occur with him during an attack.

Additional examinations are prescribed if the doctor is not sure about the causes of the headaches. He may prescribe studies to rule out other diseases.

Headache Diary

In order to do this as accurately as possible, you can lead headache diarywhere you could celebrate everything that happens to you during the episode. In it, you must necessarily indicate the date of the onset of the attack, the nature and course of the attack, how you tried to relieve the pain, how long it lasted. Keeping such a diary will help the doctor more accurately establish the diagnosis without sending you for additional examinations.

Interview: a detailed description of cluster pain attacks

Says Alexander, programmer, 28 years old:

When did you first experience a cluster headache?

The first attack happened in the beginning of October, I started wearing contact lenses for two weeks and thought it was due to them, the more I felt a strong reaction to the bright light from which the pain started (at least, it seemed)

How long did it last?

All attacks lasted approximately the same 1.5-2 hours. There were attacks 4 times a day, all at the same time: one at 3 o’clock in the morning, then at 9 in the morning, then at one in the afternoon, then at 5 in the evening.

What does this pain look like?

The pain does not look like anything at all, you can’t compare it, and you can only characterize it as absolutely unbearable, from which you want to climb the walls.

What were her symptoms?

The symptoms are as follows, an acute pain begins behind the eye, it grows within 3-5 minutes, and you understand that it has begun. The productivity of any activity decreases and reaches zero with the coming into full force of the attack. The eye begins to water, the eye is always the same. The pain squeezes both the eye and everything behind it, and strikes like a heavy hammer over the entire half of the head, which hurts, gives it to the healthy part of the head. Then the face swells, tears flow, the eye turns red, and it seems that it will burst.

How did you try to deal with her?

Frozen wet towels, a head under a tap with cold water, lying, standing, sitting, breathing fresh air - everything is useless here. Except for the ice, there appears another pain that slightly sets off the primary pain, but there is no sense in it. All possible pills prescribed by a doctor, or written on the Internet, do not help.

Which specialist did you contact? What research has been done? What tests did you take?

I went to 4 neurologists, did an MRI, did an ultrasound of blood vessels, one of the 4 doctors from the clinic for RAS employees was immediately able to make a diagnosis, although I knew him myself, I just wanted to be prescribed medications that would definitely help with the attacks.

What was assigned to you? What medications have helped?

However, all the funds were from old textbooks (the same information as on the Internet), and these funds have not been available in pharmacies throughout Moscow for several years now. When I went around and phoned all the pharmacy chains, I called the doctor and said that there were no such pills. She called me on the phone several remedies for migraines, but they are absolutely useless. As a result, more than 3,000 rubles were spent on tablets, of which there was no use.

Have you had relapses of cluster headache?

Yes, relapses occurred three times after the first attack. With periods of six months, a year, two years and three years.

When did the last attack happen?

In May 2014.

What would you recommend to people with this disease?

Unfortunately, there is nothing to advise, except that work with consciousness helped me, and, in particular, Louise Hay’s book “Heal Yourself”, in which the author calls guilty feelings or resentment (inability to forgive people) the cause of most illnesses. Getting rid of resentment and guilt, the illness recedes, 4 days after reading the book and starting work with the state of mind, the attacks became much weaker and ended a week earlier than the previous times (in total, 2 weeks instead of 3).

Important! Based on the interview, we can draw the following conclusions: the pain is very strong and unbearable, paroxysmal, debilitating. Research conducted by doctors is not very effective. Effective treatments for this disease are few, and many drugs are simply not on sale. Conventional painkillers are ineffective. Sometimes it helps to apply ice to the area of \u200b\u200bpain.

Cluster headache treatment

1 Both domestic and foreign experts agree, which helps very well during an attack absolute oxygen. To carry out correctly oxygen therapy no special knowledge required. It is enough to purchase a face mask through which oxygen will enter your lungs, a special cylinder with gas and a flow regulator.

You can also get concentrated oxygen using a special apparatus - oxygen concentrator. True, they cost a lot, but there are special small models for home use, which are not as expensive as oxygen concentrators for medical institutions. Oxygen masks, tubes, oxygen cylinders, concentrators can be bought both in ordinary pharmacies and ordered in the online store.

The simplest oxygen masks are inexpensive. For instance, oxygen mask L, Apexmed to Atmung German production costs only about 400 rubles. It is necessary for short-term oxygen supply procedures with a fixed concentration of O2 on inspiration. It is made of a thermoplastic material, which, when in contact with the body, heats up and takes the form of the patient's face, without causing discomfort during treatment. For the mask, it will be necessary to purchase disposable oxygen cannulas, you can use the same company as the mask itself, as well as oxygen cylinders. For instance, oxygen tank 18 L Atmung replaceable costs about 1500 rubles.

2 For treatment, doctors recommend triptan group products. In particular, foreign doctors prescribe Sumatriptan injections or Sumatriptan nasal spray (Imitrex, Imigran) for patients with bundle pain. All of these drugs contain sumatriptan, which relieves or alleviates severe headache. If the pain persists after the first dose of the medicine, then it is not recommended to use the medicine a second time during the same attack. If the pain has passed, but has arisen again in the next day, then repeated administration of the drug is allowed. It should be borne in mind that the daily dose of Sumatriptan should not exceed 2 doses with the introduction of the drug intranasally.

The analogue of this medicine is Immigrant spray with the same active substance. Its cost is about 450 rubles. Also, you can order Sumatriptan nasal spray produced by the company Flumefarm in Moldova. There, its cost is about 20 cu Abroad, there are special syringes with sumatriptan solution that the patient can administer on his own.

3 Also, foreign doctors prescribe ergotamine-based products, such as Dihydroergotamine and Migranal with the same active substance in the form of a nasal spray or injection. Taking these medications stimulates the contraction of the smooth muscles that cover the blood vessels. Thus, the dilated arteries put less pressure on the nerve endings, and the pain disappears. There are contraindications, so be sure to consult your doctor before taking it. Improper use of the drug or individual intolerance can cause a heart attack or stroke. Dihydroergotamine and its analogues can be bought in Russia.

4 Zolmitriptan (Zomig) in the form of a nasal spray - A rather expensive drug, the cost of which, depending on pharmacies and supplies, is from 5 thousand rubles. Zolmitriptan has a number of contraindications, therefore it should be used with caution. Before starting admission, it is recommended to undergo a neurological examination to exclude pathologies of the central nervous system, as well as assess the state of the cardiovascular system. The drug weakens not only an attack of pain, but also helps to reduce additional symptoms: nausea, dizziness, etc.

Prevention of beam pain

If you suspect that you have a headache, you should immediately consult a doctor. With a doctor, you can choose the drugs that are best for you. Not all drugs act on patients equally and are equally effective. If one medicine is not suitable for you, the doctor will be able to recommend another. In addition, there are a number of preventive drugs that can be prescribed by a doctor on cluster pain episode

Elena Malysheva in the program "Live Healthy!" talks about the methods of treatment and prevention of cluster pain:

Dr. Kulichkov about cluster headache and treatment:

Cluster headache - attacks of unilateral intense headache, which is manifested by a series of attacks in a limited time period (2 weeks - 3 months) with further long-term remission. Attacks are present from 15 minutes to three hours and can be repeated several times a day, often developing at night. With an attack there is increased sweating, lacrimation, runny nose, redness of the skin, dilated pupil, swelling and redness of the eye from the side of pain, nausea. At the highest stage of the attack, periods of apnea may occur.

Symptoms

One-sided headache in the temporal-ocular region, in some cases, pain can spread to the occipital and frontal region.

Attacks develop mainly at night.

The seriality of attacks is characteristic 1-4 times a day.

Heart palpitations.

Sweating, swelling, redness of the skin.

Rhinorrhea and nasal congestion.

Redness of one eye, swelling of the eyelid, dilated pupil, lacrimation.

Men, unlike women, suffer from cluster headache attacks four times more often. Among other things, such a headache is observed mainly in men over the age of fifty. The pain syndrome is localized in the eyeball and can give to the temple. An attack occurs, usually at night, after 2-3 hours from the moment of falling asleep. There is lacrimation, nasal congestion, and then a runny nose, redness of the skin and eyes. In most cases, these symptoms are observed for several hours, but can pass faster. In the morning, the patient does not suffer from any manifestations of malaise. Similar attacks develop in series that can last for weeks or months.

A headache at night does not allow a person to sleep normally, which ultimately leads to a violation of the normal rhythm of life. The patient begins to experience a feeling of nervousness and anxiety. Pain can cause a decrease in mental and physical activity.

Causes of cluster headache

The exact causes of this syndrome are currently unknown. There are suggestions that the pain is caused by the action of serotonin or another substance that is similar in properties to this tissue hormone. It is serotonin that stimulates the smooth muscles of the walls of blood vessels. With an excess of serotonin or similar substances in the body, severe paroxysmal headaches can occur. Doctors believe that an excess of this substance appears under the influence of alcohol and stress.

Also, the cause of pain quite often is a change in habitual lifestyle. When a person gets into stressful situations, for example, at home or at work, financial difficulties, a long trip, all these events greatly change the emotional background of a person, which ultimately leads to the development of a number of physical processes in the human body that affect the general well-being .

Quite often, the cause of a cluster attack can be drug therapy with antibiotics, drugs to expand the walls of blood vessels, and treatment of pathologies of the nervous system. Each organism individually responds to drugs, therefore, in case of pain, you can replace the drug with an analogue.

In some cases, the starting point for the onset of cluster headaches is an attack of fear (for example, fear of enclosed spaces, darkness, heights), a pungent smell, bright light.

After a series of studies, specialists noticed a number of factors that increase the likelihood of developing this disease. These include:

Chronic lack of sleep - provokes irritability, weakening of the immune system, nervousness, which ultimately leads to the manifestation of various pathological conditions.

Sex and age - men after forty years are more at risk of getting this disease every year, in women the age threshold is slightly higher, usually the disease in women begins to appear after 60 years of age. Children rarely suffer from this pathology.

Heredity.

The use of potent drugs, drugs, alcohol and other substances that can affect the central nervous system.

Smoking and abrupt cessation of this habit - large doses of nicotine have an active effect on nerve cells, while with abrupt cessation of smoking the body experiences a severe shock, which ultimately leads to mood swings, emotional stress, and stress.

Head injuries and concussions that have ever been received, sometimes even an accidental blow to the head, can cause serious consequences in the future, including the development of cluster headaches.

Cluster Attack Treatment

We use sedatives and drugs that improve the blood supply to the brain, and also use painkillers, anti-inflammatory drugs, hormones, and oxygen.

Reducing pain during the next attack is not easy. In some cases, valerian tea or a contrast shower helps.

Severe headaches make a person immediately seek help from a doctor. Cluster headache is characterized by the presence of specific symptoms, so the diagnosis will not be difficult for the doctor. After determining the diagnosis, the doctor prescribes the necessary course of therapy.

Despite the fact that the symptoms of migraine and cluster headache (Horton syndrome) are quite similar, the methods of treatment for these diseases differ.

How to protect yourself from an attack?

In people who manage to avoid stressful situations and lead an active lifestyle, this pathology rarely occurs. For many patients, the use of alcohol, neuropsychic overstrain, and physical activity can become a provoking factor.

Cluster headaches are considered one of the most severe types of headaches. This type of pain is distinguished by such a frequency and intensity of pain that even cases of suicide were noted at the time of attacks.

Cluster headache is characterized by a series of high-intensity attacks. These seizures are also called clusters, hence the term. Headache can occur several times a day and last from a couple of minutes to an hour. Attacks can wear out over a long period of time - from 2-3 days to several weeks and even months, and then disappear without a trace and not disturb for years.

Symptoms

Cluster headaches are easily recognizable and are distinguished by the following symptoms:

Attacks make themselves felt in the age interval from 20 to 50 years;
Pain occurs suddenly, there are no signs of an approaching attack;
As a rule, an attack begins late at night;
The pain is accompanied by nasal congestion, lacrimation, pain in the ear;
Cluster headache, as a rule, has a concentrated focus, usually in the eye area;
Most often, pain attacks attack in the autumn or spring months;
Attacks are repeated at the same time of the day, the focus of pain does not change;
Vision worsens, swelling of the eyelids and damage to the eye capillaries are noted;
Blood rushes sharply to the face, sweating appears;
The heartbeat becomes rapid.

Causes of occurrence

Why cluster headaches occur is not exactly established. Studies show that men suffer from this type of headache 6 times more often than women. Presumably, increased smoking and alcohol consumption affect the increase in cluster headache attacks, but this is no more than theory. It is also believed that the appearance of pain of this type is due to a genetic predisposition, however, this feature is not inherited.

Treatment

Treatment of cluster headaches is usually symptomatic and does not allow to get rid of them forever. Strong painkillers cause gradual addiction, so they have to be changed periodically.
In folk medicine, there are means to help relieve cluster headache attacks.

Cayenne pepper

This spice contains the substance capsaicin, which gives the pepper a burning pungency. Capsaicin has an irritating effect, which is why it is part of some painkillers. Ointments based on this substance must be rubbed into the temples with the appearance of headache attacks, this will help relieve pain

Turmeric

This seasoning has a soothing and anti-inflammatory property. Turmeric helps to tolerate cluster headaches and is not addictive, so you can use it regularly.

Kudzu

The plant is known as lobular pueraria. Little is known about its medicinal properties in Russia, but in traditional Chinese medicine, kudzu is on the list of 50 medicinal herbs. Helps to cope with dizziness, headaches, stuffy ear and prevents poisoning.

Ginkgo

A well-known plant that improves blood circulation, providing its flow to the brain and beneficially affecting the state of blood vessels. These properties can relieve headaches of any intensity. Unfortunately, only “live”, unprocessed ginkgo leaves, which are quite difficult to get, have a healing effect. Plant-based syrups, tablets, and nutritional supplements have an extremely dubious effect.

Nuts are extremely rich in nutrients, due to which it is a great antioxidant. In addition, walnuts have a beneficial effect on blood circulation, improve blood composition, soothe the nervous system and strengthen immunity.

Although a cure to forget about cluster headaches forever has not yet been found, it is worth making sure that they appear as rarely as possible. It is recommended to give up alcohol and cigarettes, exercise moderately, spend more time in the fresh air and adjust the diet.

In addition, it is useful to protect yourself from stress as much as possible and, if possible, find time for a full sleep.

One can talk for a long time about what a cluster headache is and how it differs from the usual one, but only those who have suffered from such a headache at least once in their life can truly understand. Their character resembles migraine, but differs even more locally, while migraine can occur in the whole hemisphere or brain lobe.

The word “cluster” in English literally means “cluster” or concentration. Imagine how the sensations of a headache concentrated at one point intensify.

To understand how to build a treatment for such a headache, you need to understand the nature: how cluster differs from extensive. Indeed, according to recently published WHO statistics, for every thousand of the world's population there is one who, depending on one reason or another, suffers from a disease with a cluster headache. And this is enough to declare the disease large-scale and try to find a universal treatment for everyone.

Symptoms of the disease

Most migraine affects on a hereditary basis, women are more likely to suffer from it, especially during a hormonal surge, menopause, or severe stress. Whereas cluster attacks of headache bother men and women alike. Moreover, it is men of athletic or dense physique who abuse smoking or alcohol, even despite the treatment prescribed by the doctor, are prone to headaches more often. The reasons, it would seem, are obvious, and yet it is extremely difficult to convince them of an adult.

A curious anatomical sign: a split chin, square contours of the face, even the color of the eyes (light gray or blue) act as causes and aggravating factors of such a disease as cluster migraine.

When the first symptom of a headache occurs and at what age, it is impossible to predict. It is precisely known that it is almost never found in children - they are more often prescribed treatment for another ailment, abdominal migraine. And here are just the main primary signs that accurately indicate that a cluster headache begins:

Flashes of light in the eyes of a burning character.
Headache syndrome is sharp, burning in nature, as if piercing the head through and through. Often, migraine focuses in the area of \u200b\u200bthe superciliary arch, which causes a feeling of pain in the eyes.
In other cases, sensations may erroneously be given to the ear, to the temporal region, to the jaw. In a word, to begin treatment, it is necessary to correctly diagnose the focus.
Symptoms of visual pathologies - for example, Horner's syndrome (in which the eyelid drops), retraction or nervous tremor of the eyeball.
The appearance of vegetative symptoms of a headache is possible - increased sweating, pallor, nausea, stuffy nose (the reasons are not hidden in infections or colds), etc.

Sensations in the eyes develop into visible signs: so, with an increase in headache, the eye begins to watery and redden. From such experiences and the physical strength of a headache, a person becomes irritable, ceases to enjoy life. Sometimes patients for treatment describe their feelings as a desire to hit their head against a wall or poke their eyes out, but in practice there have also been cases of suicide.

Harbingers of Cluster Pain

Usually attacks come and go in a short-term nature. So, for example, a person may experience 10-15 minutes several times a day, and it happens that a cluster headache recedes for six months and several years, and no one knows the reason. Since the disease is chronic, treatment aims to extend the period of remission of the headache.

Usually the disease does not have seizures longer than 1.5 hours, as is the case with migraine attacks. Another characteristic sign of the onset of the ailment is the “exact schedule”: it happens that a migraine occurs strictly at a certain time of the day, after eating, at dusk or at night in a dream. Otherwise, a special aura of headache is not observed. Also, treatment rarely can affect the change of side of the focus: sometimes headaches appear not on the right, but on the left and are less intense.

The causes of the disease

Many doctors who treat it assume that the causes of deviations lie in the malfunction of the body’s biological clock, for example, when the climate or time zone changes. Among other triggering factors, headaches are often called:

Excessive production of hormones - histamine, serotonin and other vasoactive components.
Pathology in the work of the hypothalamus.
Overfatigue and stress, as factors causing migraines.
The cluster nature lies in the deviations of the trigeminal nerve, which runs in the front of the head.
Failures in neurophysical processes, humoral regulation. This can happen in women during menopause, pregnancy, or before menstruation.
Vascular pathologies cause severe headache attacks and can lead to a stroke.

Just the last one is the common treatment - taking pills, constricting blood vessels and stopping pain. The rest of the reason should be determined by the doctor according to the results of the diagnostic examination of the headache. He also prescribes treatment.

Diagnosis and methods of dealing with cluster pain

To make an accurate one, a differential diagnosis is first made, according to which the reasons lie in the most extensive areas: from headache as a result of jaw or cranial injuries to temporal arteritis. To weed out 70% of assumptions, the patient simply needs to thoroughly describe their symptoms, their schedule of occurrence, and changes over time. What most of us cannot do and is delaying the treatment of cluster pain for a long time.

So, turning to a neurologist, describing the picture of complaints, most likely you will receive a referral to magnetic resonance imaging, which will confirm the presence of serious lesions of the head region. Also, angiogram of blood vessels allows to exclude or confirm diseases of the vascular system. To exclude the possibility of pain as a result of cervical osteochondrosis, you may be asked to have an x-ray of the cervical spine.

Treatment of cluster migraine includes taking pills, sometimes in combination with oxygen inhalations: special mask devices through which the patient inhales the oxygen composition during a headache. The following medicines are also used:

Triptans - for example, Zolmitriptan.
Nasal drops and spray containing dihydroergotamine.
Compresses with ice.
Strong painkillers like Ketanov or Ledocaine tablets.
Steroid blockers and hormones in case of prolonged and unbearable cluster pain.
Sedatives and tranquilizers.

Acupuncture often helps with headaches - acupuncture procedures are carried out in specialized massage parlors.

Disease prevention

In order not to bring your body to the critical threshold of cluster migraine, the simplest recommendations of a doctor should be followed. And first of all, abandon bad habits - alcohol and smoking cause an increase in headache attacks, aggravate their course. Also, for prevention purposes, it is advised to abandon excessive physical exertion, weight lifting, overwork and even reduce the amount of work, because you can’t buy health for a salary.

You have a headache? There can be many reasons and the success of the fight against a headache depends on the specific factors that caused it.

Let's see how it hurts.

Doctors distinguish four main types of headaches pain:

Migraine - these are pains of a neuralgic nature, which torment one one every month and several times, and the disease “bestows” another with its attention 1–2 times a year.
Tension headache - the most common, occurs rarely or often in each person. It may complicate the patient's daily activity, and if the pain is frequent, it is better to be under the supervision of a doctor. Such ailment does not pose a threat to health and life.
Chronic daily headache - if your head hurts for at least 15 days a month and more than 3 months, then this is your case.
Cluster (bundle) headache - The most severe pain of the above.

Let us analyze in more detail this cluster cephalgia (headache in scientific language).

Nature of pain - It resembles a causeless acute pain attack reaching its peak in a few minutes. For the most part, this is a one-sided headache of a constant nature, localized deep in the orbit.

Sometimes the pain is so strong and lasting that they lead a person to suicide.

An attack can last from 40 minutes to several hours. Seizure frequency can range from one case per week to six during the day, but more often one or more seizures per day. The period of pain is usually extended for 1-2 months.

Scare in this disease two things:

sometimes the period is delayed for six months;
in 10% of patients, cephalgia becomes chronic.

But there is a positive point - after the end of the pain period, the disease comes only after a few months, or even years. 3 out of 1000 people get sick.

This disease is a cyclical disorder and is directly related to the human biological clock. Attacks often occur at the same time of day.

Enzymatic activity, physiological reactions, temperature, hormonal secretion - all this is regulated by our biological clock.

Violation of this mechanism, apparently, can cause cluster headache.

The center of the puzzle can be the functions of the hypothalamus responsible for sleep and wakefulness, namely its ability to send impulses to the central nervous system that cause vasodilation.

Risk group

At risk are people aged 20 to 56 years, the most dangerous period of thirty years. In men, this disease occurs six times more often than women. In the 70s of the twentieth century, the scientist Graham made an attempt to identify the relationship between the appearance and habits of men with cluster cephalgia.

At his risk large muscular men fall, are above average, with bright eyes of green and blue, face skin is rough (like the peel of an orange), square jaw, forked chin, forehead dotted with deep wrinkles.

Most of them smoke more than a pack of cigarettes a day, and also like to drink alcohol.

The provoking factor that causes beam headache is alcohol, which even in small amounts causes seizures. During remission, alcohol does not have such an effect. Other factors are unknown.

There are two types of cluster cephalgia:

Episodic - 90% of cases, it is characterized by the alternation of the pain period (cluster), when an attack occurs day or night, with a period without pain (remission). The cluster period lasts 6-12 weeks, occasionally up to six months, and is most often tied to the seasons (autumn, spring). Some patients have 2-3 pain attacks per year, while others once every 2-3 years.
Chronic - in the remaining 10% of cases, pain is daily and lasts several years without a break. Chronic cluster pain can turn into episodic and vice versa.

Cluster headache has such symptoms:

The pain appears without warning and there are no signs of its approach.
Extremely painful attacks, but a short time and go one after another throughout the entire period of the cluster.
Usually this type of pain affects one person in the family.
The pain is always one-sided and localized around the eye, but soreness can spread to the cheek, forehead or temple. Only in one of 6 cases does pain change the side of the face.
A rush of blood to the face is possible - redness and sweat appears.
Eyelids on the sore side swell and fall on the eye, redness of the eye is also possible.
Vision may become blurry and the pupil may narrow.
Attacks often wake up at night 1-2 hours after falling asleep. while the eyes are watery and there is a stuffy nose.
During an attack, tachycardia is observed.
As previously mentioned seasonality of pain.
Alcohol can cause pain.

Diagnostics

Due to the characteristic symptoms, cluster cephalgia is easy to recognize.

But at the same time no survey methodsthat can diagnose this type of pain. Diagnosis is based on your description of the characteristics of pain and symptoms, so try to most accurately describe your feelings to a neurologist.

Sometimes, to exclude other causes of headache, a computed tomography is prescribed.

Disease treatment

Headache Headache Treatment divided into prevention and a set of methods for relieving pain during seizures.

Some resort to self-medication - taking analgesics, but this is ineffective, since they act too slowly and the pain rises to a peak long before the onset of the drug.

The best option is to seek qualified help from specialists who will prescribe you effective therapy. Treatment is aimed at maximizing the relief of cluster headaches and preventing further attacks.

Acute manifestation of alcoholic psychosis - requires an immediate response and treatment, as it can lead to death.

Features of taking the drug Betahistin: instructions for use, reviews and other information that before taking the medicine.

Pain medication

How to reduce pain:

Inhalations of 100% oxygen with a special device that includes a mask, a dispenser, and of course directly an oxygen cylinder.
Injections of the drug sumatriptan using an injector.
Various derivatives of triptan are also used, which are less effective, but also give a positive result.
Strong drugs such as somatostatin, ergotamine, and lidocaine are often used. Admission is only under close medical supervision.

Medications that are optimal if you have a cluster headache should be prescribed only by your doctor!

Preventative treatment

Preventive measures are based on the daily intake of the prescribed drug throughout the entire pain cluster. Among they are distinguished:

Calcium channel blockers (calcium antagonists) such as Verelan (verapamil hypochloride) - it prevents and reduces the number of seizures. It is prescribed for the prevention of episodic and chronic cluster cephalgia.
Lithium, in particular lithium carbonate (Escalit, Lithobid) affects the biological clock of the brain (hypothalamus). It is prescribed for chronic cluster cephalgia.
Anti-epilepsy drugs, such as Decapote (sodium valproate), Topamax (topiramate). They are prescribed when other drugs do not help.
Corticosteroids are prednisone, it is used to relieve pain for a short period until the onset of drug action, due to side effects, the number of doses is limited.

Taking drugs is under the supervision of a doctor, blood tests are performed due to the possibility of side effects.

Additional techniques

Additional methods struggle with pain can be intense physical exertion, applying ice to the temples, taking vitamins, sedatives and sleeping pills.

Some are prescribed non-steroidal anti-inflammatory drugs and hormones in case of prolonged treatment. Acupuncture, laser therapy, balneotherapy (mineral water treatment), psychotherapy and auto-training are also used.

If there is no relief

What to do if the prescribed therapy does not bring relief?

If the cluster headache does not recede, other medications are prescribed and look at the result. In some cases, I use combinations of two or more drugs.

Headache diary

Keeping a diary in which you indicate in detail how often your head hurts, at what time, for how long and with what symptoms it is accompanied - becomes a very valuable weapon in the hands of the doctor, both for making an accurate diagnosis, and for successful treatment.

Disease prevention

Now let's talk about prevention in everyday life. What can serve as the trigger with which to begin a new period of attacks? 100% of the answer is no due to the uncertainty of the nature of the disease.

Provoke lengthening and severity of the pain period can:

alcohol;
smoking;
lack of sleep (but siesta, on the contrary, contributes to the disease);
stress - do sports;
some dishes, such as aged cheese or long-term meat;
prolonged elevated body temperature, for example, when taking a bath or physical activity;
change in the usual daily routine;
change of work schedule;
moving to another climate zone.

And finally, if you experience periodic headaches, be sure to consult a doctor. The sooner the cause of the pain is determined, the sooner you will return to your usual lifestyle and good mood.

Health to you and your loved ones!

Video: Cluster headaches

Medical animation on the theme of cluster headache and its consequences. Who most often occurs and in what part of the head is the focus of pain.