What are Cluster Headaches
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What are Cluster Headaches?

Officially recognized as a syndrome for more than a hundred years, cluster headaches are rare, extremely painful and debilitating. They occur less than migraines and affect approximately 69 per 100,000 people. In a ratio of 6:1, more males than females tend to suffer from cluster headaches.

Cluster headaches are prevalent among people between the ages of 20 and 50 years.  However, rare instances of cluster headaches have been reportedly experienced by younger people, about 10 years old, and by the older ones at 80. Cluster headaches seem to attack women who are over 50 although there has been no established correlation between these headaches and menopause. On the other hand, there has been no report of cluster headaches among pregnant women.

Cluster headaches have been referred to by several other names in the past. They are now aptly termed as cluster headaches because these severe headaches are recurrent and occur in "clusters" during periods of time called cluster periods or episodes, which last for four to eight weeks. About 90% of the sufferers say that attacks usually stop after eight weeks, with 80% reporting a pain-free period for four weeks to two years. About 60% of people who endure cluster headaches claim a remission of six months to two years. In terms of duration, bouts with cluster headaches are said to last for only a few days, with some reporting a longer episode of 16 weeks. About 10% of these cluster headache cases become chronic with daily attacks running on for years.

Symptoms of Cluster Headache

Cluster headaches occur usually with the following symptoms:

- Unilateral headaches, occurring on only one side of the face.  May sometimes change sides.
- Pain is felt more near the eye and socket.
- Sudden and explosive pain.
- Tendency to wake up at night because of the headache.
- Headaches extending to weeks with pain-free remission for months.
- Stuffy nose during the headache.
- Sweaty forehead.
- Tearing and redness in the eye on the affected side.
- Drooping eyelid.
- Sensitivity to alcohol during a headache cycle.

Pain during a Cluster Headache

The quality of pain experienced during cluster headaches is portrayed as sudden and explosive, reaching its peak between two and fifteen minutes. The pain normally starts in or above the eye although the pain can originate in the face, ear or neck. Cluster headaches differ from other types of headaches in that they occur on only one side of the head. About 15% of the sufferers, however, observe the pain to be switching sides from one attack to the next and that the headache never occurs on both sides simultaneously. The pain during cluster headaches is said to be almost unbearable and can incapacitate the sufferer. Around 20% of those with cluster headaches describe their experience as something like being pierced repeatedly in the eye socket with an ice pick.

A person with cluster headaches had to suffer the agony of an attack for 45 minutes on the average although the episode can last for 30 minutes to two hours in approximately 75% of the sufferers.  Mild attacks last for ten minutes or less but the more severe cases can go on for several hours.

The experiences of people with cluster headaches vary when it comes to frequency of attacks. There could be as many as six cluster headaches within a 25-hour period or perhaps only one cluster headache during the week. An average occurrence would be one or two cluster headache attacks per day.

Another interesting observation about cluster headaches is the almost clock-work regularity of the attacks. Around 85% of the sufferers reported attacks occurring at about the same time everyday for the duration of the cluster bout. There are a few who claim experiencing random cluster headaches throughout the day outside the regular attacks. Seventy-five percent of cluster attacks happen between 9 am and 10 am, 1 am and 2 am, and 1pm and 3 pm. About half of these sufferers say that cluster headaches attack within a couple of hours of going to sleep, forcing them to wake up.

Cluster Headache Treatment

Inhalers are considered as the best treatment for cluster headaches since attacks are quick in coming and short in duration. Vaso-constrictors like Ergotine inhaler are used for treating cluster headaches because relief is attained in as short as five minutes after inhalation. The effectiveness of Ergotine has been reported in about 80% of people suffering from cluster headaches. Still, there is a newer form of treatment that uses pure oxygen. Inhalation of high-flow, concentrated oxygen appears to be effective in stopping or reducing the severity of a cluster headache attack.

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