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CLUSTER HEADACHES: PAIN IN BUNCHES

Dr. Praveen Kumar Yada, Thursday, November 7, 2019

WHAT ARE CLUSTER HEADACHES?

Cluster headaches consist of attacks of severe one-sided pain in the head. It is sometimes called migrainous neuralgia. Each attack develops suddenly, usually without any warning. Typically, you feel the pain mainly in or around one eye or temple. The pain may spread to other areas on the same side of the head. The pain is sometimes described as burning or boring. One attack lasts 15- 180 minutes, but most commonly 45-90 minutes.


WHAT ARE THE SYMPTOMS?

The pain during an attack is usually severe. Attacks often occur at night, a couple of hours after falling asleep, and will wake you from sleep. During each attack, you may also experience other symptoms. These include:

  • Redness and watering of the eye.
  • A runny and bunged-up nose.
  • Sweating of the face.
  • Swelling of the eyelids.
  • Drooping of the eyelid.
  • Constriction of the pupil in the eye.


WHO GETS CLUSTER HEADACHES?

Cluster headaches affect about 1 in 1,000 people. They are four times more likely to occur in men than in women. The first bout (cluster) typically develops between the ages of 20-40 years, but it can start at any age.


WHAT CAUSES CLUSTER HEADACHES?

Research suggests that a part of the brain called the hypothalamus becomes overactive during each attack, although it is not known what causes this to happen. During an attack, the hypothalamus is thought to release chemicals (neurotransmitters). These may stimulate nerve cells in the brain to cause the pain and other symptoms. The nerve over activity may also cause a widening or opening up (vasodilation) of the blood vessels in the affected side of the brain.

Almost all people with cluster headaches have no abnormality of the brain that can be shown by scans or tests. In about 1 in 20 people there is another family member who also suffers from cluster headaches. In a very small minority of cases, cluster headaches seem to be triggered by a tumour in the pituitary gland (pituitary adenoma) or other brain tumours.


HOW ARE CLUSTER HEADACHES DIAGNOSED?

The diagnosis is based on the typical symptoms. There is no test that can prove the diagnosis. Tests are sometimes done if the diagnosis is not clear, to rule out other causes of headache. Sometimes tests such as a brain scan may be done to rule out a pituitary adenoma (as described above). Your GP may therefore refer you to a doctor with a special interest in the treatment of headaches.


WHAT IS THE TREATMENT FOR CLUSTER HEADACHES?

Treatment is divided into treatments to stop (relieve) each headache, and treatments aimed at preventing the headaches. Some treatments are:

  • Sumatriptan Injection: Sumatriptan is the commonly used treatment to abort a headache. It relieves pain within 15 minutes in about three in four people with a cluster headache. You can be shown how to use this injection, and should use it as soon as a headache occurs.
  • Zolmitriptan Nasal Spray: Zolmitriptan is also a triptan medicine. Zolmitriptan nasal spray is an alternative to sumatriptan injection. It often works well but possibly not as quickly as sumatriptan injection.
  • Oxygen Therapy: This is an alternative treatment that may be advised, especially if sumatriptan injections or zolmitriptan nasal spray cannot be used, or do not work. It often works well to relieve pain within 15 minutes, but it does not work in everybody.


WHY KIMS?

Managing headaches is not just a matter of finding the right medication. It requires proper diagnosis and a comprehensive treatment plan. KIMS has the best neurologist in Hyderabad who with his team of excellent staff tailors a complete program for patients focused on prevention, rescue and lifestyle changes through medical care and physical therapy.

Headache treatment in Hyderabad at KIMS includes all types of headaches including migraines, tension headaches, cluster headaches, hypnic headaches and cluster headaches. With the opening of KIMS, one of the best neuro specialist hospitals in Hyderabad, we are competent in giving absolute care for patients with intense cluster headaches.

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