Cluster headaches get their name from their occurrence in cyclical patterns or cluster periods, and are unfortunately one of the most painful types of headache. The condition often wakes sufferers up during the night, with a pronounced intense pain resting on a particular side of the head, adjoining the eye area. It’s a rare condition that affects about 1 to 2 people in every 1,000, with males more likely to be affected. Sufferers usually start getting cluster headaches before age 30.
These spells of persistent attacks, called cluster periods, may continue for weeks and months, and are ideally followed by remission stretches where the pain goes away completely. These remission periods can even last as long as a few years.
Thankfully, cluster headache is a rare and atypical condition. Proper treatment can shorten the period and lessen the severity of a cluster headache, and certain medication can reduce their frequency.
A cluster headache usually strikes quickly, without warning. Common symptoms include:
- Excruciating pain felt on one side adjacent to the eye area
- Pain may spread to your head, face, neck, and shoulders
- Feeling of restlessness
- Excessive eye-watering
- Redness in the eye on the side of the attack
- Stuffy or running nasal passage on the affected side
- Sweaty, pale looking skin on your face
- Swelling of the eye on the affected portion
- Droopiness in eyelids
Cluster headache pain is characterized by a sharp, burning, or penetrating sensation. People who experience this condition assert that the pain seems like a hot poker is being stuck inside the eye, or like it’s being jolted out of its socket.
Patients often pace back and forth during an attack. The pain can be so severe that they want to bang their head against a wall, with it being impossible to get comfortable.
It’s important to note that unlike migraine triggers, people that suffer with cluster headaches usually keep from lying down when struck by an attack, because the position aggravates their pain. Symptoms similar to a migraine like nausea, aura, and susceptibility to light and sound manifest with a cluster headache as well, but only on the affected side.
Most headache neurologists have unanimously failed to ascertain the exact reason for cluster headaches. However, they do largely agree that the hypothalamus in the brain could play a part. Cluster pain attacks often occur at different times ‘like clockwork’ during the day, and the cluster cycle also follows the seasonal variation of the year.
These patterns indicate the involvement of the body’s biological clock that resides in the hypothalamus, located deeply in the central part of your brain. Abnormal functioning of the hypothalamus may explain the cyclical nature and definite timing of a cluster headache. Numerous imaging studies have identified incidents of marked hypothalamus activity during a cluster headache.
Unlike migraines and tension headaches, cluster headache isn’t accompanied by any trigger like food, hormonal imbalance, or stress. However, once a headache erupts, alcohol consumption can swiftly provoke a severe cluster. So, patients with cluster headaches should refrain from consuming alcohol during a cluster period.
Characteristics of a cluster period
Most people with the condition suffer from episodic cluster headache periods that last anything from a week to more than a year. This is followed by an interim remission period that is completely pain-free and may last for a year’s time before attacks resurface.
With chronic cluster headache periods may even last for a year or so, and painless periods have a shorter span of only a month or less.
During a cluster period:
- Headaches occur at multiple times throughout the day
- The duration of a single attack can vary from 15 minutes to three hours
- Attacks happen at the same time of the day
- Most of the attacks surface during the night, a couple of hours after going to sleep.
The pain of a cluster headache ends as abruptly as it begins. It’s intensity also plummets rapidly. Once the attack has subsided, most patients feel pain-free but terribly exhausted. Other more dangerous causes of cluster headache such as an aneurysm should be ruled out.
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