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cluster headaches

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Alternative Names
paroxysmal nocturnal cephalalgia, migrainous neuralgia, histamine neuralgia, red migraine, erythromelalgia of the head

Cluster headaches are intense, headaches in the area of the eye socket that occur in "clusters," or multiple times a day for several weeks.

What is going on in the body?
The cause of cluster headaches is unknown. The mechanism of action is suspected to be a paroxysmal, or severe and episodic, discharge of histamine from the body tissues.

What are the signs and symptoms of the condition?
Cluster headaches occur five times more often in males than in females. This type of headache is most likely to occur in 20- to 50-year-olds. Symptoms include:
  • steady, non-throbbing headache behind the eye socket, or orbit, on one side of the head. The headache is of extreme intensity.
  • possible spread to face and neck.
  • flushing of the face.
  • tearing and nasal congestion. Some people experience rhinorrhoea, which is the discharge of a thin mucous from the nose
  • headache pain lasting up to 2 hours.
  • multiple occurrences per day or night. Cluster headaches often occur regularly, for several weeks, then go away for months or years.
What are the causes and risks of the condition?
The causes and risks of cluster headaches are unknown. There is an occasional genetic predisposition to the condition, meaning that it runs in families.

What can be done to prevent the condition?
There is no effective way to prevent cluster headaches.

How is the condition diagnosed?
There are no specific tests for cluster headaches. Doctors rely on symptoms to make a clinical diagnosis.

What are the long-term effects of the condition?
There are no long-term affects of cluster headaches.

What are the risks to others?
Cluster headaches are not contagious.

What are the treatments for the condition?
Cluster headache attacks may be alleviated by inhalation of 100% oxygen for 10 to 15 minutes. Medications used during a cluster headache include: sumatriptan which is taken orally or injected under the skin, dihydroergotamine administered as spray up the nose, ergotamines or anaesthesia of the sphenopalatine ganglion or nerve.

Preventive medications include ergotamine tartrate, corticosteroids such as prednisone, and calcium channel blockers, such as verapamil. Other preventive medications include methysergide and lithium.

What are the side effects of the treatments?
Triptans and ergotamines should not be used by individuals with coronary artery disease, significant peripheral arterial disease, or poorly controlled high blood pressure. Corticosteroids may cause increased risk of infection, hypokalaemia, which is a low potassium level, hypoglycaemia, which is a raised blood sugar level, weight gain, or fluid retention. lithium can cause tremors, ataxia, which is a lack of muscle co-ordination, sleepiness, and pseudodementia. Calcium channel blockers can cause constipation or light-headedness. Methysergide can cause inflammation of the space behind the abdominal and pelvic cavity, or pulmonary fibrosis, a hardening of the lung tissue, and must be discontinued for 1 month every 5 months.

What happens after treatment for the condition?
There are no significant complications after treatment.

How is the condition monitored?
Cluster headaches should be monitored by a doctor.

Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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