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$Unique_ID{BRK03802}
$Pretitle{}
$Title{Headache, Cluster}
$Subject{Headache Cluster Cluster Headaches Vasogenic Facial Pain Cyclic
Cluster Headache Chronic Cluster Headache Trigeminal Neuralgia Migrane
Headache Tolosa Hunt Syndrome Giant-Cell Arteritis}
$Volume{}
$Log{}
Copyright (C) 1989 National Organization for Rare Disorders, Inc.
720:
Headache, Cluster
** IMPORTANT **
It is possible that the main title of the article (Cluster Headache) is
not the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Cluster Headaches
Vasogenic Facial Pain
Disorder Subdivisions:
Cyclic Cluster Headache
Chronic Cluster Headache
Information on the following diseases can be found in the Related
Disorders section of this report:
Trigeminal Neuralgia
Migrane Headache
Tolosa Hunt Syndrome
Giant-Cell Arteritis
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for e
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Cluster Headaches are a rare form of severe disabling headache. The
headache is a deep, nonthrobbing, extremely painful one which tends to recur
in the same area of the head or face with each occurrence. They usually come
on during sleep and awaken the patient. They are typically associated with
watering of the eyes and nose.
Symptoms
Cluster Headaches can be of two types, cyclic or chronic. They take their
name from the fact that they usually occur together, one to four times a day
for weeks or months, then stop for a while and occur again months or years
later. They usually affect young to middle aged males. They often arouse
the patient from sleep because of pain.
The pain of a cluster headaches is deep, agonizing, nonthrobbing and on
only one side of the head. The area of the head or face involved is always
the same. The pain may occur in the head, face, eye, temple or forehead.
The involved eye and nostril will usually water excessively, and the eyelid
may droop. When the headache passes, the patient will fall into a deep sleep
only to be awakened again by another headache. This may continue several
times a day, sometimes for weeks or months. Some patients may be unable to
continue a normal work schedule. It is important to note that drinking
alcohol can act as a trigger and can bring on attacks in persons who suffer
with Cluster Headaches.
The term Cyclic Cluster Headache refers to the fact that these headaches
will often occur together for weeks or months, and then not appear again in
clusters for months or years.
When the Cluster Headaches occur daily, and the clusters do not end, the
disorder is called Chronic Cluster Headaches.
Causes
The exact cause of Cluster Headaches is unknown. However, many scientists
think that they may occur from spasms, swelling (edema) or inflammation of
the carotid artery in the neck. Others believe it may be caused by hormone
imbalances.
Affected Population
Cluster Headaches affect young to middle aged males almost exclusively.
However, in rare cases they also afflict women.
Related Disorders
Symptoms of the following disorders can be similar to those of Cluster
Headaches. Comparisons may be useful for a differential diagnosis:
Migraine Headaches usually involve one side of the head. Individuals who
suffer from these intense headaches may have a genetic predisposition to
them. Often associated with these painful attacks are double vision,
irritability, nausea, vomiting, constipation or diarrhea, and sensitivity to
light. Medical researchers believe constriction of the cranial arteries may
trigger migraine headaches, but the cause of the constriction is not known.
Tolosa-Hunt Syndrome includes chronic headaches, mild fever and vision
impairment followed by painful eye muscle paralysis. Swelling, protrusion of
the eye, drooping eyelid, diminished vision and abnormal skin sensations
around the eye may be associated with the paralysis. These symptoms usually
occur only on one side of the head. Additionally, symptoms often associated
with migraine headaches such as double vision, nausea, vomiting and a general
feeling of discomfort may develop. However, fever and eye muscle paralysis
do not occur with migraine headaches. (For more information on this
disorder, choose "Tolosa-Hunt" as your search term in the Rare Disease
Database).
Trigeminal Neuralgia (Tic Douloureux) is characterized by recurrent
episodes of intense pain at the upper jaw and side of the nose. Symptoms are
limited to one side of the face, with flushing of the skin and tearing of the
eye on the affected side. (For more information on this disorder, choose
"Trigeminal Neuralgia" as your search term in the Rare Disease Database).
Giant Cell Arteritis is a disease that may simulate an infection with low
fever, malaise, loss of appetite, severe weakness and weight loss. Aching
and stiffness of muscles of the trunk, neck, shoulders and hip areas may also
occur. A severe, throbbing, boring headache occurs in the temporal area,
often accompanied by redness, swelling, tenderness, pulsations and knotting
of the temporal artery. Half of the patients have eye symptoms and 40% may
experience vision loss. (For more information on this disorder, choose
"Giant Cell Arteritis" as your search term in the Rare Disease Database).
Therapies: Standard
Treatment of Cluster Headache is often delayed because of sudden onset during
sleep. Patients may sometimes be helped by inhaling ergotamine or oxygen.
Sometimes use of the following drugs may prevent the headache from recurring:
Methysergide, lithium carbonate, prednisone, verapamil, or nifedipine. Other
treatment is symptomatic and supportive.
Therapies: Investigational
Scientists are attempting experimental surgery to treat extreme or chronic
Cluster Headaches that do not respond to drugs. By severing nerves which
project to the sinuses and palate (the sphenopalatine ganglion neurectomy
procedure) surgeons may alleviate the pain associated with Cluster Headaches
in certain cases. This procedure has been tried on an experimental basis in
a limited number of patients when conservative measures have proven
ineffective. The long-term safety and effectiveness of this procedure is
still under investigation.
This disease entry is based upon medical information available through
December 1989. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Cluster Headache, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
National Migraine Foundation
5252 North Western Avenue
Chicago, IL 60625
(800) 523-8858 (Illinois)
(800) 843-2256 (outside Illinois)
NIH/National Institute of Neurological Disorders & Stroke (NINDS)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5751
(800) 352-9424
References
INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
Co., 1987. Pp. 2180-2185.
VASOGENIC FACIAL PAIN (CLUSTER HEADACHE). L.R. Eversole, et al.; Int J
Oral Maxillofac Surg (February, 1987, issue 16 (1)). Pp. 25-35.
CLUSTER HEADACHES. J.P. McKenna, Am Fam Physician (April, 1988, issue 37
(4)). Pp. 173-178.
CLUSTER HEADACHE PAIN VS. OTHER VASCULAR HEADACHE PAIN; DIFFERENCES
REVEALED WITH TWO APPROACHES TO THE McGILL PAIN QUESTIONNAIRE. A. Jerome, et
al.; Pain (July, 1988, issue 34 (1)). Pp. 35-42.
UNILATERAL IMPAIRMENT OF PUPILLARY RESPONSE TO TRIGEMINAL NERVE
STIMULATION IN CLUSTER HEADACHE. M. Fanciullacci, et al.; Pain (February,
1989, issue 36 (2)). Pp.185-191.