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Most already know this: Part 2
« on: Feb 2nd, 2003, 7:57pm »
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Location of Pain: The pain is located behind one eye or in the eye region, without changing sides. It may radiate to the forehead, temple, nose, cheek, or upper gum on the affected side. The scalp may be tender, and the pulsing in the arteries often can be felt.  
Duration of Pain: The pain of a cluster headache lasts a short time, generally 30 to 90 minutes. It may, however, last from 15 minutes to three hours. The headache will disappear only to recur later that day. Typically, in between attacks, people with cluster headaches are headache free.  
Frequency of Headaches: Most sufferers get one to three headaches per day during a cluster period (the time when the headache sufferer is experiencing daily attacks). They occur very regularly, generally at the same time each day, and have been called "alarm clock headaches" because they often awaken the person at the same time during the night.  
Most cluster sufferers (80%-90%) have episodic cluster headaches that occur in periods lasting seven days to one year, separated by pain-free episodes lasting 14 days or more.  
 
In about 20% of people with cluster headaches, the attacks may be chronic, meaning there are less than 14 headache-free days per year. Chronic cluster headaches vary from episodic cluster headaches, as they are continuous without remission periods.  
 
Cluster headaches are not typically associated with nausea or vomiting. It is possible for someone with cluster headaches to also suffer from migraines.  
 
Is There Any Way to Tell That a Cluster Headache Is Coming?  
 
Although the pain of a cluster headache starts suddenly, there may be a few subtle signs of the oncoming headache. Some signs include:  
 
Feeling of discomfort or a mild, one-sided burning sensation.  
The eye on the side of the headache may become swollen or droop. The pupil of the eye may get smaller and the conjunctiva (the pink tissue that lines the inside of the eyelid) will redden.  
Nasal discharge. There may be nasal discharge or congestion and tearing of the eye during an attack, which occur on the same side as the pain.  
Excessive sweating.  
Flushing of the face on the affected side.  
Light sensitivity.  
How Are Cluster Headaches Treated?  
 
Abortive medications: The most successful treatments are Imitrex (sumatriptan) injections and breathing oxygen through a face mask for twenty minutes. Other choices include: Zomig (zolmitriptan) tablets, ergotamine drugs and intranasal lidocaine.  
Preventive medications: Your doctor can prescribe preventive medications to shorten the length of the cluster headache period as well as decrease the severity of the headaches. All cluster headache sufferers should take preventive medication unless their cluster periods last less than two weeks. Some medications used in the prevention of cluster headaches include: calcium channel blockers (verapamil), lithium, divalproex sodium, corticosteroids (only short courses), methysergide, melatonin and Topamax.  
Surgery: This may be an option for people with chronic cluster headaches who have not been helped with standard therapy. Most of the procedures involve blocking the trigeminal nerve.  
All of these treatments should be used under the direction of a doctor familiar with treating cluster headaches. As with any medication, it is important to carefully follow the label instructions and your doctor's advice.  
 
Reviewed by Department of Neurology, The Cleveland Clinic.  
 
Medically reviewed by Charlotte E. Grayson, MD, Dec. 2001, WebMD.  
 
Copyright ©2002 content, The Cleveland Clinic. The information provided by The Cleveland Clinic is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition. For additional health information, please contact the Health Information Center at The Cleveland Clinic, (216) 444-3771 or toll-free (800) 223-2273, Ext. 43771.  
 
 
 
© 2002 WebMD Inc. All rights reserved.
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