Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        Cluster Headache Help and Support >> Cluster Headache Specific >> Cluster lump on back of neck
        
(Message started by: BB on Oct 7^th, 2006, 11:33am)

Title: Cluster lump on back of neck
Post by BB on Oct 7^th, 2006, 11:33am

Hello everyone

Our kind lady Margi told me about this cluster " lump" that most clusterheads have. Apparently its a ganglion of some sort and it "connects " to the hypothalamus and it gets swollen and palpable during cluster.

Last night when Daniel had his attack, I felt the base of his neck and sure enough there was this soft but slightly firm lump at the base of his skull in the middle, its about the size of a sugar cube. It felt spongy to touch and was quite hot.

When I applied ice wrapped in a wet tower directly to this 'lump" it soothed the pain immediately and quite considerably.

As the attack eased off, this lump felt less and less hot and less and less swollen and by the time the drilling in his eye stopped, the lump went too.

I have been searching for any literacy related or mentioning of this ganglion but could not find any, not even on this website.

I am quite intrigued by this and would like to hear from anyone if they know what it is or have seen/felt one.

Also try applying ice in wet towel like I have done and see if it would help the pain too. :)

Thank you all and painfree wishes to all of us.

Annette

Title: Re: Cluster lump on back of neck
Post by Jonny on Oct 7^th, 2006, 2:12pm

I never had one of those, but read of many folks that have.

Title: Re: Cluster lump on back of neck
Post by LeLimey on Oct 7^th, 2006, 2:24pm

I have this sometimes Annette but not all times, I've found by accident that ice on the back of the neck is hugely effective. I generally use an icepack on the back of my neck as well as one against my face if I don't have O2 to hand, I can abort so fast with O2 as a rule that I don't bother with ice.
Its always good to have tips though and this one and the way its explained so well will be really helpful.
Thanks alot :)
Helen

Title: Re: Cluster lump on back of neck
Post by BigCoffinHunter on Oct 7^th, 2006, 3:40pm

That's fascinating, I never heard that. Is there any literature on this lump?

Title: Re: Cluster lump on back of neck
Post by georgej on Oct 7^th, 2006, 8:22pm

Hi Annette,

I always get a ganglion lump at the base of my neck (located approximately two centimeters to the left of my extreme upper thoracic vertabrae--not the cervical vertebrae, about the level where the top of the shoulder is) during a cycle. Your description of how it feels to palpitation is quite accurate. It's painful and tender to the touch, and remains so for the duration of the cycle. It doesn't entirely subside until the cycle has been over for a week or so.

During a hit, this area is quite painful--although it in no way compares to the knifepoint behind the eye.

I have no idea what the mechanism of this might be, but it is invariably associated with my cluster cycles--I never notice it when I'm out of cycle.

Best,

George

Edited to add:

Ice applied to this area helps in the short term, but ice is something I don't use on my neck or head unless I have no other options. When removed, (in my experience) it causes a rebound, and another peak begins. I usually end up with a massive shadow that lasts into the next day. I'm always sorry when I use ice.

Title: Re: Cluster lump on back of neck
Post by BB on Oct 8^th, 2006, 3:53am

Hi George,

Its interesting to hear that applying ice caused rebound and shadow for you.

Did you put the ice straight on and then remove it straight off? I am just wondering if it was the sudden change in tempeature that caused the rebound.

Ice ( coldness to be exact ) is a vasocontrictor also. But if its applied and then removed suddenly it can cause a sudden change in temperature that can lead to either spasming or rebound swelling of the affected blood vessels.

When I applied the ice, it was applied after I had cool the spot down with some cold water first, also I made sure that the towel was quite wet as water transmits the coldness without the "shock" of the sudden temperature change.

Once the attack was over, I removed the ice and put wet towel on his neck again for a while to help the skin normalise the temperature gradually. He didnt get any rebound headaches or shadows after.

I wonder if this would help stop the rebound headaches and shadow for you too George?

Thanks for reading. PF wishes to all.

Annette

Title: Re: Cluster lump on back of neck
Post by LeLimey on Oct 8^th, 2006, 9:22am

Thats a really good idea Annette, thanks for sharing it. I've never rebounded from ice (I do always wrap it though but in a dry cloth) that tip makes alot of sense though and I'll definitely try it.
Helen

Title: Re: Cluster lump on back of neck
Post by georgej on Oct 8^th, 2006, 9:35am

Yes, I have been applying ice directly, and then removing it.

I like your suggestion, Annette, and will give it a try next time. It makes a lot of sense.

Best wishes and thank you,

George

Title: Re: Cluster lump on back of neck
Post by maffumatt on Oct 8^th, 2006, 12:34pm

I don't get it on my neck, I get it on my jaw, its not big, but its there and is very sensitive. It is one reason I had so much dental work before I found out what CH is. It goes away with the pain. Ice doesn't work for me as well as heat. I have a cloth sack that is filled with field corn that I put in a microwave. It holds the heat for a long time and molds to wherever I place it.
Matt

Title: Re: Cluster lump on back of neck
Post by lskilly on Oct 8^th, 2006, 3:53pm

I dont know if this is a Ganglion or a Trigger point ( a lump caused by an acculation of Lactic Acid ) I had one Dr. inject them with Lidacain to see if it would help my CH. Now I just mash on them with ice seems to do just as good.

Skilly

Title: Re: Cluster lump on back of neck
Post by E-Double on Oct 8^th, 2006, 7:23pm

mine is called Harry

Title: Re: Cluster lump on back of neck
Post by BB on Oct 8^th, 2006, 9:35pm

on 10/08/06 at 15:53:24, lskilly wrote:

Thanks Skilly

Its very interesting, I will look more into accumulation of lactic acid.

Did the injection stop the pain or abort the cluster at all?

Annette

Title: Re: Cluster lump on back of neck
Post by JeffB on Oct 9^th, 2006, 11:12am

I get the lump

Title: Re: Cluster lump on back of neck
Post by roy21302 on Oct 9^th, 2006, 12:05pm

Annette,
Thanks for this posting, I don't know if I get a lump, but I have an area at the base of the skull just to the side of neck that is always hot, it switches sides when the headache does. I have for years sat with Ice packs on this area during attacks. It does really help, I usually leave it there untill the pain has well gone. During shadows this area is also tender. Cheers Roy [smiley=huh.gif]

Title: Re: Cluster lump on back of neck
Post by lskilly on Oct 9^th, 2006, 6:42pm

It's been 8+ years since I had the treatment to the Trigger points, but after 3 trys We gave up on it. I dont think it made any difference at all. When I was having CH several times a day for 10 years you willingly submit to anything that might work.

The only thing that has really made a difference for me was and is Biofeedback. (self hypnosis) I was able to abort the CH 8 years ago and then I quit practicing becasue I thought I had them stopped forever. Pretty dumb of me. They are back with a vengance now.

Skilly

Title: Re: Cluster lump on back of neck
Post by Barry_T_Coles on Oct 9^th, 2006, 10:35pm

I also get the ganglion lump approximately two centimetres to the left of my cervical spine at about C4 - C5.
http://www.hughston.com/hha/spine.jpg
It’s one of the first indicator's that I’m about to get hit as I can feel the swelling and tightness.
I found out about it when I was getting a bad hit and knew nothing about CH, in an effort to wrench my head off my shoulders and throw it as far as I could I found that if I pushed my index finger into the lump I could get some relief for a mini second.

I have a TENS machine and was willing to try anything to get me out of the hell I was in and I found that I could get some minor relief by applying the pads to either side of the lump and with time could reduce the lump, this in turn reduced the intensity of the hit a little.

Once I was diagnosed with CH and found this site I read where some people could get relief by standing under the shower with the water as hot as they could stand running on the back of their neck, it didn’t work for me it just intensified the hit.
I’ve since found out about the ice trick and for me it works a treat and as Helen says if you wrap the ice or freezer pack in a dry hand towel you won’t get the sudden rush of cold and you can leave it on for any length of time.
When at home or where I can keep them in a freezer I use the gel filled cold packs that you will find in most large first aid kits; they are more pliable than straight ice and can mould to the area, what would be ideal is the silicon filled breast implant bag as it’s the perfect shape to fit that area “I’m not kidding “but where I could get one of those would be anyone’s guess.

Kind Regards
Barry

Title: Re: Cluster lump on back of neck
Post by Margi on Oct 10^th, 2006, 10:44am

sorry I haven't answered your email yet, Annette - just a busy weekend.

If you're searching the archives for more info on this, try "cluster bump" - I think that was the terminology used when the subject first came up.

I've never heard that it was filled with lactic acid though. :-/

Title: Re: Cluster lump on back of neck
Post by Sandy_C on Oct 10^th, 2006, 1:34pm

Thanks for the very interesting post, Annette (and Margie, too, who talked about a "cluster lump").

I can't say that I've ever noticed a lump during a hit, probably because I'm so focused on the pain going on in my right eye and right side of my head. But, I have noticed that the back of my neck is very sore during and immediately after the hit. I've always put it down to tension, but next cycle, I'll definitely check for a lump of some sort.

I also use the gel packs (I am the proud owner of 6 of em - 4 at home and 2 at work). I use two packs during a hit, wrapped in a soft towel. I started out with just the gel pack without wrapping it, but ended up with "freezer burn" on my face - not pretty. One pack goes directly above and partially covering my right eye, and the other goes along the right side of my face, covering my ear down to my jaw to help with the awful pain I get in my ear, jaw, molars, and across the roof of my mouth (I'm also sucking on ice cubes). I do not immediately remove the packs when the hit is over, but just sit back, leave them in place and let them warm up slowly. Doing this has never produced rebounds - or freezer burn ;;D

Sandy

Title: Re: Cluster lump on back of neck
Post by Margi on Oct 10^th, 2006, 1:55pm

We keep 3 gel packs on hand at all times. Mike lays one on the back of his neck at onset and leaves it there until he either melts it or the attack is gone.

We put one inside a cloth gift bag to lessen the shock of the cold at first. After awhile, he takes it out of the bag and applies it directly.

Annette, I just typed "cluster headache ganglion lumps" into google.com and it came up with quite a few links.

Title: Re: Cluster lump on back of neck
Post by Bob P on Oct 10^th, 2006, 6:06pm

http://www.pahlow.net/temp/Gray844.jpg
The only input to the eye from the spinal cord is from the sympathetic system, from the upper cervical ganglion. This supplies the size of the pupil, sensation of the face, sweat glands of the face, and the eye lid muscles. This could be our lump.

Dr. Robinson at the Vancouver Conference said that there was a nerve ganglion there.

Title: Re: Cluster lump on back of neck
Post by AussieBrian on Oct 10^th, 2006, 6:56pm

Through ten years of misdiagnosis I always believed that it was the lump causing the headaches, as though a nerve was pinched. Massage was very nice, just ineffective, and the best relief I got was standing in the shower turning it from hot to cold, hot to cold etc. (Got it wrong once, scalded my scalp, and half my hair fell out. Didn't even realise til morning.)

A neuro I visited actually injected it hoping to break it up. Don't know what he used but it was strangest feeling imaginable, ice chrystals floating in hot air. Did nothing for the headaches but at least it stopped my wallet from pulling my pants down.

Title: Re: Cluster lump on back of neck
Post by Chillrmn1 on Oct 12^th, 2006, 5:15pm

I also get the lump which is noticeable at the start of an attack.

Title: Re: Cluster lump on back of neck
Post by georgej on Oct 13^th, 2006, 1:00am

Barry, if I'm reading the diagrams that have been posted correctly, (and I may not be) you're getting the cluster lump at the middle cervical ganglion near C4/C5 and I'm getting it at the lower cervical ganglion near C7/T1 .

Interesting.

Best,

George

Title: Re: Cluster lump on back of neck
Post by leftsideonly on Oct 13^th, 2006, 2:12am

Never noticed a lump on my neck but I have one in my mouth. Its on the roof of my mouth (On the left side of course like the pain) Right where you can't feel bone anymore before the throat. I suck on ice cubes or popsickles during my attack to help ease the pain. Oh ya it also gets hot to the touch. Weird huh?/

Title: Re: Cluster lump on back of neck
Post by Barry_T_Coles on Oct 13^th, 2006, 7:35am

on 10/13/06 at 01:00:26, georgej wrote:

Hi George
I may be reading the diagrams wrongly myself but if I draw a line from the bottom of my ear lobe around to the back of my neck that is the location of the lump.
Looking at the diagram that Bob posted it would line up with the middle cervical ganglion.
When the lump is active the tightness starts at this point and travels upward toward the left side of my head at an angle of about 45 degrees.

Regards
Barry

PS: Good diagram Bob, I'm going to store that one in my little trove of info.
Barry

Title: Re: Cluster lump on back of neck
Post by Sandy_C on Oct 13^th, 2006, 3:13pm

on 10/13/06 at 02:12:59, leftsideonly wrote:

I'm glad you mentioned the pain on the roof of the mouth, Andre, because I get that too. Mine is not necessarily a lump, because it runs from above the upper back molar and runs all the way across the roof of my mouth to the center - it's more like a strip of swollen tissue. I think it's a vastly swollen blood vessel, because I don't think a nerve causes that kind of swelling (does it anyone?). My swelling is very painful, and also very hot as well. I jam ice cubes in my mouth and hold them against the swelling just to try to relieve some of the pain. What I find interesting is that I've been out of cycle for 14 months now, and if I run my tongue across the roof of my mouth, I can still feel that the right side (I'm a rightie) is somewhat more swollen than the left??

So, in my opinion - no it's not weird at all. I'd like to hear if anyone else has this problem during hits.

Sandy

Title: Re: Cluster lump on back of neck
Post by georgej on Oct 13^th, 2006, 9:39pm

So if it is true that my cluster lump is associated with the lower cervical ganglion, and Barry's is associated with the middle cervical ganglion, it sounds as if Annette's husband's is associated with the sphenopalatine ganglion at the base of the skull. Perhaps Matt's is associated with another ganglion in the jaw. Don't know about the ones in the roof of the mouth--perhaps there's another there. My understanding of anatomy is not so hot.

This is getting rather interesting, I think.

Is the swelling in the ganglion itself, or is it in the tissue surrounding the ganglion? Either one could cause a lump, I would think.

Here's a further question: When the blood vessels in the head swell during a hit, are they venous vessels, arterial vessels, or both? I'd think if arterial vessels were swelling, that the pain would be pulsating--and it doesn't seem to do that.

Interesting thread altogether.

Best regards,

George

Title: Re: Cluster lump on back of neck
Post by BB on Oct 14^th, 2006, 12:36am

Hi all,

So far what I have come up with is this lump is one of the several ganglions of the sympathetic nervous system , of the cervical chain to be exact, as the picture BobP posted.

It has several ganglions which are fusions of nerve bundles. Where a clusterhead gets his or her lump depends on which ganglion is affected.

The sympathetic nervous system is the autonomic nervous system. Interruption to its function leads to motor nerve failure causing the Horners syndrome of droopy eyelids and teary eye and sweaty brow.

The cervical ganglion lies right next to the carotid artery which gets swollen and pulsating before and during a cluster attack.

George, both arteries and veins in the brain become swollen and the carotid artery is the supplier which siphons the blood at a much higher speed and flow volume before and during an attack.

This gives rise to many interesting questions which I have not been able to find an answer to yet:

1- If these ganglions regulate motor nerves only and not sensory nerves, how can cooling them down with ice relieve the pain ?

2- Is it the swelling and pulsating carotid artery next to it that "irritate" it and then lead to inflammation of the ganglion?

3- If its inflammation that causes the ganglion to swell how can it go down so quickly as soon as the attack wears off?

4- Can one "do" something to the ganglion apart from ice that may stop or block or greatly reduce the pain of CH?

5- Occipital Nerve Block can reduce the pain greatly as Alchemy would tell us, then can something similar be done to these cervical ganglions ?

The searche continues. I will post again once I find out more information on these things.

Thanks for your interest.

Painfree wishes to all.

Annette

Title: Re: Cluster lump on back of neck
Post by AussieBrian on Oct 14^th, 2006, 4:21am

I'm with Sandy and Andre 100%. I get a terrifically tender spot on my upper back palate like a pencil is being driven into it, through my nostril, and directly into my eye in a perfect straight line. Dunno if there's a nerve or a blood vessel follows that exact line but it's very real to me.

Equally there's so many little things that crop up which rarely, if ever, get mentioned here. Anyone ever noticed a tiny red line across the bridge of the nose? Always wondered what it was then came across a tiny reference to it in a headache book and it seems it's a typical CH syndrome.

Ah, well. Better days ahead.

Title: Re: Cluster lump on back of neck
Post by kcopelin on Oct 14^th, 2006, 12:20pm

Ya see, this is the kinda thread that makes all the other stuff unimportant-way to go!!!!
I always get a ganglion lump, upper cervical ganglion (thanks!!!) and it is noticeable to my husband, and immediately preceeds the clamy sweating thing, which immediately preceeds a hit. The swelling leaves as fast as it starts-hubby has been giving me a neck rub, felt the lump rise up then said-you're getting clammy-then he backs away really fast.
Ice affects inflammation-but in my case does nothing for the lump-the lump just seems to be a precursor and I don't really treat it-the hit is coming too soon to worry about that.
I know this sounds weird or something, but I'm glad I'm not the only one who gets these and I betcha there are important links for researchers here.
Man, is this place awesome!!!!
kathy

Title: Re: Cluster lump on back of neck
Post by BB on Oct 14^th, 2006, 1:25pm

Hi everyone,

Now its getting interesting!

I have found that cluster headache was used to be called sphenopalatine neuralgia, amongst other names.

The sphenopalatine ganglion is a bundle of nerves from the vidian nerve, on the 2nd branch of the trigeminal nerve. Its part of the parasympathetic nervous system and it supplies the eye, the forehead, the nose and the palate ( roof of mouth ). Its the one that causes the eyelid to droop, the forehead to sweat, the pupil to constrict, the eye to tear and the nose to block.

Its also called nitrergic nerves which release nitric oxide when inflammed. Nitric oxide then causes a Ca+ influx which in turn causes the cerebral ( brain ) blood vessels to spasm and/or swell.

This explains why medication that block nitric oxide and Ca+ channels work to prevent cluster attacks.

Its also interesting that Roy noticed that when his cluster switched side so did his ganglion lump to the corresponding side.

It appears that inflammation of these nerve ganglions directly affect the brains blood vessels leading to a cluster attack and that the inflammed nerves themselves add to the pain felt during an attack. That would explain why ice or heat applied directly over the swollen ganglion would help to reduce the pain, fairly considerably too I may add.

Therefore if in some way, we can prevent these nerves from getting inflammed we might be able to prevent most if not all attacks and/or at least reduce the pain to a more manageable level.

Take care and again thank you all for reading and for contributing.

Painfree wishes to all.

Annette

Title: Re: Cluster lump on back of neck
Post by pattik on Oct 14^th, 2006, 4:27pm

Like Sandy, I have always been focusing elsewhere. But during my last headache cycle, I was watching for "the lump" and did find it--base of the scull where it meets the neck on the affected side. It hung around until my cycle had ceased.

Title: Re: Cluster lump on back of neck
Post by unsolved1 on Oct 14^th, 2006, 11:17pm

No clusterlumps here that I know about. A little swelling near my eye, but not on my neck.

Also wanted to mention that I have had 2 bi-lateral Sphenopalatine Ganglion Blocks (1 week apart from each other) . It was scary as hell and made the attacks grow out of control. It put a real hurting on me for sure. Never again !!

RFG, Radio Frequency Generator, didn't help any either.

Goodluck lumpy ! ;) (just kiddin')
UNsolved

Title: Re: Cluster lump on back of neck
Post by BB on Oct 14^th, 2006, 11:57pm

Hi Unsolved,

Thanks for posting your experience with sphenopalatine block. So the blocks didnt help AND made the attacks worse?

Did the specialist explain why or dont they know either?

Is the antihistamine treatment still working for you?

Thanks heaps and painfree wishes to you.

Annette

Title: Re: Cluster lump on back of neck
Post by Bill_G. on Oct 16^th, 2006, 9:32pm

Wow, what an interesting set of notes to read. Before seeing this I never thought to notice. Will look for it now. [/b]THANKS FOR THE INFO.[b]
Bill

Title: Re: Cluster lump on back of neck
Post by deltadarlin on Oct 17^th, 2006, 8:31am

Not a cluster sufferer here, but do have migraines and do get *lump* around C2-C1 area. Can put pressure on it and the migraine will ease up, leave off pressure and it's like getting hit with a sledgehammer.

'darlin

Title: Re: Cluster lump on back of neck
Post by lskilly on Oct 17^th, 2006, 3:16pm

Popcicles shoved against the roof of my mouth. I thought I was the only one doing that. I t does seem to help crazy as it sounds.

Skilly

Title: Re: Cluster lump on back of neck
Post by keithr1024 on Oct 19^th, 2006, 7:54pm

hello bb

I also get a lump at the base of my skull at the back of my neck' it's off to the right (the cluster side of my head).and larger than a sugar cube more like like a walnut shell. during attacks i grind that lump into a hard ice pack preferably one that has good edges for trying to smash it or break it down. use a couple ice packs one for grinding one to cool the effected side near the temple. Also I went to a chiropractor and he diaginosed me with cervical kyphosis( loss of curve in the neck). just thought you'd like to know hang in there and pain free wishes .ps. dose anyone get pain and numbness in their arm and shoulder structure during cycle? My treatment plan is as follows lots of water, vitiamins , predisone taper ,verapamil ,meleatonin , ice packs and last but not least oxygen oh and if it,s good and cold outside jumping jacks and shorts and if that fails the concrete is a good destraction

Title: Re: Cluster lump on back of neck
Post by BB on Oct 19^th, 2006, 11:05pm

Hi Keith ,

Thanks for your post, its interesting that you mean shoulder pain.

The cluster lump as I described is actually the swollen ganglion as part of the autonomic nerve chain, it can cause referred pain to the upper body including shoulders and arms.

Annette

Title: Re: Cluster lump on back of neck
Post by AussieBrian on Oct 22^nd, 2006, 9:25am

Copied from another thread as it is just as relevant here.

on 10/22/06 at 09:16:35, keithr1024 wrote:

there was talk of the cluster lump in earlier post and after that i led me to do some searching and i found this under human circadian rhythm Melanopsin is a photopigment found in specialized ganglion cells of the retina that are involved in the regulation of circadian rhythms and pupillary reflex. In structure, melanopsin is an opsin, a variety of G-protein-coupled receptor. It is presumed that melanopsin signals through a G-protein of the Gq family, as invertebrate opsins are known to do, but this is not firmly established. It is also believed to be similar to invertebrate opsins in possessing an intrinsic photoisomerase activity. i really don't know if this has any bearing on ch's but it might lead some of the members to search in a productive direction.
keep on keeping on everyone!

Title: Re: Cluster lump on back of neck
Post by leftsideonly on Oct 23^rd, 2006, 12:07am

I'm impressed by the knowledge of some of these folks but none of that means much to me - sorry. But I was wondering about something - I get a lump in my mouth - on the roof near the throat - very hot to touch during an attack and gets better with ice applied directly to it. I am new here but thought I'd throw this out there - I notice alot of us has had some sort of head trama - I've certainly had more than my share. I got shot in the head when I was younger, the bullet went in one side of my head and out the other - but through the roof of the mouth. I wonder if the "lump" has something to do with the head trama. Maybe some of these folks that have the "lump" in the neck can expound upon weather or not they have had head or neck trama due to like an auto accident or something. I noticed on fella had a lump in his jaw - could this "lump" have something to do with trama to the jaw?? Or if other folks have a "lump" in other places on the head.
Anyway I definately have a lump that is associated with my headaches. It's always there even when I'm not in an episode - just very sensative and hot during an attack.

Andre

Title: Re: Cluster lump on back of neck
Post by BB on Oct 23^rd, 2006, 12:29am

Hello Andre,

These cluster ganglion lumps are apparently swollen and inflammed nerve bundles, which became hot and tender during an attack and usually for the length of the cycle.

There is no literature to say that they are caused by trauma.

Lumps caused by physical traumas such as a gun shot wound would be scar tissues and if it causes pain would do so ALL the time, not just during a cluster attack or cycle.

It seems like no matter where these lumps are, applying heat or cold or pressure to them reduces the cluster pain in the head itself, which is a worthwhile thing to do.

As to why and how it works, I do not yet know, but plan to ask the Pain management specialist and the Neuro professor the next time I get to see them.

Take care and PF wishes to you.

Annette

Title: Re: Cluster lump on back of neck
Post by BB on Mar 6^th, 2007, 9:49pm

Bumping this as there has been a few mentions of the cluster lump lately.

Annette

Title: Re: Cluster lump on back of neck
Post by UN solved on Mar 6^th, 2007, 9:57pm

I've never read any CH literature that mentioned this 'lump'. I do not get this effect. I don't doubt your stories though. I have read that steroids can cause this 'lump' after excessive use. I'm wondering how many of you have used steroids ?

UNsolved

Title: Re: Cluster lump on back of neck
Post by BB on Mar 6^th, 2007, 10:15pm

Its because the lay term cluster lump is not used academically. Its actually the stellate ganglion. If you look up stellate ganglion, parasympathetic nerve pathways, autonomic features and cluster headaches, you will find a lot of articles.

It seems that not everyone has one though and even in the same person, sometimes its there and sometimes its not. If its swollen, hot and tender during an attack then putting wet ice on it then seems to help the pain a fair bit.

Annette

Title: Re: Cluster lump on back of neck
Post by froggy on Mar 6^th, 2007, 11:40pm

What a truly small group we all belong to. You can add Tony to the list. He gets the ganglion knot at the base of his head to the right. Sometimes I apply great pressure on it and he says it relieves the pain. But I have to be really laying into it. Don't want to push too hard.

BB, that post about what CH used to be called is going to be very useful. Now I can convey to anybody that will listen, a more comprehensive description of CH.

Remember Jim? He said that back in the 1950's, CH was called Hornton's headaches (not exactly sure about the Hornton name, but it is something like that). So, it's not surprising to hear another name for CH. Great find.

Title: Re: Cluster lump on back of neck
Post by ndshrubs on Mar 14^th, 2007, 4:58pm

on 03/06/07 at 23:40:23, froggy wrote:

Remember Jim? He said that back in the 1950's, CH was called Hornton's headaches (not exactly sure about the Hornton name, but it is something like that). So, it's not surprising to hear another name for CH. Great find.

I believe it's Horton's. No relation to the elephant who heard a who. ;)

You may also see it as Horton-Gilmour, Horton-Magath-Brown, Hutchinson-Horton, or similar. References below for the curious and pain free.

J. Hutchinson:
Diseases of the arteries. I. On a peculiar form of thrombotic arteritis of the aged which is sometimes productive of gangrene.
Archives of Surgery, London, 1889; 1: 323.

B. T. Horton, T. B. Magath, G. E. Brown:
An undescribed form of arteritis of the temporal vessels.
Mayo Clinic Proceedings, Rochester, Minnesota, 1932, 7: 700-1.

Title: Re: Cluster lump on back of neck
Post by Bob P on Mar 14^th, 2007, 6:20pm

What you are thinking of is Horner's syndrome:

http://www.revoptom.com/handbook/sect6g.htm

It's what causes the droopy eye in clusterheads.

Interesting connection with the occipital nerve stimulation being successful?

Also there is Bing-Horton syndrom:

http://www.whonamedit.com/synd.cfm/1576.html
which are the headaches themselves.

Too many Hor's in this thing!

Title: Re: Cluster lump on back of neck
Post by Julygirl0721 on Mar 14^th, 2007, 9:58pm

Hi

I never had a lump I did use Ice on the back of my neck seems like that just made me cold.
Glad that the ice works for some :) lol.. on the horton hears a who comment :P good one.

Title: Re: Cluster lump on back of neck
Post by BB on Mar 14^th, 2007, 10:57pm

on 03/14/07 at 21:58:58, Julygirl0721 wrote:

Hi

I never had a lump I did use Ice on the back of my neck seems like that just made me cold.
Glad that the ice works for some :) lol.. on the horton hears a who comment :P good one.

So far the consencus seems to be unless you get a hot tender swollen ganglion lump, putting ice on your neck doesnt do much to the CH pain. But if you do, then it seems to help a fair bit.

The lump may not be on the back of the neck though, maybe more onto one side then the other, most commonly on the same side as the CH.

Annette

Title: Re: Cluster lump on back of neck
Post by Annette on Nov 13^th, 2007, 6:20am

Bump for Adam

Title: Re: Cluster lump on back of neck
Post by ski2k on Nov 13^th, 2007, 8:49am

Thank you Anette! Some very interesting reading and lots of great information here!
Although I'm not "planning" on ever getting another cluster headache... I will keep this in mind, and search for any lump I may have, should it happen.
I see that before the "bump", the last post was in May of this year. Any interesting findings since then?

PF wishes,
Adam

Title: Re: Cluster lump on back of neck
Post by sldrswyfe on Nov 13^th, 2007, 11:59am

sorry adam...somehhow this thread went from two responses plus mine...to three pages...?????

I didn't know...

Title: Re: Cluster lump on back of neck
Post by Annette on Nov 13^th, 2007, 5:28pm

Dont worry SW, this is an old thread, I just bumped it up.

Adam

There hasnt been any new finding about the ganglion. I have been looking still but no new study on them.

What is your thought ?

Title: Re: Cluster lump on back of neck
Post by spc351 on Nov 15^th, 2007, 4:55pm

I have a lump but it's permanent. If I draw a line from the bottom of my ear lobe around to the back of my neck, there's a lump. I've had it for around 20 years, about the same amount of time I've had clusters. I've always wondered what the heck is was there for. Interestingly, this is the exact spot that I experience pain when I don't have my daily coffee on time.

Title: Re: Cluster lump on back of neck
Post by schaan on Nov 15^th, 2007, 11:00pm

thanks for bumping the bump about the bump

i hadnt noticed one but ill check it out

ive finaly got a neuro that is willing to learn with me

Title: Re: Cluster lump on back of neck
Post by ski2k on Nov 16^th, 2007, 12:05am

Ya know... This has been running through my head a lot. This is such an interesting thread.
It would seem logical, that numbing this lump somehow would in turn numb the pain of the CH. But somebody wrote about having Lidocaine shots, and it not helping. Hmmm.... Doesn't Lidocaine pretty much "stay" where it's administered? It's pretty local, isn't it? I mean... would injecting it into this lump, actually stand a chance of numbing all the nerves in this nerve cluster, ir would it just numb around the injection site?
Are there other numbing agents out there that tend to "travel" through the nerve or nerve cluster, thereby effecting all the nerves attatched to that bundle? Could such an agent be used more effectively?
I know, I know... More questions than answers. It just got me to thinking, is all. I guess I don't know enough about anesthetic meds to answer any of those questions on my own.

Adam

Title: Re: Cluster lump on back of neck
Post by Annette on Nov 16^th, 2007, 4:21pm

Your question is spot on Adam, there are other agents that can be used to inject into ganglions to block the whole nerve root. They do use it to try to treat CH. The most common one they inject is the sphenopalatial ganglion.

The injection mentioned here was lidocaine and it was given by a GP, who really was just testing by trials and errors, he didnt really know how it would work. Normally you need to see an aneasthetist at a pain clinic to have these types of nerve block properly done.

It works for some, not for many for some unknown reasons. The main pain one feels appears to come from the trigeminal nerve more than the parasympathetic nerves. Furthermore these injections wear off fairly quickly, the longest they last is may be 6 weeks, if that. If you have a long cycle or if you are chronic, then it wont work very well. Injections into these ganglions are not a pleasant thing to have and you cant have them repeatedly every few weeks or so.

However, people do have the same thoughts as you and trials are being conducted in this area.

Title: Re: Cluster lump on back of neck
Post by christophercheek on Dec 5^th, 2007, 1:45pm

Yes I have a lump on the back of my neck at the base of my skull about the same size except it's always there and during an attack I dare not touch it or it's a 10 on the KIP scale really fast. Ice nor heat works for me scalp far to tender to touch.
I did ask the Dr. about this lump he just passed it off as a lympnode.
Chris

Title: Re: Cluster lump on back of neck
Post by Sandy_C on Dec 5^th, 2007, 2:47pm

Thanks for bumping this thread back up. I read this way back when, and didn't pay much attention because I was out of cycle at the time. My cycle is trying to start again, and I'm fighting it with my seeds, with success so far. However....

Just reading this thread again - last Friday we drove 6 hours down to my daughter's house, and the right side of the back of my head, neck and shoulder started hurting (I'm a rightie). While at my daughter's, she, my other daughter and I went to a spa, and I had a deep tissue body massage (OH..... ;;D). Anyway, my "stiff neck" disappeared. Thought, OK, just from the drive, no big deal.

But now it's back, as are at least two, what I would call, mini shadows - not hits, per day, plus at least one at night.

I just now sat here and ran my fingers up and down my neck on both sides, from shoulders to base of skull. The right side, about two inches right of the spinal cord, and about mid ear height, has a very small spot that is larger than the left???? I wouldn't call is a "lump", more of a "pimple", but there is a definite difference. And, it's a little sensitive (not really painful, just a little sore) when I touch it.

I intend to try to keep monitoring this "pimple" of mine to see 1) if I AM going in to cycle, will it enlarge, become more painful, etc., and 2) if I can abort this cycle, will the "pimple" disappear.

Again, I'm glad this got bumped up. Thanks.

Sandy

Title: Re: Cluster lump on back of neck
Post by thomas on Dec 5^th, 2007, 3:23pm

I mash the shit out of mine while rubbing my temple very vigorously with the other hand. Sometimes it seems to help. :-/

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 5^th, 2007, 4:20pm

on 12/05/07 at 13:45:13, christophercheek wrote:

.
I did ask the Dr. about this lump he just passed it off as a lympnode.
Chris

Chris, I think its your doctor who doesnt know about CH ganglions. Next time you see him ask him about sympathetic nervous system activation during a CH hit and sphenopalatial injections to treat CH and see if he knows anything about it.

Before I learnt about CH, I would have thought any lump around the neck to be a lymph node too. Now I know differently. Lymph nodes dont get enlarged, hot and tender unless you have an infection nearby, like a bad sore throat or ear infection or something, or worse yet cancer.

So if your doctor thought it was a lymph node and its thats big and tender and he doesnt check it out for you with blood tests and ultrasound then I would be very wary of him.

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 5^th, 2007, 4:22pm

on 12/05/07 at 15:23:27, thomas wrote:

I mash the shit out of mine while rubbing my temple very vigorously with the other hand. Sometimes it seems to help. :-/

Thomas, have you tried putting ice or heat on it ? It may help more than just smashing it .

Just a thought.

Title: Re: Cluster lump on back of neck
Post by thomas on Dec 5^th, 2007, 5:10pm

on 12/05/07 at 16:22:44, Annette wrote:

Thomas, have you tried putting ice or heat on it ? It may help more than just smashing it .

Just a thought.

Yeah, hot shower water helps a lot.

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 6^th, 2007, 4:01pm

Great to hear that it helps Thomas.

I read up a bit more about it and its definitely a nerve ganglion firing up when the sympathetic nervous system is activated. They are mainly sensory nerves so they cause pain. Sensory nerves can be tricked by other senses such as sense of touch ( thats why pressure on hit like massaging helps ), sense of temperature ( hot or cold ). Overloading the senses of these nerve ganglions will see them "forgetting" the pain sensation and carry new senses to the brain instead. Obviously, touch or temperature senses are much easier for the brain to cope with than pain.

Keep tricking them folks with whatever your are more comfortable with. It does help and it makes scientific sense. :)

Painfree wishes to you all.

HUGS

Title: Re: Cluster lump on back of neck
Post by mikeh on Dec 7^th, 2007, 7:49am

About three hours ago I was in the throes of a hit, sitting in my chair with my head in my hands (trying to squeeze it like it was a giant zit), and my wife came up behind me and said "What's that lump on the back of your neck ?". I'll try ice next time - if there IS a next time....

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 7^th, 2007, 3:20pm

Hi Mike

Welcome to the " lumpy club " :P ;;D

If ice doesnt work, try something hot like a heat pack or hot shower.

It seems some people like the cold, some prefer heat.

I hope it will help, but I hope even more that there wont be a next time :)

Painfree wishes to you.

Title: Re: Cluster lump on back of neck
Post by E-Double on Dec 7^th, 2007, 10:52pm

on 12/05/07 at 15:23:27, thomas wrote:

I mash the shit out of mine while rubbing my temple very vigorously with the other hand. Sometimes it seems to help. :-/

I used to do this too but then I found out that the lump was my twin ;;D

Title: Re: Cluster lump on back of neck
Post by brewcrew on Dec 7^th, 2007, 11:08pm

on 12/07/07 at 22:52:42, E-Double wrote:

I used to do this too but then I found out that the lump was my twin ;;D

Andrea Martin, right?

Title: Re: Cluster lump on back of neck
Post by SchwarzenSchafe on Dec 9^th, 2007, 3:36pm

There's no ganglion under the angle of the jaw, in the hollow created between the sterno-cleido mastoid (neck muscle, makes the divet at the sternum-collarbone articulation) and the jaw is there? I get a lump there that I rub when I get hit, it isn't painful but it swells up, I've always thought it was a lymph node and had no idea why it would swell when hit.

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 9^th, 2007, 6:34pm

Autonomic Nervous System

The autonomic nervous system (ANS) is considered to be an efferent system that controls smooth and cardiac muscle contraction, exocrine secretion, endocrine secretion, and metabolism. ANS helps to maintain a proper internal environment by coordinating the visceral activities of the body. The homeostatic mechanisms provided by ANS occur below the level of consciousness and therefore are involuntary. This contrasts with the somatic nervous system that controls the skeletal muscle of the body and is voluntary. ANS is organized into three divisions: sympathetic, parasympathetic, and enteric nervous systems. For sympathetic and parasympathetic nervous systems, each effector cell of an organ is influenced by a sequence of two neurons. A preganglionic neuron whose cell body arises from the central nervous system and forms a synapse with a postganglionic neuron at a location outside of the spinal cord.

Sympathetic:

Cell bodies of preganglionic neuron of this division are located in the intermediolateral horn of the spinal cord. The axons of the myelinated preganglionic sympathetic neurons leave the spinal cord via the ventral roots of the spinal cord at the level of T1-L2 (thoracolumbar). The preganglionic neurons then make synapses with postganglionic neurons in the paravertebral sympathetic chain ganglia (the upper chain ganglia merge into superior, middle and inferior cervical ganglia) or in the prevertebral collateral ganglia (celiac, superior and inferior mesenteric ganglia). The nonmyelinated axons of the postganglionic neurons travel from these chain and collateral ganglia to the tissues that they innervate (see figures).

Parasympathetic:

Like the sympathetic nervous system, each effector cell is influenced by two neurons in series. The cell bodies of preganglionic neurons of this division are located in the cranial portion of the brainstem and in the sacral segments of the spinal cord (craniosacral). Unlike the sympathetic system, the preganglionic neuron is long and terminates close to the effector organ, making synapses with the postganglionic neuron that is present close to or within the organ. The cranial part of this system is supplied by the four cranial nerves (cranial nerve #3=oculomotor, 7=facial, 9=glossopharyngeal, and 10=vagus). These nerves innervate the head, thoracic viscera, and most of the abdominal viscera. The neurons from the sacral (S2-S4) part of the parasympathetic nervous system innervate the lower abdominal and pelvic viscera.

Cranial nerves:

Olfactory (I)
Optic (II)
Oculomotor (III)
Trochlear (IV)
Trigeminal (V)
Abducent (VI)
Facial (VII)
Vestibulocochlear (VIII)
Glossopharyngeal (IX)
Vagus (X)
Accessory (XI)
Hypoglossal (XII)

Some ANS functions are served by:

- Oculomotor nerve (pupillary constriction and accommodation)
- Facial nerve (lacrimation and salivation)
- Glossopharyngeal nerve (salivation)
- Vagus nerve (input to thoracic and abdominal viscera)

Axons of the sympathetic preganglionic neurons leave the spinal cord via the ventral roots and end in the sympathetic ganglion chain or in the collateral ganglia where cell bodies of postganglionic neuron are located. Axons of the parasympathetic preganglionic neurons leave the brain stem (cranial outflow) and end near the visceral structures in the head, thorax and upper abdomen. Another group of axons of the parasympathetic preganglionic neuron leave the S2-S4 of the spinal cord and end near the viscera in the pelvic region.

* Ganglion - a group of nerve cell bodies
* Viscera - organ of digestive, respiratory, urogenital and endocrine systems as well as spleen, heart and great vessels; hollow and multilayer-walled organs. (Viscus - singular form of viscera)
* Ramus - a primary division or branch of a nerve or blood vessel.
* Splanchnic - visceral
* Mesentery - peritoneum attached to the abdominal wall and enclosing in its fold a part or all of one of the abdominal viscera.

Neurotransmitters released by neurons of the ANS

The major neurotransmitter released by the preganglionic neurons of the sympathetic and parasympathetic system is acetylcholine (ACh). ACh acts on the nicotinic cholinergic receptors on postganglionic neurons and causes depolarization and firing of the postganglionic neuron. The action potentials that arrive at the nerve terminal of the postganglionic neuron then cause release of synaptic vesicles containing norepinephrine or ACh by the process of exocytosis. The neurotransmitter released by the sympathetic postganglionic neuron is norepinephrine (NE) whereas the neurotransmitter released by the parasympathetic postganglionic neuron is ACh.

Exception:
The postganglionic sympathetic fibers that innervate blood vessels of skeletal muscles and sweat glands in the skin are cholinergic, i.e., ACh is the neurotransmitter. They are referred to as the “cholinergic sympathetic” pathway. The adrenal medulla is innervated by the preganglionic cholinergic fiber. Adrenal gland releases both epinephrine (80-90%) and norepinephrine (10-20%).

The effects of the sympathetic nervous system are more widespread, massive, diffuse, and generalized than those of the parasympathetic system. This is because of the divergent nature of the sympathetic nervous system. Each preganglionic neuron synapses with many postganglionic neurons each with different neuro-effector junctions. Furthermore, stimulation of the adrenal gland results in release of both epinephrine and norepinephrine (catecholamines) into the blood stream. Also, the catecholamines are deactivated more slowly than ACh.

In general, sympathetic nervous system stimulates those activities that are expressed during emergency and stress situations, also called the “fight, fright and flight activities”. There is expenditure of energy due to acceleration of the rate and force of heartbeat, increase in blood pressure and sugar.

The effects of the parasympathetic nervous system are localized and discrete, and ACh is inactivated quickly by the enzyme cholinesterase. The parasympathetic system stimulates those activities that bring about conservation and restoration of energy stores. The two systems act in concert to maintain the internal environment of the organism for a given physiological state of the individual.

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 9^th, 2007, 6:49pm

Sympathetic Chain

http://i18.photobucket.com/albums/b149/bargainbazzar/sympathetic.jpg

Parasympathetic chain

http://i18.photobucket.com/albums/b149/bargainbazzar/parasympathetic.jpg

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 9^th, 2007, 6:53pm

on 12/09/07 at 15:36:50, SchwarzenSchafe wrote:

I am not 100% sure if I have got it right but you might be referring to the submandibular ganglion which is under the jaw, the position may not be exactly the same in different people, it maybe a few cms out from under the jaw line but its around there never the less.

Check the diagram above.

I hope this helps.

Try applying ice or heat to it next time during a hit and see what it does to the pain level.

Good luck and painfree wishes to you.

Title: Re: Cluster lump on back of neck
Post by Chappy on Dec 14^th, 2007, 5:08am

Thank you so much for this thread! You may have changed my life in a small way!

I'm a new clusterhead, having been diagnosed last Thursday, and just having found this site yesterday. Unfortunately, I've had 8 years dancing with the devil (I've been calling it that for 2 years, not knowing what it was). 8 years of doctor's scratching their heads, X-rays, CTs, MRIs, pills pills pills, more pills (did I mention pills?). Physical therapists, more doctors, neurologists ("you don't have any neurological symptoms - I don't know why you were referred here"). Chiropractors, more PTs, pain specialists, more chiros, massage therapists. Anyway, my wife finally said "screw it," and we finally went to Mayo on our own dime. Their docs weren't much better, but after $25k that our business had to take a loan to pay for and their general doctor telling me I just needed to lose weight 6 weeks ago ("But I was thin and healthy when this SH** started years ago, you Bi**!!!!!!"), the Headache Fellow in the neurology dept finally diagnosed me with chronic cluster headaches last thursday.

So why am I excited about this thread? Well, I've had plenty of misdiagnoses over the years, and "headache" doesn't come close to fitting what the average person would think of the symptoms I've experienced the past 3 years. I've been worried that I may have some underlying problem beyond CH, and CH is simply a symptom of something else, especially since I have begun every visit to every doctor for the past 8 years with the following story:

"In April of 2000 my wife was rubbing my head while we lay in bed, and she felt a lump on the back of my neck, left side, at the base of the skull, an inch left of center. I went to the doctor, and she said 'there's nothing there but soft tissue, so I wouldn't worry about it. Just wait a month and see if it goes away.' Well, I didn't feel anything at the time, and I was perfectly healthy, but my neck started to hurt, and then I had a headache that lasted 6 months without stopping, and it hasn't gone away for long since."

Doctors' eyes usually glaze over when I tell that part of the story, and then start with their own questions, and I've never had even one of them sound interested about the lump-in-the-neck. Since that was the first physical symptom I ever had, I figured it should somehow be important, but they just stare at me, and act like I never mentioned it. Even the neuro who diagnosed CH just gave me the standard "smile and wait for the patient to stop talking so I can hear myself talk again" look, and didn't say a thing about it. I've Googled many times trying to find something, but never did (obviously didn't try "cluster lump on back of neck", or I would have had my diagnosis years ago).

Reading this thread gave me the most hope I've felt in 8 years, that maybe cluster headaches really is the one and final answer to the utter hell that I've been through - not just for the headaches, but for everything else. From everything I've read, nearly all of my non-headache symptoms can be explained by automonic activation, but little things like that swelling at the back of my neck that started it all were still bugging me, especially since over a dozen doctors didn't seem to take it seriously, especially the world-renowned neuros I mortgaged my children to see at Mayo.

Okay - sorry. I'm not usually as angry as I sound right now. I had my first nasal Zomig spray 2 days ago, and my first headache free day in 18 months, and they're back tonight. That's the only treatment I have right now that has worked, my headache came back tonight, and I'm waiting until tomorrow to use another because my %#$!ing doctor said to only use 2 per week, and I want to be headache free on Saturday to have fun with my boys for the first time this decade.

I'll post my story in the "1st post" section soon - maybe after the meds give me more pain-free days and I can laugh at it a bit more.

Title: Re: Cluster lump on back of neck
Post by Chappy on Dec 14^th, 2007, 5:24am

on 12/09/07 at 15:36:50, SchwarzenSchafe wrote:

Annette is 100% right - you're feeling the submandibular ganglion. Before I had even heard of CH or this whole cluster lump thing, about 8 weeks ago, I had a bad swelling in exactly that spot. My gums became badly sensitive like Gingivitus, and all of my teeth felt like they had cavitis. I couldn't chew or eat anything for 2 or 3 days, and had to put food in a blender and suck it through a straw. Searching images on the internet, all I could find there was the submandibular gland, which excretes saliva, and can sometimes become blocked by a stone and cause a similar problem, but it doesn't go away as quickly.

Your problem, if you have CH, sounds exactly like what everyone else here has, but must be a swelling of the submandibular ganglion rather than the various other ganglion nerve bundles that others have reported. Mine has become tender quite a few different times with headache attacks, but whenever I mentioned it to my neurologist they just asked if I grind my teeth. I hate smileys, but here goes: >:( Yeah, it's just TMJ. ::)

It almost brings a tear to the eye. ;;D (For those of you paying attention, that's my first ever CH joke!!!! I'm only at a kip 3, which is as good as I get, so deal with it)

Title: Re: Cluster lump on back of neck
Post by SchwarzenSchafe on Dec 16^th, 2007, 1:46am

Hehe... thanks. Yes, I've read a bit about the submandibular ganglion now and the location and everything fits. It's enlarged right now even, out of cycle. Funny you mention sensitive teeth and gums, as years ago (before being diagnosed) I went through a period wondering if impacted wisdom teeth where the cause. During hits I commonly stand hunched over the sink with my eyes closed brushing my teeth to massage my upper gums on the afflicted side.

Title: Submandibular Ganglion
Post by Chappy on Dec 16^th, 2007, 7:47pm

Let me take another shot in the dark....

When my submandibular ganglion really acts up, that also seems to be when I get alot of pain in the throat area. Normally pain shoots from my nostril back along the eye toward my ear/neck, but when the submandibular ganglion is fired up then the nostril stabs seem instead to shoot down the back of my throat toward my adam's apple. It's still ipsilateral, on the left side where the rest of my pain is.

Ever experience anything like that?

Title: Re: Cluster lump on back of neck
Post by Annette on Dec 19^th, 2007, 5:34pm

Hi Chappy

Welcome to the Board and I am glad the thread helps you. It helped my husband a lot because applying ice to his "lump" reduced the cluster pain quite a lot for him.

I am starting to think there are 2 main components to CH and they are not always there to the same degree:

1- Vascular : with vasodilatation leading to the compression of trigeminal nerves causing the drilling pain behind the eye, ear, face and jaw.
2- Neurological : with activation of the autonomic nervous system causing Horners syndrome and pain/tension in the neck and shoulder as well as facial pain.

It seems you may have either or both with any particular hit or cycle and the symptoms you experience may vary accordingly.

It appeared some people have the vascular component as the major or only component and therefore they dont get the ganglion lump. For those Verapamil, oxygen and imitrex seem to work very well as they are all powerful vasoconstrictors.

For those who have a strong neurological component , they may need more than just vasoconstrictors to dampen the whole thing down. I guess this is when anticonvulsants work better?

I noticed with my husband that even within the cycle itself, some hits are more vascular based and others can be more neurological based. When it seemed more vascular based he would get hotter, more flushed and sweaty and the lump didnt get quite as large or it may not even be there, otherwise the lump would get quite big and quite a lot more tender. I also noticed that when the ganglion got swollen large quickly, ice applying directly to the ganglion worked really well but caffeine drink would not help.

Title: Re: Cluster lump on back of neck
Post by Annette on May 3^rd, 2008, 4:50pm

http://i18.photobucket.com/albums/b149/bargainbazzar/HN019.jpg

I would like to add this diagram to this thread to show how the synapses in the superior sympathetic ganglion in the neck are directly connected to the nerves that control the blood flow in both the internal and external carotid arteries.

When internal carotid artery dilate enough, it will squish the adjacent trigeminal nerve root causing its sensory ( pain ) branches to fire, leading to CH pain.

When the external carotid artery dilate, you get flushing of the skin and the extra blood flow can cause the rise in temperature often experienced during a CH hit.

It also activates

1- Levator palpebrae which causes drooping of the eyelid.
2- Dilator pupilae which causes the pupil of the CH eye to dilate.
3- Vasomotor nerves which cause the blood vessels in the head and neck area to dilate.
4- Sudomotor nerves which cause the sweating above the eyebrow.

Below is an excellent diagram showing the trigeminal nerve and its ganglion and nerve root.

http://i18.photobucket.com/albums/b149/bargainbazzar/labeleddiagram.jpg

Title: Re: Cluster lump on back of neck
Post by Jean on May 4^th, 2008, 3:06pm

Hi All,

I can't believe how much I have learned in the short time that I have been coming to this site. I also have a lump on the back of my neck just to the right of my spine at the base. I have only had lots of shadows so far this spring, thanks ( I think) to starting Verapamil before my cycle started. It seems to have been more noticeable lately. I never made the connection between CH and the lump before. You guys are a plethora of knowledge!

Jeannie

Title: Re: Cluster lump on back of neck
Post by Annette on May 4^th, 2008, 4:19pm

Hi Jeannie

I am glad to hear you are having a mild cycle. If you have a swollen ganglion lump, try applying ice to it during a hit, it will help reducing both the pain and the duration of it.

Painfree wishes to you.

Title: Re: Cluster lump on back of neck
Post by ak_baumgard on May 13^th, 2008, 9:27am

Hi Annette.(my name also) Re: the ganglion lump : I get this with most of my headaches that last longer than 30 min. I find ice to be effective as a distraction ,and also soothing. My daughter who is a licensed massage therapist has taught my husband how to massage that lump, and I work on it myself. However , it doesn't make the fact that my head seems to have a huge spear point stuck in it at the same time I feel like a bird of prey is lifting me by the skull and crushing most of my head in the process.

I think the ganglion is a by-product of the CH, not a cause!

Title: Re: Cluster lump on back of neck
Post by Annette on May 13^th, 2008, 5:58pm

on 05/13/08 at 09:27:35, ak_baumgard wrote:

I think the ganglion is a by-product of the CH, not a cause!

Hi Annette :)

You are absolutely right ! The ganglion is just the indication that the sympathetic nervous system is overactive and nerves are firing in those ganglions causing pain and heat. They are not the cause of CH just part of the neurovascular cascade occurrring during a CH hit.