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        Cluster Headache Help and Support >> Cluster Headache Specific >> Cluster-migraine--does it exist?
        
(Message started by: Bob_Johnson on Mar 25^th, 2007, 11:35am)

Title: Cluster-migraine--does it exist?
Post by Bob_Johnson on Mar 25^th, 2007, 11:35am

Curr Pain Headache Rep. 2007 Apr;11(2):154-7.

Cluster-migraine: does it exist?

Applebee AM, Shapiro RE.

Given C219B, Department of Neurology, University of Vermont College of Medicine, 89 Beaumont Avenue, Burlington, VT 05405, USA. robert.shapiro@uvm.edu.

The nosological boundaries between cluster headache and migraine are sometimes ill-defined. Although the two disorders are distinct clinical entities, patients sometimes present with clinical scenarios having characteristics of both headache types, but either do not fully meet International Classification of Headache Disorders, Second Edition diagnostic criteria for either disorder or have sufficient symptoms and signs to allow both diagnoses to be present. These occasions provide diagnostic challenges and include what is variously described as migraine-cluster, cyclical migraine, clustering episodes of migraine, cluster with aura, or atypical cluster without autonomic symptoms or severe pain. Patients with symptoms overlapping cluster headache and migraine likely reflect the inherent clinical variability in each of these two disorders, rather than distinct diagnostic entities in their own right.

PMID: 17367596

Title: Re: Cluster-migraine--does it exist?
Post by bluebrain on Mar 27^th, 2007, 5:04am

Doesn't surprise me, specially if you accept that serotonin plays a key role in the ethiology of migraine and Cluster headache even though the anathomical structure involved in each case is different.
Best wishes, Bluebrain.

Title: Re: Cluster-migraine--does it exist?
Post by swimchica623 on Mar 27^th, 2007, 1:05pm

I get em, but since I get clusters and migraines independently and they I don't get these combos frequently I wonder if its just the two coming at the same time possibly?
Lisa

Title: Re: Cluster-migraine--does it exist?
Post by dannyboy on Mar 28^th, 2007, 10:32am

The whole thing is connected but separate. Cluster, Migraine, Tension Headache, TN, etc

The reason they're connected is that our diagnoses are SYMPTOMATIC. We add up a list of syptoms and then classify that particular combination of symptoms with a name. (A better idea is to identify the physical structures that the pain is comming from and classify like that... but we're not there yet. We're still caught up trying to give things names)

Every year the International Headache Society has to add a bunch of new classifications to the list because someone high up reports new combinations of symptoms.

Cluster, Migraine, Tension Typre, TN, are obviously completely different and separate conditions, but they do lie on a CONTINUUM. More in overlap in some people and less in others.

In the old days people got thrown out of clusterville for suggesting an overlap between Cluster and TN. Now its recognised. Same with cluster/migraine.

A toast... to ye olde den wannabe Lion Hunt...

Shut up

Title: Re: Cluster-migraine--does it exist?
Post by writer on Mar 28^th, 2007, 11:02am

Bob,

Thanks so much for posting this.

You're right--in the past, any hint of cluster being some sort of migraine variant (despite MDs calling it that) used to be grounds for furious flaming.

Title: Re: Cluster-migraine--does it exist?
Post by blmiller84 on Mar 31^st, 2007, 7:22pm

Cluster-Migraine as in a combo of both hitting you at once or a person getting both types of headaches?

I sometimes swear I get both. Inbetween my CH cycles I will have a random day or two of a migraine type headache (with my aura and everything). When I have my CH cycles now, I don't get my aura anymore (I think thanks to my year + on a preventative). At the beginning of random CH cycles I get the migraine headache for a few hours during the day and when I pass out at night I wake up a few hours later with a CH type headache.

I've noticed the migraine type headache preceeding the CH cycle causes a different type of cycle for me. Not so much of the CH symptoms unless it wakes me up at night (which happens every few days instead of nightly!). I still get the stuffed up nose and eye pain and such, but less of the "i can't sit still" thing. Oooh.. and I dont' crave salt during my CH only cycles. Before my migraines morphed or whatever they did into CH, I would crave salt whenever I had the "I want someone to cut off half of my head" pain. It did me no good, I just wanted salt.

Title: Re: Cluster-migraine--does it exist?
Post by Rosybabe on Apr 10^th, 2007, 1:31pm

when I am in cycle I only get the CH type of pain, but during the year I will get random migraines like when my period comes or if I get to eat something smoked, they are very different.

Title: Re: Cluster-migraine--does it exist?
Post by UN solved on Apr 10^th, 2007, 7:41pm

I believe that people can have 'clustering episodes of migraines' ... but I think they are 2 seperate beast.

There's nobody that can convince me that when I'm having a kip 10 ... it is somehow like a migraine. ::)

UNsolved

just ramblins ...
I remember my first kip 10 @ age 19. No Imitrex or any other Triptans , No O2, No pain meds ... STRAIGHT TO THE ER ( I was 'trippin' - thought I was gonna die ) .... After a cpl shots of Morphine ... I was trashed and had no more pain. BUT ... I do remember the ER doc saying that you can't come here 'just for a headache' ..... HOLY $HIT ... Did he say that ? ---> If it wasn't for my girlfriend and my dad ... He would've swallowed his teeth that night ! I would've beat him into submission !! LOL ... It's kinna funny now, looking back at it !!

THANK GOD FOR IMITREX !! WORKS EVERYTIME FOR ME !! :D

Title: Re: Cluster-migraine--does it exist?
Post by BrianJ on Apr 12^th, 2007, 10:51am

i get both clusters and migraines i dont get many migraines when im not in cycle but i get a few migraines that overlap with my CH hits when in cycle and some times even at the same time wich is pure hell

CH and migraines are very differant i can live with migraine and work but CH well i dont need to go in to that you all understand

Title: Re: Cluster-migraine--does it exist?
Post by pubgirl on Apr 21^st, 2007, 9:20pm

as said- the monumental difference in levels of pain make it very hard for CH'ers to ever see that migraine could be related in any way to CH but as a sufferer of both I am convinced they are.

I was a migrainer, then developed CH as well in my 40's. The bastard of it is that now I have CH (seasonal episodic) my migraines which are intermittent are much more vicious in pain levels and have autonomics with them which they never had before. It almost seems as if the CH has "sensitised" my head and made it more susceptible.

Totally unscientifically, the reason for my belief that my migraine and CH are related (or one is an offspring of the other) is that the pain emanates from exactly the same section of my brain though the pain levels and duration are totally different.

I know the section of my brain as I call it my "hotspot", when a migraine is brewing, or a CH is about to slam me, a part of my brain deep in the left side feels "hot".
If I had a diagram of the brain cells I could pinpoint the exact spot to a neuro.
With a CH attack I have less than a minute before the pain is at full power, with a migraine it gradually builds over a period of about 20 minutes if I don't tackle it.

Whatever else, that for me tells me the 2 headaches have the same location and many of the same symptoms, they are just triggered by different things.

I suppose the good news is that for me the treatments are exactly the same. 02 works for almost all of them, and triptans mop up the rest, migraine or CH, so I don't get worked up nowadays about which one it is.

W

Title: Re: Cluster-migraine--does it exist?
Post by lionsound on Apr 21^st, 2007, 10:43pm

i get CH and migraines and other sundry HA's too.
So I can see where someone is likely to say i have cluster-migraines or migraine-clusters or whatever.

HOWEVER...it was those very diagnoses that caused years of miss-treatment of my headaches. Now my Dx says migraines AND CH which gets me a very different list of prevents and treatments and attention than the former.

Title: Re: Cluster-migraine--does it exist?
Post by George_J on Apr 23^rd, 2007, 9:43am

Those who do not get cluster headache find it difficult to comprehend what a CH attack is like. To some extent, I suppose, I can understand this--I have no idea what a migraine might be like. I don't get them, and have never had one. Only CH.

The descriptions I've seen and the symptoms of migraine I've read about can only sketch a caricature of migraine, and cannot communicate the experience. I can empathize with a migraineur (as far as empathy is possible, anyway), but I cannot ever really understand what it is like to have a migraine headache.

That's why I try not to be too hard on non-clusterheads who seem unable to comprehend CH.

Unless they are simply dismissive, self-absorbed, and stupid (and you can spit in any direction and hit people like that), they are most likely not being deliberately callous... They simply don't understand--because they cannot. Just as I cannot comprehend migraine.

I'm relatively sure that a condition we could call cluster-migraine exists. Whether that is because migraine and CH are part of a continuum, or whether it is because migraine and CH are distinct headache types that sometimes manifest at the same time, I cannot say.

Best wishes,

George

Title: Re: Cluster-migraine--does it exist?
Post by taraann on Apr 23^rd, 2007, 12:38pm

[smiley=twocents.gif] of MY cluster migraine episodes. I started out as a teen with migraines on occasion. Then early adulthood brought on monthly or in other words hormone triggered migraines and since then I almost ALWAYS get a migraine started right before my period starts and it ends a few days into my period. Ok fast forward to about 9 yrs ago (2 yrs before I became pregnant with my first born child) I had my first actual cluster episode, at the time I had zero clue what the hell was going on. It started off as a "regular" migraine and then morphed into this stabbing concentrated area of pain. This went off and on for a few weeks to about a month and a half. Was admitted for testing, blah blah. Then the stabbing pain just disappeared.

Back to my normal monthly migraines for about 6 months or so and again as described above happened. This time I saw a neurologist who after all the usual rounds of tests and meds trials deemed it "cluster migraines".

For many years I was an episodic CH'er. And many of my cluster cycles were triggered by my monthly migraine.

Now I am a properly ::) dx Chronic Ch'er with monthly migraines. But still to this day during that monthly time my Ch is almost always guaranteed to spiral out of control during my migraine time. It seems the migraine triggers the ch, the migraine finally fades off into the distance and then I'm battling the beast a lot harder for awhile.

So do cluster migraines exist? I believe they do, it's all dependent on the patient, symptoms, history, etc.

I am trying hard to type this in as intelligently as possible but I am horribly sleep deprived and just plain blah right now, so if I have written anything backwards or something let me know so I can clarify.

Title: Re: Cluster-migraine--does it exist?
Post by ClusterChris on Apr 25^th, 2007, 9:15am

According to my doctor Thats the name of CH's, "How are your Cluster Migraines?" She asks!

Just thought I'd throw that in there!

Chris

Title: Re: Cluster-migraine--does it exist?
Post by Margi on Apr 25^th, 2007, 10:42am

to me, it's an oxymoron, the term 'cluster migraine' - like 'jumbo shrimp'.

I wholeheartedly agree with Unsolved.... 'A cluster of migraines' could be (and should be) changed to read 'a group of migraines'. In this case, 'cluster' is only an adjective, not a noun as it in when it describes cluster headaches.

Title: Re: Cluster-migraine--does it exist?
Post by Bob_Johnson on Apr 25^th, 2007, 10:58am

Please reread the second sentence of the original message/abstract.

The authors are NOT confusing two different headache types. They are calling attention to the reality that elements of both types can appear at the same time. This produces confusion and difficulty for both patient and physician--the core idea in the article.

Title: Re: Cluster-migraine--does it exist?
Post by pieface_49 on Apr 25^th, 2007, 7:39pm

Thanks for the post Bob,
I suffer from both, the migraine (rebound headache) I contribute to the CH. Being that our systems are so chemically out of balance, both due to meds and the CH, I found this to be an interesting article.
http://www.healthcentral.com/migraine/medications-32544-5.html

Quote:

Medications such as ergots, triptans, opioids and barbiturates should not be used more than ten days per month.

http://www.headaches.org/consumer/topicsheets/analgesicrebound.html

"Migrainous Neuralgia" is a medical term used in the past. It is written in the "medical info" to the left. I want to know who came up with the term "Cluster Headache"? What a misnomer and an injustice to us. Even many in the medical profession today hear "headache" and want to prescribe aspirin.

Donnie

Title: Kunkle EC "invented" CH ?
Post by cluster on Apr 27^th, 2007, 7:35am

As far as I know, the term "cluster headache" was first used by EC Kunkle in 1952:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=13038844

Best wishes,
Friedrich

Title: Re: Cluster-migraine--does it exist?
Post by porquipine on Apr 29^th, 2007, 9:30am

Hey, everyone. I'm new to this board, not new to migraines. Wondering what you guys think of this, especially in light of the article posted here: For the past two years, I've had basically one long continuous "migraine with aura" in varying degrees during February, March and April, without much problem the rest of the year. I definitely don't have attacks of pain at a level 10 or anything, but I'm wondering if maybe what I have isn't some sort of migraine with cluster features (to the extent it seems so cyclical, predictable and bunched together)?

What's weird, too, is that this year, the first two weeks of April, my head felt completely "normal - - " no pain, no dizzines, no exhaustion, no nothing. Then back to being messed up. Yesterday I read an article by some Mayo doctors in Heachache mag [2003; 43: 282-292] about how cluster headaches often decrease within two weeks of the clock change (first Sunday in April/last Sunday in October) and I thought that was quite a coincidence. I had also started 500 mg magnesium in late March too though . . .

So I guess I'm wondering if I shouldn't try lithium or melatonin or some of the meds you guys use (or oxygen
)??. I took a methyprednislone pack this week without much success. Maybe I should try another pack? I'm seeing a headache doc in a couple weeks because I think my local neuro doesn't really know what he's talking about. Right now I'm on 25 mg topamax with the plan to work my up.

The timing just seems too bizarre (i.e., every Feb-April)! Thanks for any thoughts - - Beth

Title: Re: Cluster-migraine--does it exist?
Post by pieface_49 on Apr 30^th, 2007, 9:05pm

Hello Beth,
I do not think anyone is going to answer. The questions you ask are for a medical professional to answer. I can say this. My cluster cycles seem to coincide with severe allergy infections. My worse infections usually subside in January or February and a cluster cycle starts for me. Do my cluster headaches have something to do with allergy infections? Cluster headache is so unpredictable I don't know. Keeping a headache diary http://www.migrainehelp.com/pdf/MigraineDiary.pdf might help you and your Doctors. Just do a Google search for "headache diary" and you will find many.

Donnie