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New Message Board Archives >> Jan-Mar 2003 >> Most people already know this: Part 1
(Message started by: DaveHar on Feb 2nd, 2003, 7:56pm)

Title: Most people already know this: Part 1
Post by DaveHar on Feb 2nd, 2003, 7:56pm
The term "cluster headache" refers to a type of headache that recurs over a period of time. People who have cluster headaches experience an episode one to three times per day during a period of time (the cluster period), which may last from 2 weeks to 3 months. The headaches may disappear completely (go into "remission") for months or years, only to recur. A cluster headache typically awakens a person from sleep 1 to 2 hours after going to bed. These nocturnal attacks can be more severe than the daytime attacks. Attacks appear to be linked to the circadian (or "biological") clock. Most people with cluster headaches will develop cluster periods at the same time each year -- either in the spring or fall or the winter or summer.

Cluster headaches are one of the most severe types of headache. It can be 100 times more intense than a migraine attack.

Who Gets Cluster Headaches?

Cluster headaches are the least common type of headaches, affecting less than 1 in 1,000 people. Cluster headaches are a young person's disease: the headaches typically start before age 30. Cluster headaches are more common in men, but more women are starting to be diagnosed with this problem. The male to female ratio is 2-3:1.

What Causes Cluster Headaches?

The true biochemical cause of cluster headaches is unknown. However, the headaches occur when a nerve pathway in the base of the brain (the trigeminal-autonomic reflex pathway) is activated. The trigeminal nerve is the main nerve of the face responsible for sensations (such as heat or pain.)

When activated, the trigeminal nerve causes the eye pain associated with cluster headaches. The trigeminal nerve also stimulates another group of nerves that causes the eye tearing and redness, nasal congestion and discharge associated with cluster attacks.

The activation of the trigeminal nerve appears to come from a deeper part of the brain called the hypothalamus. The hypothalamus is home to our "internal biologic clock" which regulates our sleep and wake cycles on a 24-hour schedule. Recent imaging studies have shown activation or stimulation of the hypothalamus during a cluster attack.

Cluster headaches usually are not caused by an underlying brain condition such as a tumor or aneurysm.

What Triggers Cluster Headaches?

The season is the most common trigger for cluster headaches, which often occur in the spring or autumn. Due to their seasonal nature, cluster headaches are often mistakenly associated with allergies or business stress. The seasonal nature of cluster headaches most likely results from stimulation or activation of the hypothalamus (see above).

Cluster headaches are also common in people who smoke and drink alcohol frequently. During a cluster period, the sufferer is more sensitive to the action of alcohol and nicotine, and minimal amounts of alcohol can trigger the headaches. During headache-free periods the person can consume alcohol without provoking a headache.

What Are the Symptoms of a Cluster Headache?

Cluster headaches generally reach their full force within five or ten minutes after onset. The attacks are usually very similar, varying only slightly from one attack to another.

Type of Pain: The pain of cluster headache is almost always one-sided, and during a headache period, the pain remains on the same side. When a new headache period starts, it rarely occurs on the opposite side.
Severity/Intensity of Pain: The pain of a cluster headache is generally very intense and severe and is often described as having a burning or piercing quality. It may be throbbing or constant. The pain is so intense that most cluster headache sufferers cannot sit still and will often pace during an attack.

Title: Re: Most people already know this: Part 1
Post by Bob P on Feb 3rd, 2003, 9:15am
Web MD needs to update their info.  In a survey of over 12,000 cluster sufferers, conducted at CH.com, only 28% of sufferers said their clusters start in Spring or Fall.  The seasonal thing is a myth.

Title: Re: Most people already know this: Part 1
Post by don on Feb 3rd, 2003, 11:45am
Myth?

I think 1/3 of sufferers reporting seasonal triggers would eliminate the seasonal thing as a myth. Maybe not quite fact, but not myth either.

Title: Re: Most people already know this: Part 1
Post by Bob P on Feb 3rd, 2003, 2:16pm

Quote:
The season is the most common trigger for cluster headaches, which often occur in the spring or autumn. Due to their seasonal nature, cluster headaches are often mistakenly associated with allergies or business stress. The seasonal nature of cluster headaches most likely results from stimulation or activation of the hypothalamus (see above).  


Geez, what a politician.  No wonder you're Prez.

13% - Spring
9% - Sumer
15% - Fall
7% - Winter
34% - Random

I guess you could say they are seasonal, they occur in Spring, summer, Fall and Winter.

I still say the Spring/Fall thing ranks right up there with the square jaw and hazle eyes.

Title: Re: Most people already know this: Part 1
Post by Ueli on Feb 3rd, 2003, 3:17pm
The WebMD article states:

Most people with cluster headaches will develop cluster periods at the same time each year (the rest of the sentence is a enumeration of the four seasons).

If we want to check this statement against the survey of this site, we must first notice that we can't use the percent figures given, as these are always related to the total of 12026 respondents. But obviously some compulsive survey takers, that did not answer correctly, messed up the data: 86 did not know if they are male or female. 140 obviously have no cluster at all since none of the options (left, right or both sides) applied.

The percentages in the "when does the cycle start" question sum up short of 100% for another reason: this question does not apply to chronics.

So what can we conclude from the numbers of the survey?

5567   57.0%   starts at same time of the year
4206   43.0%   at random time
9773   100%    total

So, unless we assume that 57% is equivalent to "most", the statement from WebMD quoted above is not consistent with our survey.


What about the often quoted "cluster periods usually start in spring or fall"?

1637   16.8%   starts in spring
1888   19.3%   starts in fall
6248   63.9%   other
9773  100%     total

Here we get a mere 36.1% that matches the statement. Since we are talking about half of the year, the number should be ways above 50%, near to 100%, if the seasonal thingy were more than a myth.

Statistics can be (ab)used to "prove" almost anything, it just depends on interpretation. ::)

Anyway, what is it good for to feed doctors such numbers. They should rather learn to recognize the symptoms and to treat them effectively.
Statistics are a great tool for gamblers and related people, like insurances and planing for the future.
Trying to decide, if a specific case is what it seems to be or not, by using some number collection is a gross abuse of statistics and should be threatened with death penalty.

Ueli

Title: Re: Most people already know this: Part 1
Post by Jarvis on Feb 3rd, 2003, 8:48pm
Yes so 98.7% have rounded heads.......  I think we can safely assume that people get cyclical clusters at different times. Otherwise its interesting but useless facts. Unless we could create an ideal climate where clusterheads could live....... how about an island with a bubble. Ueli can be in charge of all food inspections, I'll handle the climate conditions cause I like 73deg F. not C. with the help of a few engineers on this site. Bob maybe you could run the circadian clocks. Dave Har can keep everyone indoctrinated with the facts we need to know. jonny can sit at the gates and holler at meegrainers. Someone will have to make sure only young people get in as this is after all a "young persons disease" Oh we'll need a doctor to make sure all clusterheads stay medicated as Dave states in part 2. Mr.Happy can make us smile. Roxy can show us where  the beef is. We'll need to find lots of female supporters cause women dont really get clusters .Athos has to do the dishes .........Clusterheads; Please sighn up here with all available skills......   If we were to take all the survey results as gospel we could then create that ideal society........................ I have to stay home though cause I cant cross the street as statistically speaking most pedestrians get hit by cars that way.     ..           Maybe I need to be medicated huh.

Title: Re: Most people already know this: Part 1
Post by athos12 on Feb 3rd, 2003, 9:11pm
Where are soap and a towel?


That was great!



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