I was interested in the discussion on a previous thread about CHs and auras. I don't get visual auras, but there are definite precursors to my getting a hit. For me, it starts with something I can only describe as a kind of buzzing in my nose on the affected side, like there's a hive of bees up there. If I don't act to abort quickly, it progresses to a buildup of pressure on the affected side, and then turns into a CH hit. Does anyone else have identifiable events prior to a hit?  Are all auras visual by definition? Just curious. lance

This is one of two citations in the last 15-years!
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Curr Pain Headache Rep. 2001 Feb;5(1):55-9. 


Premonitory symptoms in cluster headache.

Raimondi E.

Catedra de Neurologia, Facultad de Medicina, Universidad Nacional de Rosario, 9 de Julio 3826, Rosario 2002 PKP, Argentina. raimondi@cablenet.com.ar

Cluster headache is one of the most excruciating headaches affecting human beings--especially the male sex. Most of the cluster headache cases are of episodic nature, with active cluster periods lasting generally between a few weeks and 2 or 3 months. A still undetermined percentage of patients report nonpainful sensations preceding the onset of the pain attack for a variable period of time. If occurring only a few minutes or a few hours before the onset of pain, such symptoms are called prodromal. When occurring for several days, weeks, or months before the pain, they are termed premonitory symptoms. The author believes that premonitory symptoms have not been properly diagnosed and emphasizes the need to investigate their presence, because by knowing them advances can be made in the understanding of the physiopathology of this particular cephalalgia. Furthermore, it can also allow the physician to be ahead, by giving preventive treatment and stopping or diminishing the intensity and duration of the pain attacks.

Publication Types:
Review

PMID: 11252138 

Not an aura, a feeling almost of doom. (I've heard the same description used by people in the early stages of a heart attack) Before there are any physical sensations, I start feeling terrified, when I'll turn to Christ in an almost panic and say I'm in trouble!

Within a minute or two, the pressure will start in my right ear, the eye starts drooping, the tension starts up the neck, and he's baaaack!

Joe

My other half always seems to know when I'll get one. She notices that I'll sometimes repeat words when I'm talking, almost as if stuttering, or notice that I'm on edge. For myself, I just feel a bit irritable, audio-phobic and just not quite right. Sometimes those feelings just fade away after a few minutes but normally in a minute or three I'll suddenly get hit by a CH.

Then it's a case of getting to my oxygen and telling the beast where to go.

Usually about an hour before I get a hit my nose starts dripping (only on the right side - my hit side) its as if I have left the tap on!
I also repeat myself and feel very very anxious like you describe Joe a feeling of impending doom.

So when I reach for a hankie, repeat and pace I know I'm about to get a visit from an unwanted guest!  >:(
Sue

Ask your partner/SO if they've noticed any particular *quirks* before a headache starts.

I know with Jimbo, he tends to put pressure on a particular spot (in fact, that spot is permanently dented now).  Some people are hair pullers, some people get a jumpy leg, etc.

I also get that ill feeling that I'm about to get hit.  I also get a weird feeling in my stomach.  Like the sympathetic par sympathetic nervous systems is being stimulated. 

During a cycle my whole personality changes.  I tend to be more on edge and very irritable.  I tend to be withdrawn.  I also get the pressure behind my left eye that it starts at a 1 and grows.

I think we all get some kind of warning that we all know just what's about to come.  I think for some of us it's really hard to describe we just know.

Sami

I get a "funny Feeling" (no, not THAT funny feeling).

I can't really put it into words.....just that "something" that tells me hell is fixin' to come calling....get to an O2 tank...like NOW!

My normal fun loving self disappears, I become irritable, nervous...I know its coming....it's weird....right eye becomes teary, red...others have noticed and asked if I'm okay...only if they knew that in about 30 minutes I'll be on my hands and knees....

Even though the pain of my attacks is worst at the back of my head, I usually get precursor pain in the form of stabbing above my right eye, or sinus pain on the right side, or both. Then I know that within the next few hours, I'll get hit with a whammy. Sometimes the same pain comes back for the duration of the attack, sometimes not.

Hmmm...more similarities than I would have thought. I'd like others to jump in here, too. Perhaps it's something that Dr Goadsby could address? Bob, only two citations in 15 years. Would the fact that we do have precursors aid in research do you think? But more to the point for us, do you find paying attention to the precursor and slamming your favorite abortives at all helpful?  I know I tend to wait a bit to see if it's real, and really coming. I'm stupid. The precursors are 100% in predicting the onset of a hit. It's me that wants it to turn out differently every time. Blessings. lance

Since I suffer mainly nightime hits, I just wakeup at about kip 6 or 7. But for daytime hits, it starts by gettting coming and going orbital pain and a burning sensation in the nostril on the side of my attacks and within 10 min.s ...its on.

I don't get premonitions that the cycle is coming on but....
When in cycle and they wake me out of dead sleep, I have heard in my ear that's on the same side as the pain, a barely perceptible "tingk....tueeeeeeeeeeeeee!" that rises in pitch until I can't hear it any more and then the pain starts.

During this most recent cycle, I had a couple of  strange dreams that I was being stalked. Once, by a water snake that morphed into a spiky, muscular, fanged, gaping jawed prehistoric cat.

I wish there was a way to edit these posts after posting them! I accidentally hit post instead of preview...
I wanted to add that when the prehistoric cat with the steel trap jaws turned and stared at me I ran like the dickens and escaped down a flight of stairs to a secret basement where it couldn't get me. 
At that moment I awoke with the pain just beginning to build and I ran downstairs which is where I keep my O2 and got rid of the beast!

How absolutely Jungian of you. Get archetypal dreams often?lance

Glassman wrote on Feb 11^th, 2011 at 12:22am:

I wish there was a way to edit these posts after posting them! I accidentally hit post instead of preview... I wanted to add that when the prehistoric cat with the steel trap jaws turned and stared at me I ran like the dickens and escaped down a flight of stairs to a secret basement where it couldn't get me.  At that moment I awoke with the pain just beginning to build and I ran downstairs which is where I keep my O2 and got rid of the beast!

Hit the "modify" button in the top right corner of your post. You can then modify your post. It's considered "Internet polite" to add a ps for your edit..such as

edited for spelling...to add something...etc.

Joe

No, no premonitory symptoms. 

I almost always get hit at night during REM sleep.  By the time I'm awake, it's just me and the thing coming on like a freight train.

Best,

George

Much obliged, Joe!
P.S. I did it!

I do get my fair share, Lance. But that one was a doozy!

yup, whenever the lights start irritating me...might be the kitchen light or the bathroom light or the hallway light, but one of them will just be TOO bright [smiley=yikes.gif] ...then I know I'm about 25 min away from a hit. BTW I think all lights are too bright all of the time, but I know it's just me...they normally don't irritate me.

Days before a cycle starts I am like a bloodhound.  I can smell everything.   It's not fun, let me tell you :-/

I'm real "edgy" about a week before it starts.

Normally a few weeks before a cycle starts I'll get a slight burning sensation on the temple (rhs) or a kind of mini hit that lasts a minute or two.  I'm getting those now so I guess another is on the way.  Oh the joys  ::)

During a cycle I usually get hit in the night so just bam and its a happening thing.  Although last cycle I did get some day hits and that was tricky - felt like it was comming on all day and sometimes never eventuated - frustrating!  Rather just wake with it and deal with it!!

The best way I can describe the prelude to a hit is pressure. My right eye and right side of my head feel heavy, my eye feels like it's bulging. Then, the watery eye starts, to go with the stuffy right nostril

Sometimes, it never gets further along then that. I get a lot of daytime hits that are along the lines of Kip 4-5ish. I guess they're almost really bad shadows? Not sure how else to describe it.

This leads me to a sort of related questions......does anyone have cycles that are different? In other words does the time of day, frequency of hits, duration of hits and severity of hits remain consistent from one cycle to the next? Or does it vary?

primetime wrote on Feb 14^th, 2011 at 3:20pm:

The best way I can describe the prelude to a hit is pressure. My right eye and right side of my head feel heavy, my eye feels like it's bulging. Then, the watery eye starts, to go with the stuffy right nostril Sometimes, it never gets further along then that. [...] This leads me to a sort of related questions......does anyone have cycles that are different?

I'm in cycle, and have shadows pop up and I'm never sure when they'll turn into a full blow cluster attack.  Mostly I feel fine, but will have very short bursts of pain, lots of pressure behind the eye, even watering and runny nose but goes away within 5 minutes.  Its annoying, as I sit on edge waiting for one of these shadows to blow up into an attack..

My cycle is worse than ever; and its different than the last time (except 930am is pretty consistent time) but all through afternoon evening night i get hits anytime and they are sometimes very bad kip 10 and sometimes only 4-5s.  always keeping me on my toes

Does anyone else notice they are more likely to get hit after a real stressfull day?

Stress is a "one or the other" trigger around here. For some, like me, sustained periods of stress will bring on an attack. For others, as soon as they relax from a stressful day, THEN they get hit! Called the "let down hit."

Joe

Guiseppi wrote on Feb 16^th, 2011 at 11:37pm:

Stress is a "one or the other" trigger around here. For some, like me, sustained periods of stress will bring on an attack. For others, as soon as they relax from a stressful day, THEN they get hit! Called the "let down hit."Joe

I guess I'm one of the really lucky one's who get both! I can't stress out physically or emotionally, and I can't lie down to relax. I'm down, then I'm up pacing; then sorta reclining then up and walking. It's a litte schizoid.  :D lance

It's a litte schizoid.   lance

Hmm...fits you Lance! ;)

Joe

Guiseppi wrote on Feb 16^th, 2011 at 11:37pm:

Stress is a "one or the other" trigger around here. For some, like me, sustained periods of stress will bring on an attack. For others, as soon as they relax from a stressful day, THEN they get hit! Called the "let down hit."

I'm certainly one who gets more hits when stress comes off, this could be a weekend or when I get home from work. Looking at my CH diary I can see I get over 4 times as many hits on a Friday night as on a Tuesday (it's almost may day off from CHs).

Stress seems to aggrevate my CH.

Going through a lot between work, family, friends and go figure CH join in the mix.

CH seem less often on the weekend for me than, a monday or Tuesday.

I get a light thumping blood pressure type feeling behind my left eye temple area. After that it's into my upper jaw to top of left side of my head. Also kinda notice a tingle in my nasal cavity. And then it's on. Unfortunately :-/

I get pressure on the bridge of my nose. if that happens i know its coming.

I know a cycle is starting up when I get a kip 3-4 after a beer or alcoholic drink. This may go on for a couple of weeks. I only get one after drinking, until they intensify to a kip 8. After a kip 8 hit, I quit drinking. I might go another week with no hits Then BAM!! Get one everyday, once a day around the same time without drinking. I used to take prednisone and it would go away. Except this last time, the prednisone didn't work. Now I get 5-8 hits at a kip 9-10 in a 24 hour time frame.
   As for a hit! It starts out ...well!! imagine there is a loose knot in that nerve that goes out the back of your eyeball. You know its there because you can feel the pressure from the extra space the loose knot takes up. Now imagine there is a little gremlin that has a hold of that nerve, like a piece of rope, pulling with his little hands while his little spiked foot is propped up against the back of your eyeball. He starts pulling with his little hands and pushing with his foot. The knot tightens, the pressure builds. Sometimes he likes to take his time and stay in that same position for a little while. Like an hour or so. He may even get tired and decide to quit. Most of the time he ends up putting his other foot up and pull as hard as he can and gets that knot so tight the pain becomes intense. And if that wasn't enough, he calls his little buddies over and they start poking the back of your eye with little spears that really don't seem little but they have to be to fit in behind your eye. That's when I do the cluster dance hoping that the little suckers will get tired and leave me alone. Can't think, Can't do anything, right nostril stuffy and dripping. If I hold my head just right I think it doesn't hurt as bad, but I can't think, I can't sit still. Maybe a should hold my head a little different and swing back and forth a little harder. No a little slower???.. The whole side of my head hurts. I get religious and make all kinds of promises. This wont last forever...OMG!! what if it does?..After an hour or more I am to tired to care. When its over, I want to take a nap but know I can't because if I do I will get another.
Then I learned about O2 on this site...Wow, that was a close call.
Sorry,
Kinda went off subject, but I really needed to get that out...
    

I have recently noticed a feeling I can only describe as a release of some chemical. Close in feeling to an IV injection, warm rush coursing through my body, but VERY subtle. Then I get the edgy feelings, like the bottom just dropped out. Then a "thick" feeling on that side of the head, the usual eye, nostril and slam.

My temple starts to thump. And my jaw gets sore. And I can't stand noise. Especially Generators, AC's, Fridges, Florescent lights, etc.

I get fidgety and irritable, especially toward the wife.  She always seems to get the brunt of it.  I've tried hitting an energy drink in the precursor stage, but have found it does no good until that actual attack has started.  Then if I follow up with another it does nothing.

I'm also another that gets "let-down" attacks.  Sundays seem to be my worst as I normally stay pretty busy on Sat.  When I teach on Sunday Morning in Bible Study I usually get hit pretty hard during the main service afterward.

Jerry

i get all the common symptoms everybody mentioned, but if it is really really quiet...I can hear very faint sounds of popping in my head, kinda like the cereal-rice crispies...snap, crackle, pop...very faint sounding...all I can think of are brain cells bursting and then all the common symptoms (stiff and painful neck/temple pressure/burning eye/nasal congestion) come rushing in like a killer tsunami

about 3 weeks before they start I have the feeling of something in my right eye that I have to keep pulling the lower lid down, nothings there just the feeling when the difficulty swallowing happens I know for sure it's back. I've noticed that the more I touch my eye trying to get nothing out the faster I'll bring on the cycle. I also always start having bad dreams about pain for a week before it really hits.

I only get a couple of minutes warning of an impending attack. It starts with a small amount of pain behind my eye that feels like a pulled eye muscle <?> and hurts a bit worse when my eye moves around. I know I'm getting ready to get pounded on so I immediately take action. The longer I wait to use an abortive med (Imitrex), the longer and more intense the attack will be.

During the attack, I smell everything. I can hear everything too, even footsteps in the grass at nearly 100 ft away. Even the smallest amount of light is too much and painful. Hypersensitivity is almost an understatement.

My husband tends to know when I have one coming on.  He says that he can see it in my face.  I guess my left eye gets red and saggy.  Sometimes I will get a runny nose on my left side.

Imitrex4Breakfast wrote on Oct 25^th, 2011 at 7:27pm:

During the attack, I smell everything. I can hear everything too, even footsteps in the grass at nearly 100 ft away. Even the smallest amount of light is too much and painful. Hypersensitivity is almost an understatement.

I find my senses become superhuman too, before and during attacks. Light, sound, smell, touch to the area, (not sure about taste) are all overwhelmingly alert.

Quote:

Hypersensitivity is almost an understatement

This is very much the case wtih me as well. I can usually tell when i have one coming on. My left temple (my hit side) starts with small shadows of pain, that then lance into my left eye. I usually put a bit of pressure on my temple, which makes the shadows go away, but i know i've got about 5-10 minutes to get somewhere private so i can do my little dance.

My wife and I have recently let our friend move in for a month or so until his new place is ready for him. He is a night owl, and i usually get night hits in winter, so i'm pacing from living room to kitchen to hallway to front door, turn around and do it all over again.

Roommate will get up to get a glass of water, and i swear it takes him 30 minutes to pour the water and go back to his room (it probably takes all of 30 seconds, but those are LONG seconds). Even the fridge light is blinding to me. ANY noise is too much for me, any touch is too much...