Hi everyone! I'm a 16 yo Male who thinks he may be suffering from clusters.

I've been experiencing severe pain on the right side of my head for minutes to hours at a time this year. Last September it was happening almost every other day and always shortly after my second period class. My doctor prescribed me Imitrex at 50 MG in a pill form for the onset. She assumed migraine because my mother had them. The Imitrex helped. This pain was a 5 or 6 at minimum. It was more painful than anything I ever felt.
This summer, I started getting the same sort of headaches and my parents took me to the hospital after a 2 hour one. It just stopped after 2 and half hours. This was the worst pain I have ever felt ever and I wanted it to end, I almost jumped out of a window. My mom told me she's had two of these types of headaches in her life, and she said they were more painful than giving birth. IS it possible she had non chronic clusters and I have chronic clusters?
My neuro thinks that it's over use of Tylenol, which is not true, because I've been having these after a month with zero Tylenol pills. I've seen the other things being CPH and seizures that cause headaches. I've had a clean EEG and I assume that CPH will be what will my neuro look for at our next appointment.
Does this sound like a cluster headache disorder? Imitrex helped my pain, but didn't eliminate it. It helped the pain go down so I could get to sleep and I felt washed out the rest of the day.
I've read that imitrex is often prescribed for Clusters, but doesn't work on CPH.

edit: if this is in the wrong place, please move it. I'm new here :)
I'm very scared and I don't want to sound like I'm psyching myself into this diagnosis. It sounds like a horrible condition and I want to exhaust every resource. I'm just wondering if it sounds like a cluster headache disorder from those who suffer from the painful condition.

Take the quiz on the bar to the left of the screen called cluster quiz.  You don't give much of a description of your symptoms - but take the quiz.  If it is CH, you should have a better idea after taking the quiz.

Also - Imetrix in pill form does not normally work fast enough to help and 50mg 1/2 the normal dose given.  If the quiz makes you think you might have them - and your doctor rules out other things, ask him to try the injectable form of Imetrix - normal dosage is 6mg/0.5ml - should work in 5 to 15 minutes depending on how soon after the CH starts you take the injection.

Good luck - for your sake, I hope it is something else.

gah I knew I forgot something. I will take the quiz, but here is what happens during and leading up to these headaches.

10-5 minutes before, short burst of pain on the right top of my head and behind my eye.
During attack: terrible pain on the top of my head, the forehead, and throbs near the back, always on the right. I usually start crying hard on the right, followed by less crying on the left. My right nostril gets stuffy and my left nostril starts running. This only happens if the attacks last more then 5 to 10 minutes. I've woken up in the middle of the night with these headaches and I haven't been able to move my right arm.
The right side of my chest often tingles.

I have a horrible fear of needles, but I could try the subcotthing injections. I'm going to call the doctor who prescribed me the imitrex and ask her to up the dose.

edit: quiz results
1 - no
2 - no
3- no
4- yes
5- no
6- no
7 - no
8- no
9- yes
10- yes
11- yes
12- yes
13- no
14- yes
15- yes
16- yes

When you have a family history of headache making a good diagnosis becomes more complex. IF you are starting to have Cluster, it's very common for the symptoms to vary in quality, degree, location, duration often for months before settling down into a stable picture. So, takes some patience before a doc can make a solid call.

Many neuros lack skill/training with Cluster. If you have the option&$ seek a specialist.
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LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.


2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE On-line screen to find a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

6. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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Generally, imiterx pills are the least effective form of this med for Clusters--too slow acting. But before you can get into treatment, it's essential to have a good Dx. There are many disorders which mimic Cluster and so sorting thru the potentials is essential.

IF this turns out to be Cluster, it will become important for you to learn about them. We're talking about a condition which will continue for years but which, with good treatment, need not become an impossible burden.

While seeking a doc, start learning. Buttons, left, starting with OUCH. Then,


Three sites which are worth your attention: medical literature, films, plus the expected information
about CH.

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE
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START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Search under "cluster headache"
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START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE
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This one is a bit deep but file for future use:


Cluster headache.
From: START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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It's possible for one person to have both episodic and chronic cluster, chronic usually developing after some time of have episodic. But the "rules" with this disorder are rough approximations--experience varies widely amont us.


Best to you!

Hey dork,

It sounds like you may be going through the beginning states of Cluster headaches. It started a little earlier in life than myself i was 22.

Talk to your Dr about 02 for treatment. Oxygen at at least 15 lpm with a non-re breather mask will cut that 2 1/2 hours down to about 10 mins. Also there are many other tricks to this trade like slamming a red bull at the onset and many many more ways to stop and prevent these things from making you jump out that window.

It's not the worst thing in the world, you will be back to your normal life soon. Your not chronic!! Keep fighting the fight.

And please try to understand that you don't have to fear these headaches.. But you must learn and respect them as they are some seriously bad ass Attacks!!

Coach Bill

Bill and Bob have given you excellent advice. Liooking back I realize my ch started in my late teens and didn't really establish a pattern until my 20s. An accurate diagnosis is key to an effective treatment regimen. Starting with a headache specialist neuro now can save you a lot of pain.if it is ch its not the end of the world. I am 52 and they have not killed me yet!

Joe