Hi,

Thanks for taking the time to read and reply if you can in advance.

Im in my mid 30's, I do have somewhat of a stressful life, career wise, but I don't believe what I have is stress related only. Here's my dilema. As far as I can remember, I have mild headaches on a regular basis, I would say on average once a month. Most of the time, I can already blame myself for the headache because I either slept late, didnt eat well or bad sleeping habits while Im sleeping, such as arching my neck, back, etc... When I have these headaches, they normally last from 1 to 4 hours as I can endure the pain and if I really want to get rid of it quickly, I either take a nap or take an aspirin, tylenol or panadol. I don't consume alcohol during the week and most of my headaches occur on weekdays, not weekends, so I know the pain isn't from a hangover but I do smoke and often times I feel when I have a headache in the morning, I remember that I smoked a little too much the night before (but again no alcohol), so I blame it on smoking.

However, 6 days ago, I suffered from an unbearable headache which I can only describe as a huge amount of pain on the right side of my head, around the temple area, and felt very sensitive behind my right eye. To the point where if I pressed lightly on my eye lid towards the back of my head, it actually provided me with a little relief, but the head pain was still there. As I normally do for all headaches, I tried to go to sleep, this time I took two panadols, put a cold towel on my right eye and over my forehead, and the result was nothing, just pain, pain and more pain. Finally at some point I managed to fall asleep in the early hours of the morning. The pain stayed with me the whole day but not as strong as it was in the evening and early hours. At mid day, the pain came back strong, so I went to the pharmacy on my way home. The pharmacist recommended Excedrin or Voltaren but both were out of stock, so she gave me Advil. I took two and the excruciating pain has never returned since, but....

Now the pain comes and goes, from the right side to the left side, not strong pain though, but enough to remind me that its there. The same with the eye pain, it now sometimes happens on the right and at times on the left. When I compare the past week to my past headaches, this is very unsual not only because the pain is overwhelming but because its not pain all around the head, but only on either sides and most of the time combined with behind the eye pain.

Am I suffering from cluster headaches?

Is there anything I can do at this stage just to self-diagnose myself until I can pin-point and say yes I suffer from cluster headaches or should I be rushing to the hospital and expect the worst?

Thank you again for those who take the time to reply.

Hi,

Thanks for the prompt response and recommendation.

Will do the needful as far as sourcing the right specialist. Unfortunately the list provided through the links will be of no use to me as I live in Middle East where healthcare is not at its best nor is it easy to find specialty care as I am use to in the states or canada but will have to try and find one before my next trip back home in a few months...

Thanks again, much appreciate it!

Hi Chris,

As Bob mentioned, it can take some time for hallmark symptoms of CH to crystalize.

In the meantime (hoping that it isn't CH), I would keep a detailed diary of your headaches, become conscious of any triggers and do some more reading on this site.

If it is CH, this is the site to understand all about it and to get prepared for an appointment with a qualified neurologist, or better still, a headache specialist.

Good luck.

FIRST, go to your personal page and add info about your location. We have a significant # of folks outside the U.S. and it helps, in offering infor/sources, to know where you live.
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So, some basic information which you may be able to use in discussions with your present doc.
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Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (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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HERE ARE TWO MAJOR DOCUMENTS WITH RECOMMENDED TREATMENTS FOR CLUSTER HEADACHE, ONE FROM A U.S. PHYSICIAN, THE SECOND FROM EUROPE.
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Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
Here is a link to read and print and take to your doctor.  It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S.  (2002. Rozen)
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Treatment guidelines from Europe

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A. May, M. Leone, J. Áfra, M. Linde, P. S. Sándor, S. Evers, P. J. Goadsby:
EFNS guidelines on the treatment of cluster headache and other
trigeminalautonomic cephalalgias.
European Journal of Neurology. 2006; 13: 1066–1077.

Download free full text:
Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
(Thanks to "cluster" for link.)
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See the PDF file, below.