Hi. My husband is 29. He has a history of migraine headaches. He has also had very intense headaches starting a couple of years ago. The "attacks" have woke him up from a dead sleep, in uncontrollable pain. His reg. Dr said these were cluster headaches (not a neuro.) However, they did not seem to follow any pattern and happen very often, until now.

Starting on Oct 19th, he started getting what started out as a headache. Later that evening it turned into a migraine like headache with sensitivity to lights and sounds, throbbing pain. No OTC meds helped. Starting the following Monday he started having these extremely painful "attacks" again. We took him to the VA Emergency Room. They gave him several pain meds and an injection of imitrex. That "attack" stopped eventually, but after the pain meds wore off he still had a migraine.

It has basically been the same pattern for the last 2 weeks with the extremely painful attacks. He's been unable to work and lost his job this week because of these headaches  However he is still having a migraine like headaches in between these attacks as well.

I was curious if having a bad headache between each attack is typical of a cluster headache? The only time of the day that he is headache free is in middle of the night. Then through the days it is a mix of him sleeping and waking up because his head hurts (the migraine like headaches) then at almost 2pm he has been getting these attacking CH like headaches.

He has an appointment with a neuro at the VA next week. I have been researching everything to do with ANY kind of headache. He does have CH symptoms, but also symptoms of migraines and tension headaches. They did a head CT with out contrast, and said it was normal... Although CT's do not show much.

Does this sound like CH or something else?

Just for the record, your husband's headaches are very similar to mine. Like a migraine, I can be very sensitive to sound, mildly sensitive to light, and I also get nausea sometimes. It wasn't until I went through several cycles that I started getting the regular "alarm clock" and "awoken after an hour's sleep" headaches.

Does your husband want to lie as still as possible in a dark quiet area? If so then it's more likely to be migraine. It's almost impossible to stay still during a CH attack.

Doctors sometimes prescribe a spectrum of painkillers to ensure that they cover everything, but a successful diagnosis probably requires trying only one thing at a time. If the Imitrex worked, then he's narrowed it down to either migraine or CH. If oxygen works, then it's not migraine.

Try the cluster quiz on the left for more info. Also consider oxygen therapy if he's in the emergency ward next time (it help confirm diagnosis of CH). But most important, head over to the neuro asap (which you've already booked. )

Edit: Top marks to your husband's regular doctor for knowing about CH. Many of us remain undiagnosed for years or even decades!

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Bob's right on, as usual. Any guesses we make at this point are not only premature but potentially harmful. A good headache specialist is needed to cut through the various knots you describe. It is not unusual for the pattern to have no pattern in the beginning. Nor is it unusual to have a mixture of headache symptoms. After a particularly nasty hit I'd often have a migraine brought on by the incessant pounding. At that point pain killers did most definitely help; not the Cluster but the residual headache. Please encourage your husband to find and visit a headache specialist in your area. God bless. lance