Treatment of cluster headache

Cluster headache is rare, but one of the most painful. Attacks usually occur in series over several weeks or months, may recur several times per day and significantly affect well-being, work capacity and sleep.

At the Oxford Medical medical center, you can undergo a comprehensive examination and receive a consultation from an experienced neurologist. After establishing the diagnosis, the neurologist selects an individual treatment tactic aimed at reducing the frequency of attacks. To make an appointment for a consultation, call the contact center or use the online appointment form on the clinic's website.

Cluster headache is a form of primary headache characterized by recurrent attacks of very intense pain that occur mainly on one side. In medical literature, the term cluster cephalalgia is also used, and another name for the disease is bundle headache, since attacks usually occur in series over a certain period of time. The disease has a chronic course with periods of exacerbation and remission, when symptoms may completely disappear for a certain time.

Unlike secondary headache, cluster headache is not the result of trauma, the development of a tumor or another structural pathology of the brain. It develops as an independent disease.

Doctors of Oxford Medical explain that the correct determination of the type of headache is important, since the tactics of treating cluster headache differ significantly from the treatment of other neurological diseases.

Cluster headache is associated with a disturbance in the functioning of nervous mechanisms that participate in the regulation of daily biorhythms. That is why in many people attacks occur approximately at the same time of day or recur in certain seasons of the year. As stated in a study published in the US National Library of Medicine, such cyclicity may be associated with the functioning of the hypothalamus — a structure of the brain that participates in the regulation of biological rhythms.

At the same time, there are factors that may provoke the appearance of attacks or increase the risk of their occurrence during the period of exacerbation:

• alcohol consumption;

• smoking;

• disturbance of sleep schedule;

• night shifts at work;

• a sharp change of time zone;

• strong odors;

• overheating.

It is also known that the disease is diagnosed more often in men than in women. In some cases, hereditary predisposition is traced, which may indicate the role of genetic factors in the development of the disease.

Doctors of Oxford Medical explain that provoking factors are not the direct cause of cluster pain. However, during the period of exacerbation, they may contribute to the occurrence of attacks and influence the frequency of their recurrence.

Unlike patients with migraine, people with cluster headache often experience pronounced psychomotor agitation during an attack. It is difficult for them to remain motionless, so they may walk around the room or constantly change body position.

If cluster headache is suspected, it is necessary to consult a neurologist. During the consultation, the doctor clarifies the nature of the pain, its localization, the duration of attacks, the frequency of their occurrence and the presence of accompanying symptoms.

In most cases, the diagnosis is established on the basis of the patient's complaints, medical history data and neurological examination. At the same time, an important task of diagnosis is the exclusion of other diseases that may be accompanied by similar symptoms. Special attention is paid to differential diagnosis with migraine, trigeminal neuralgia, eye pathology, maxillary sinusitis and other diseases that may be accompanied by pain in the area of the eye or face.

To clarify the diagnosis, the doctor may prescribe:

• MRI of the brain;

• computed tomography;

• additional examinations according to the clinical situation.

Doctors of Oxford Medical recommend not postponing the examination if attacks recur regularly or become more intense. Timely diagnosis allows establishing an accurate diagnosis, excluding other causes of pain and selecting the most effective treatment tactic.

The treatment tactics depend on the frequency of attacks, the duration of exacerbation periods and the individual features of the course of the disease. The main tasks of therapy are rapid relief of the condition during an attack and reducing the risk of repeated exacerbations.

Depending on the clinical situation, the following may be used:

• drugs of the triptan group for rapid relief of an attack;

• short courses of anti-inflammatory therapy during the period of exacerbation;

• calcium channel blockers for the prevention of repeated attacks;

• other medicinal products for controlling the course of the disease as prescribed by the doctor.

Doctors of Oxford Medical explain that cluster headache requires a different approach to treatment than most other types. Drugs that help some patients may be insufficiently effective in other cases, so the therapy scheme is selected individually after establishing the diagnosis.

Following certain recommendations may help reduce the risk of attacks and facilitate control over the disease.

For prevention, it is recommended:

• to maintain a stable sleep schedule;

• to avoid alcohol consumption during periods of exacerbation;

• to give up smoking;

• to avoid a sharp change in the work and rest schedule;

• to limit the influence of individual provoking factors whenever possible.

It is useful to keep an attack diary, noting the time of their occurrence, duration and possible provoking factors. Such records may help the doctor assess the course of the disease and, if necessary, adjust treatment.

Cluster pain requires accurate diagnosis, since its symptoms may resemble manifestations of other neurological and otolaryngological diseases. That is why the first step is a consultation with a specialist who will assess the clinical picture and determine the further tactics of examination and treatment.

Current prices for doctors' consultations can be viewed here. To make an appointment with a doctor at Oxford Medical, use the online appointment form on the website or contact the contact center.

The information is for informational purposes and does not replace a doctor's consultation.

Sources:

• International Headache Society

• US National Library of Medicine

• National Center for Biotechnology Information