What is a cluster headache?
Cluster headache is one of the most painful types of pain. It is a neurological disorder manifested by a sharp, sudden headache, usually localized on one side of the head, most often in the eye area, especially above the eye, behind or in the temple. The pain is very severe and recurrent, and can last from 15 minutes to 3 hours. The pains occur in clusters, or attacks occurring at a specific time of day or night. They last for weeks, months or even years. They then go into remission and cease. Additional symptoms include redness, swelling or tearing of the eyes, sweating, sensitivity to light, irritation of the nasal mucosa, facial flushing, phonophobia, muscle tension, feelings of anxiety, confusion and even aggression. The causes of cluster pain are not entirely clear. They are linked to the activity of a part of the brain-the hypothalamus-the biological clock of humans.
What are the symptoms of cluster headache?
Cluster headache is a self-limiting condition, it is not a symptom of another disease. It affects men more often than women and is a rare disease. It reveals itself in the age range of 30-40 years. The characteristic symptoms of cluster headache are:
– pain appears suddenly, with no previous foreboding symptoms, without warning,
– The pain is sharp, stabbing, throbbing, excruciating, increases very quickly, is considered the most severe type of headache,
– The extent of the pain affects only half of the head, involving the area around the eye, temples, radiates to the teeth, cheek, jaw, and even the occiput of the skull, most often always affecting the same side,
– Pain attacks occur in sequences, one after the other, and there may be 1 to 8 attacks per day,
– Cluster pain lasts from 15 minutes to 3 hours,
– appears in specific time sequences, in clusters, at fixed times of the day and night, usually an hour or two before going to bed, at night or in the morning,
– Seizures may occur at certain times of the year, such as spring or autumn,
– pain subsides as suddenly as it appeared, patients feel fine during the intervals between attacks, but are exhausted and tired,
– After the seizures comes a period of remission, or withdrawal of symptoms, the break can last a month, a year, or even longer.
Symptoms accompanying cluster headache affect the half of the face that is pierced by pain and are:
- Redness of the eye, bloodshot conjunctiva,
- constricted pupil,
- facial swelling,
- drooping eyelid,
- facial sweating,
- facial redness,
- irritation of the nasal mucosa,
- Runny, watery runny nose,
- Clogging one nostril,
- In exceptional cases, nausea may occur,
In addition, patients often move around, rocking back and forth. Sitting or lying down increases the pain. Patients may feel:
- psychomotor agitation,
- After the seizure has stopped-exhaustion, depressive and anxiety disorders.
What is the difference between a cluster headache and a migraine?
Similarities of migraine and cluster headache:
- diseases of the primary-self group,
- paroxysmal, unexpected character,
- involves half of the head, but in the case of migraine, the pain can also be bilateral,
- sharp, pulsating, wrenching character, with high intensity,
- hypersensitivity to sound and light,
- An intense, pungent odor can be a pain trigger.
Differences between cluster headache and migraine:
- With migraine , nausea and vomiting are more common,
- with migraine, the pain increases during physical activity, with the patient preferring to lie down or sit, as opposed to cluster pain, where the patient even sways to relieve the pain,
- Migraine has a neurovascular basis,
- in migraine, the pain can wander to different parts of the head, cluster pain usually localizes to the same part,
- Cluster pain, unlike migraine, is not triggered by stress, food, alcohol, or hormonal changes. Sometimes, however, a patient diagnosed with a cluster period avoids alcohol, as it can exacerbate the pain,
- Migraine pain lasts from 4 to 72 hours, in children it can be shorter, cluster pain from 15 minutes to 3 hours and recur in cycles,
- Migraine more often affects women, cluster pain – men.
How common are cluster headache symptoms? Attack pattern.
Cluster headache usually manifests itself on a daily basis, with attacks lasting several weeks or even months, the most common range being 4 to 12 weeks. They then subside, only to return after a few months or years. Patients observe that attacks usually occur at consistent times of the day or night, recur annually for years, and can even last a lifetime. The cyclical nature of the symptoms has to do with the rhythm of the day and the seasons: spring/autumn.
Causes of cluster headache.
The exact cause of cluster headaches is unknown, but studies and observations suggest that abnormalities in the body’s biological clock (hypothalamus) play a significant role. Smokers and patients with a family history of similar conditions have a higher risk of pain, although genetic susceptibility has not been confirmed in studies. Seizures can be activated by alcohol, intense odors such as gasoline, paint, solvents or even perfume. Some medications, such as nitroglycerin used for heart disease, can also contribute to pain activation.
How to diagnose a cluster headache?
The correct diagnosis of cluster headache is quite a challenge. There are no tests or studies to confirm the ailment. A detailed interview with the patient is essential. A helpful tool is to keep a pain diary, recording the date, strength scale, frequency and length of pain. Patients are often misdiagnosed, and the time to start treatment is significantly prolonged. Usually the doctor refers the patient to a dentist, ENT specialist, physical therapist, therapist, or psychologist. This is due to the wide divergence of symptoms and the lack of observable recurrence of pain. The average time for diagnosis of the disease is seven years.
Treatment methods for cluster headache.
A cluster headache is not life-threatening, but it does introduce a great deal of discomfort. The pains are so severe that women who have given birth naturally consider cluster pain worse than labor pains. Sometimes patients have suicidal thoughts. Treatment is very difficult, based mainly on prolonging remission between seizures. During a violent attack, the patient rarely has a chance to get to a doctor before the pain subsides.
Pharmacology in the treatment of cluster headache.
Painkillers such as paracetamol are too slow to work, triptan nasal spray, triptan injections, oxygen therapy-inhalations of oxygen lasting about 15-30 minutes-are used on an ad hoc basis. To prevent pain activation, doctors prescribe calcium channel blockers(verapamil), glucocorticosteroids and lithium carbonate.
Transcutaneous vagus nerve stimulation.
Transcutaneous vagus nerve stimulation, or TVNS for short, is an innovative method involving the use of electrical current to stimulate the nerves of the neck. It relieves pain and reduces the frequency of seizures.
Stimulation device implant.
For the treatment of cluster headache, an electrical implant is recommended in the facial cavity, on the cheek. The device emits a current that stimulates the parasympathetic area of the nervous system. Like TVNS, it reduces pain and the frequency of its occurrence. Read more about the method here.
Unconventional treatments for cluster headache with psychedelics.
Traditional treatments are not among the fully effective ones, and long-term use leads to many cardiovascular disorders, induces diabetes, organ fibrosis, osteoporosis, emotional disorders and more. To help, recent findings suggest that taking the tryptamines LSD, or psilocybin found in hallucinogenic mushrooms, can break cluster headache cycles and extend remission periods. Unfortunately, the effectiveness and safety of this method has not yet been significantly confirmed in studies. To cite a 2006 study by Dr. John Halpern, director of the Integrative Psychiatry Laboratory of the Division of Alcoholism and Drug Addiction at MCLean Hospital and an assistant professor of psychiatry at Harvard. In collaboration with Andrew Sewell and Harrison Pope Jr. , Halpern published an analysis from observing 53 patients using LSD or psilocybin as a treatment for cluster headache. The results were surprising, with 41% of those surveyed reporting a reduction in seizure intensity and frequency. 52% of patients said the pain disappeared completely from their lives, and 95% of those taking the previously mentioned psychedelics between attacks found that the episodes lengthened in duration, or did not occur at all. Unfortunately, the study is unreliable because researchers’ access to psychedelics is restricted by law, and patients taking the substances risked violating the law, including serving jail time for possession of illegal psychedelics. However, sufferers are determined enough to decide to take such dangerous steps. Conducted in the United States research revealed that 55% of patients with cluster headache had thoughts of committing suicide. Microdosing psilocybin means taking small doses of psychedelics that are imperceptible to the body, but have a significant effect on the resolution of pain symptoms and minimize the effects of PTSD (post-traumatic stress disorder) symptoms caused by clusters. Interesting information on the topic of treatment with psychedelics is provided by a new series on Netflix-“How to Change Your Mind.” Hopes for the development of research and confirmation of its safety are given by more countries that are decriminalizing psychedelics and granting permission for scientific experimentation.
The above article is educational and does not urge the use of psychedelic drugs, which are banned in Poland.
The content on psychodelicroom.co.uk is educational, research, and is an expression of many opinions, to which one should reserve. We do not encourage or even discourage the use of any means of influencing consciousness, all of which can both cure and do great harm. In particular, we advise against growing mushrooms from growkits in countries where it is illegal – min. in Poland – because it involves criminal liability. We recommend that growkits purchased from us be disposed of 72 hours after receipt.