Cluster Headaches

• Cluster headaches are severe and unbearable unilateral headaches, usually centred around the eye.
• Cluster headaches are called cluster headaches as they come in clusters of attacks and then disappear for extended periods.
• A patient may suffer 3-4 episodes a day for weeks or months, followed by a pain-free period lasting several years.
• Associated symptoms of cluster headaches are typically unilateral: Red, swollen and watering eye, Pupil constriction (miosis), Eyelid drooping (ptosis), Nasal discharge, Facial sweating.
• Cluster headaches can be triggered by alcohol, strong smells or exercise.
• Attacks of cluster headaches last between 15 minutes and 3 hours.
• Cluster headaches cause severe pain and are sometimes referred to as "suicide headaches" due to their severity.
• A typical patient with cluster headaches is a 30-50 year old male smoker.
• Treatment options during acute attacks of cluster headaches include triptans (e.g., subcutaneous or intranasal sumatriptan), High-flow 100% oxygen (may be kept at home), Verapamil (the first line for prophylaxis to prevent attacks), Occipital nerve block, Prednisolone (e.g., a short course to break the cycle during clusters), Lithium.