What are the other Names for this Condition? (Also known as/Synonyms)

• Ciliary Neuralgia
• Erythroprosopalgia of Bing
• Horton’s Headache

What are Cluster Headaches? (Definition/Background Information)

• Cluster Headaches are a series of short but extremely painful headaches, lasting up to several weeks or months at a time, generally followed by remission periods when the pain stops
• Cluster Headaches are the most rare and severe form of headaches. The pain from this condition is usually unilateral (one-sided), and is focused around the eye, temple, or forehead area
• The exact cause for Cluster Headaches is not clearly known. However, they can develop due to a combination of biological and environmental factors, such as activated nerves in the brain and seasonal changes
• There is no cure for Cluster Headaches, and so the treatment plan focuses on reducing the severity of the pain and preventing future episodes
• The prognosis for Cluster Headaches is good. However, although the pain may be managed with treatment, it may never go away completely

Who gets Cluster Headaches? (Age and Sex Distribution)

• Cluster Headaches are the rarest types of headaches, affecting less than 1 in 1,000 individuals worldwide
• Most individuals generally develop the condition between the ages of 20-40 years
• Males are more prone to developing Cluster Headaches than females
• Individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Cluster Headaches? (Predisposing Factors)

Some known risk factors for Cluster Headaches may include:

• Smoking
• Alcohol and substance use
• Family history of the condition

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Cluster Headaches? (Etiology)

The exact cause for Cluster Headaches is not known. However, it has been suggested that the condition may develop due a combination of biological and environmental factors that include the following:

• Biological factors: An abnormal signal from the suprachiasmatic nucleus in the brain (an area responsible for sleep and wake cycles) activates a nerve in the brain, known as the trigeminal nerve, which causes sensations like heat and pain on one side of the face. The signal can be triggered by various factors
• Environmental factors:
  • Seasonal changes such as spring and autumn
  • Frequent alcohol use
  • Chronic smoking
  • Cocaine use
  • Strong smells
  • Bright or flashing lights
  • Hot temperatures
  • Exertion during exercise

What are the Signs and Symptoms of Cluster Headaches?

The common signs and symptoms of Cluster Headaches may include the following:

• Sudden excruciating pain located behind the eye that may radiate to other areas of the face, neck, and shoulders
• Swelling around the affected area
• Drooping eyelid on the affected side
• Excessive tearing and redness of the affected eye
• Nasal congestion on the affected side
• Excessive facial sweating
• Pale or flushed skin
• Sensitivity to light
• Restlessness

How are Cluster Headaches Diagnosed?

A diagnosis of Cluster Headaches is made based on the information gathered from the following:

• Complete physical examination
• Thorough analysis of personal and family medical history
• Neurological examination by a qualified healthcare provider
• Imaging tests such as MRI and CT scans (of the head and neck region)
• Differential diagnosis to rule out other conditions that may manifest with similar signs and symptoms

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Cluster Headaches?

The complications of Cluster Headaches may include the following:

• Changes in alertness resulting in reduced quality of life
• Loss of movement or sensation
• Excessive drowsiness
• Excessive nausea or vomiting causing electrolyte imbalance
• Convulsions/seizures
• Changes in vision
• Inability to function in regular activities, resulting in decreased quality of life

How are Cluster Headaches Treated?

Presently, there is no cure for Cluster Headaches. The treatment focuses on decreasing the severity of the pain. Due to the sudden onset of this condition, it may be difficult to treat. Some of the following methods of treatment may be used:

• Oxygen inhalation for instant relief
• Injectable medication to reduce pain symptoms
• Local anesthetics to numb the pain
• Surgery, which is usually performed as a last resort

Some treatment methods include medications at the start of a cluster period to prevent subsequent attacks. These medications may include:

• Calcium channel blockers
• Corticosteroids
• Lithium carbonate
• Nerve blocks
• Melatonin

How can Cluster Headaches be Prevented?

• It is difficult to prevent the onset of Cluster Headaches, because they develop suddenly. However, the following methods may aid minimizing the likelihood of developing the condition:
• Quitting smoking
• Discontinuing alcohol and drug use
• Seeking medical treatment soon after symptoms begin appearing, to help slow down progression of the condition
• Active research is currently being performed to explore the possibilities for treatment and prevention of conditions such as Cluster Headaches
• Regular medical screening at periodic intervals with tests and physical examinations are recommended

What is the Prognosis of Cluster Headaches? (Outcomes/Resolutions)

• The prognosis for Cluster Headaches is typically good
• With regular and consistent treatment, individuals may learn to manage their pain and lead a near normal life. However, the pain may never completely go away

Additions and Relevant Useful Information for Cluster Headaches:

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/