Cluster Headaches

According to most the articles I have seen on these terrible type of headaches, men mostly get cluster headaches and women get migraines. I am lucky enough to get both, and numerous other types.

These cluster headaches have been happening (multiple times a day) on a daily basis for the last few weeks, to the point that I called to make an appointment with the headache clinic in the hospital I see my MS neurologist. Currently, their first opening is in October (sad face emoji). Experiencing this pain 2 or more times a day (which apparently is normal for cluster headaches) is worse than the one migraine I typical have each week. At least with my migraines I have three meds to take at the onset and when one doesn’t work, I move to the next and regardless I have a dark, quiet place to rest while I wait for the meds to kick in.

My cluster headaches feel like a little creature is trying to pitchfork stab its way out of my left eyeball. This article is not super encouraging “Cluster headaches, which occur in cyclical patterns or cluster periods, are one of the most painful types of headache. A cluster headache commonly awakens you in the middle of the night with intense pain in or around one eye on one side of your head. Bouts of frequent attacks, known as cluster periods, can last from weeks to months, usually followed by remission periods when the headaches stop. During remission, no headaches occur for months and sometimes even years.” Until this recent time, cluster headaches were not a frequent occurrence for me. I would have maybe 2-5 days a year and then they were gone.

Studies suggest that these types of headaches (which apparently are “rare” (per article above) usually occur on the right side of the head. However, they are characteristically always and only on ONE side of the head. That’s how I know the difference when the pain starts. All of my other types of migraines or headaches start in a corresponding area on the right side of my neck to head.

WebMd states “We don’t know what causes them, but we do know that a nerve in your face is involved, creating intense pain around one of your eyes. It’s so bad that most people can’t sit still and will often pace during an attack. Cluster headaches can be more severe than a migraine, but they usually don’t last as long.” This has me wondering if the increased frequency of my now daily cluster headaches could, somehow, be related to my MS. WebMD also indicates that the signal seems to come from a nerve deep in the brain, in the hypothalamus.

Cluster headaches typically reach full pain level within 5-10 minutes. the pain is typically one sided. The pain is usually behind or around the eye but can radiate to to your temple, forehead, nose and scalp. If that wasn’t fun enough they can last anywhere between 15 minutes to 3 hours, with the average of being 30-90 minutes. You can get one every other day or up to 8 or more a day. Currently I have bouts multiple times a day and I have a lot of other pain in my body so the pain is not as intense to having me pacing but I do have to push on the pressure point by my eye and basically stay in one spot not doing anything until the pain goes away because I am unable to focus my eyes or thoughts when it hits.

One of the medications I take for migraines (in pill form) is used in shot form for cluster headaches. There is a large variety of treatments from medications taken orally, injected or inhaled to shots that block nerves in your occipital lobe, devices implanted in your head and preventative medications to try. Some think that keeping a regular sleep schedule will decrease the frequency as it may be linked to your circadian rhythm, though my sleep has not changed in the last few weeks compared to previous months and years.

This article suggests using high flow oxygen to relieve the symptoms and notes that cluster headaches and migraines (though two completely different things) are typically treated the same, leading to limited success. They also note that pills in any form are not recommended because these types of headaches reach their peak very quickly and last on average an hour which would not be helped by oral medication. Being that is occurs to 1-2 out of 1,000 people, insurance often is an issue with getting treatment for cluster headaches.

Sources: https://www.migrainetrust.org/about-migraine/types-of-migraine/other-headache-disorders/cluster-headache/, https://americanmigrainefoundation.org/resource-library/cluster-headache-2/, https://www.webmd.com/migraines-headaches/cluster-headaches, https://www.mayoclinic.org/diseases-conditions/cluster-headache/symptoms-causes/syc-20352080, https://www.everydayhealth.com/news/it-migraine-cluster-headache/, https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-whats-the-difference-between-cluster-and-migraine-headaches/,

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