Hi everyone,
Last Saturday I had another of my mysterious headaches. When I described the symptoms to my son, an ENT (ear, nose and throat MD), he suggested I may be having cluster headaches and I should see my local doctor. Perhaps you can help me figure this out.

I've had 4 of these headaches over a period of about 3 years. The first 3 were in airplanes and this last one was during a drive where I dropped about 3,000 feet in elevation. So it seems to be triggered by air pressure changes.

It feels like someone cracks me across the right eye with a baseball bat, then drives a pin cushion of needles around my eye and forehead. The pain comes on without warning. It is extreme for about 15-20 minutes, then subsides. After that, I feel twinges of pin cushion feelings and aches which diminish rapidly. Pain is gone within 30 minutes. Even when the pain is gone, there is still a mild sensation which continues for hours.

I may go a year before I have another one. I don't know if I am having cluster headaches, because I have them so infrequently. Also, no one has mentioned altitude or air pressure changes as a trigger.

I thought the problem was associated with my sinuses until my son, suggested otherwise.

I plan to see my primary care internal medicine doc soon.

Do you have any words of advice?

Thanks

Welcome!


Quote:

I plan to see my primary care internal medicine doc soon.

That's the best advice I can give. There are other disorders that can mimic clusters so it's best to get checked out to rule out anything else.

If you are diagnosed with CH, there are many treatments that can help.

Bill

The diagnosis is in the details. A referral to a headache specialist is your best bet. Take the cluster quiz on the left of the board. Start keeping a headache diary with as many details as you can. Keep track of what meds you've taken to deal with an attack, what's worked and what hasn't worked.

Like Racer says, if the diagnosis is CH, don't lose this website, it'll be your new best friend! Good luck on the road to diagnosis.

Joe

Four headaches in three years sounds like four headaches in three years.

        Kinder gentler Potter

I'm not one for getting headaches, typically. Occasional sinus pressure or infection explains all but these 4 bizarre, and alarming ones. I was sweeping these under the carpet, but I had this last one with my wife while I was driving, so, well, she wants me to pursue it. I'll seek some medical advice and see where that leads. If it comes down to dealing with one of these a year or so, with no growing or dangerous consequences, I can live with this and count myself fortunate. I thank you for taking the time to discuss this with me.

When a cluster picture is first starting to show it's common for the early symptoms to be very mixed and confusing. It took me nearly four-years to develop a pattern which could be diagnosed.

At this stage finding a good headache specialistg is your best first step. Too many docs, including neurologists, have inadequate experience and skill in headache.
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LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.

2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE  On-line screen to find a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box.  Call 1-800-643-5552; they will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.
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But you will find it useful to read the full article (link, 2nd line):

 
Cluster headache.
From: START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]

Hello, I started getting mine in my early 20's every 2-3 years at the same time of the year, Late fall. There are many symtoms of cluster headache that share with other types of headaches, But there are a few very distinct things that serpartes them. Do they come at night, everynight?? Does your affected eye water during the attack? little things like that. I beleive whats hurting you is real, But it just doesnt sound like my clusters, although we are all different. Keep us updated please.


                              Challening, More assertive.. Coach Bill >:(