I am new here.  Found you guys while endless searching for answers to my pain.  I was told about four or five years ago during a 3 week headache that I had clusters. Well actually I was told that I didn't really fit any headache, migraine, cluster or tension, specifically but closest to cluster. After several different meds, normal MRI, three weeks later I was pain free.  I have had an occasional headache since then but nothing that firocet or motrin won't cure.  About 6 weeks ago I felt a sharp pain in my left temple area, felt like an explpsion.  Left me with a dull pain in that area for rest of day.  The next morning it was gone.  A few weeks ago it came back, not the explosion pain but a dull left sided temple pain.  Which has remained.  I went to new dr, bc my old pcp was out of office for rest of year.  New dr told me well sounds like headache here is rx for firocet and midrin.  I told her I was really worried about pain being one sided and explosion like.  Her answer was don't worry about it if you didn't have unilateral body numbness. That was two weeks ago today.  A few days after I saw her I called back and demanded f/u MRI, she hesitantly ordered it.  I never made it to that appt because I ended up in ER with bp of 185/85, was put on O2, given compazine, decadron, and toradol IV, and normal CT scan, felt better when I left ER and next two days felt normal.  Then the 645 pm witching hour comes and they start all over again.  Don't know if I should go ahead with MRI, or what.  I don't have all of typical symptoms that everyone else displays.  This makes me wonder if I am expericing clusters.  I have this pressure in my left temple, sometimes it radiates to left jaw and teeth hurt, occasionally I have ice pick feeling in left eye.  Pressure is constant, if it does let up in moves to base of my neck and sometimes down my neck and burning into my left ear.  The reason I went to ER was because from base of my neck to top of my head was on fire! I am not sensitive to light and I do not have horner's syndrome and rarely lacrimal or nasal drainage.  I have tried sinus meds, toradol po, firocet, midrin, and relpax.  I woke up this am with just slight feeling of headache on that side and took relpax. Right now I feel ok.  Not totally normal but not debilitated either.  The last time four years ago I experienced this was this exact time of year, however, I just don't remember it being unilateral.  I feel so bad for yelling at my kids but I just can't take them running around.  I feel on edge and feel like if I could just cut a hole in my temple to relieve the pressure I would be ok.  Please help me!!!!!!!

htmanuel wrote on Nov 16^th, 2009 at 9:25am:

I told her I was really worried about pain being one sided and explosion like.  Her answer was don't worry about it if you didn't have unilateral body numbness.

Sounds like she is saying it doesn't sound like a stroke.



Quote:

I have this pressure in my left temple, sometimes it radiates to left jaw and teeth hurt, occasionally I have ice pick feeling in left eye.

The trigeminal seems to be active, one-sided, timely, base of the neck affects some, autonomic not proceeding but, any referral possible to a headache doc?  Keep a log of each headache like this.  When, how long, pain level, affected areas.  So far, in the temple region, sharp pain, felt like an explosion, pressure, and at wake up time, slightly that feeling occurring, debilitating mentioned. 

Not a doc, no diagnosing, but seems worth looking into with a specialist.

My first reaction to reading your message: you were being treated for migraine; symptoms of wandering pain is not uncommon with early period of Cluster development.

Hardly a final judgment. For that you need to find a good headache specialist:

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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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--link, line above--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]