I just found this site and decided to go ahead and introduce myself, though my last period of attacks was six months ago. Anyhow here is a little bit about me. I had my first round of attacks in my junior year of undergraduate school, had no idea what it was, and just figured it was a bad headache. I thought that was pretty odd though, since I never NEVER had gotten head aches before in my life. I was so irritable for six weeks that my girlfriend (now wife) thought I was having migraines.

Then when it ended I immediately forgot about it. Had no interest in looking it up or anything like that, which seems strange in retrospect because I was a biochem. major and I am usually all over that kind of stuff.

Well now I am in medical school, which is pretty tough to say the least. The analogy is that it's like trying to drink from a fire hose. Well unfortunately at the very beginning of the year I started another cycle of attacks. This time the rythmic nature was too much to ignore, and after a lot of reading I self-diagnosed cluster headache. Went ahead and ran this by a neurologist in the department and he confirmed. Thankfully not chronic.

Well this whole thing has certainly sparked an interest in the issue for me, particularly in how much many of you seem to have run across some poor physicians, which is very unfortunate. And I cancertainly appreciate how difficult it would be going to the ED where you would inevitably be labeled a "pain case". Also, I never would have thought simple things like the terminology would affect you (i.e. Calling it a "headache").

That's all for now I guess.
Best Regards,
tanstaafl15

 
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]

===============
MANAGEMENT OF HEADACHE AND HEADACHE MEDICATIONS, 2nd ed. Lawrence D. Robbins, M.D.; pub. by Springer. $50 at Amazon.Com.  It covers all types of headache and is primarily focused on medications. While the two chapters on CH total 42-pages, the actual relevant material is longer because of multiple references to material in chapters on migraine, reflecting the overlap in drugs used to treat. I'd suggest reading the chapters on migraine for three reasons: he makes references to CH & medications which are not in the index; there are "clinical pearls" about how to approach the treatment of headache; and, you gain better perspective on the nature of headache, in general, and the complexities of treatment (which need to be considered when we create expectations about what is possible). Finally, women will appreciate & benefit from his running information on hormones/menstrual cycles as they affect headache. Chapter on headache following head trauma, also. Obviously, I'm impressed with Robbins' work (even if the book needs the touch of a good editor!) (Somewhat longer review/content statement at 3/22/00, "Good book....")

HEADACHE HELP, Revised edition, 2000; Lawrence Robbins, M.D., Houghton Mifflin, $15. Written for a nonprofessional audience, it contains almost all the material in the preceding volume but it's much easier reading. Highly recommended.
====

Here is a link to read and print and take to your doctor.  It describes preventive, transitional, abortive
and surgical treatments for CH. Written by one of the better headache docs in the U.S.  (2002)
 
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============================================

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE
ALL NEW!! HEADACHE 2008-2009
The new 72 page Headache 2008-2009 is hot off the press! Click here to download the PDF instantly! (free)

If you would like a bound copy, send $12 (includes shipping) to
Robbins Headache Clinic
1535 Lake Cook Rd.
Suite 506
Northbrook, Ill.60062

OR call 847-480-9399 to use Visa or Mastercard.

Hey tanstaafl15,

I hope you become a practicing headache specialist. :)

bejeeber wrote on Jan 24^th, 2010 at 10:53pm:

Hey tanstaafl15, I hope you become a practicing headache specialist. :)

Ya me too.  we need more doctors who are in the know!
hope your cycle is short.

Me 3 ;D We can use all the help we can get.

for sure! sorry u had to find us! but WELCOME!!!

Thanks for the encouragement. I hope that my experience gives me a little more pause when dealing with pain patients. There is a saying that "Doctors hate pain", because it is very nebulous and for all our progress we often can't really control it. And if I didn't mention it, I am interested in neurology, so I guess I may see a few cases in the future.

If you do get a few cases push H2O HARD!! It worked wonders for me during my last cycle.

Bob Greenwood wrote on Jan 25^th, 2010 at 11:31am:

If you do get a few cases push H2O HARD!! It worked wonders for me during my last cycle.

H₂O, or O₂?

LMAO!! Sorry. O2 :D I guess my meds are doing more than I thought they were ;D

Bob Greenwood wrote on Jan 25^th, 2010 at 11:54am:

LMAO!! Sorry. O2 :D I guess my meds are doing more than I thought they were ;D

Both can work in combating CH. That's why I asked.

Here's to more meds!