I've been getting these headaches since i was a teenager, i had always thought they were migraines. I'm 31 now. My clusters are episodic and last from a month to two months.my last remission lasted over a year then in december they came back.  I finally went to the doctor last week and told him i was having migraines and he agreed and i was prescribed propranolal for my blood pressure and there is evidence that it also helps with migraine.  He also prescribed me sumatriptan (imatrex) in pill form.  I read the information sheet that came with the imitrex and it said that relief came usually within two hours of ingestion.  Two hours! within two hours my pain is either gone or i'm contemplating suicide.  I was researching online last night and found cluster headaches.  The information i read described what i was going through to a T.  This morning i found this site and while reading the descriptions of what sufferers go through it matched exactly what i have.  There is a comfort in reading that there are other people out there that know exactly what i am feeling when these attacks occur. I'm going back to my doctor tomorrow to talk about what i can do.  I think the misdiagnosis as migraine is partially my fault as i went in with a preconceived notion and didn't give an accurate description of my symptoms.  I think communication with your doctor is a common problem.  Hopefully we can come up with a solution.  I'm on my sixth week of my cycle and if history holds true it may be coming to an end.  After four consecutive nights of excruciating pain i finally made it through last night without an episode. I hope it is over the stress of worrying when the next one is going to hit is driving me nuts.  I'm glad i found this site. It helps the stress a bit.

Greetings Bils!  You found the right place.  We all understand what you're going through especially in that initial phase when you're trying properly determine what it is you have.  Your doctor should refer you to a good neurologists/pain management specialists.  Get the MRI, EEG scans to rule out the worst.  Then they can get you on a good preventative drug and abortive drugs like Imitrex as injection form.  The pills are worthless.  The shot relieves me in 3-5 minutes.  Also, look into oxygen therapy.  Most on here use that as your #1 abortive.  Imitrex and other triptans
affect everybody different, but O2 is natural and that again can abort CH in 5 or so minutes at a high flow rate (15 LPM or higher).  Look into Melantonin as a sleep aid and energy drinks (Red Bull/Monster with 1000mg taurine) at onset.  Chug the energy drinks. 

All I can suggest here is read everything, listen to everybody and have a positive attitude.  Try not to think when the next hit is coming.  It will drive you crazy.

Best of luck and I wish  you pain free days real soon.

Cheers,
Chad

Even when doctors know it is CH, they still routinely, mistakenly, and inexcusably prescribe imitrex pill form - there is a constant stream of people coming thru here who report having been prescribed pill form with poor results.

Injections work good for me, as does O2. I like to have them both at my disposal, trying the O2 first, and if that fails, or isn't available, I pull out the big guns (injection).

From what I've observed around here, O2 is the most unanimously endorsed abortive. Sounds like since you're at the tail end of an episode, you may not need a preventative at this point (?)

These are some critical bits of info for you regarding O2 and injections that could pretty much save you (especially if you experience another episode down the road) as they have me:

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

Read the whole aricle; good introduction. Link on 2nd line.
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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]
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Also get the PDF file, bottom of this message.

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Hi Bils,

I know exactly what you're going through.  I carried the diagnosis of migraines for 15 years until yesterday, when I saw my new neurologist for the 1st time.  He told me one of the things that helped him with his diagnosis was how specific I was in describing my headaches.  So, yeah, a good description does help, although it's a shame it's not recognizable sooner because of the immense degree of pain we experience.  What I recommend doing is writing down every little detail of your symptoms on a piece of paper so that you don't forget anything and making an appointment with a doctor who specializes in cluster headaches.  Also write down what gives you relief, if anything, and what does not help.  My neurologist also looked at those things since cluster headaches tend to respond differently than migraines to different medications.  Hope this helps.