Curr Pain Headache Rep. 2002 Feb;6(1):65-70.   

 
What predicts evolution from episodic to chronic cluster headache?

Torelli P, Manzoni GC.

Headache Centre, Institute of Neurology, Strada del Quartiere, 4, Parma 43100, Italy. paolatorelli@libero.it

Over the last few years, attention has increasingly been focused on the evolution of cluster headache over time. Predictive factors have been identified that are correlated with an increased risk of unfavorable evolution from the episodic form to the chronic form of cluster headache. Late onset, the presence of sporadic attacks, a high frequency of cluster periods, and short-lived duration of remission periods when the headache is still in its episodic form all correlate with a possible worsening of the clinical picture over time. The reasons for evolution of episodic cluster headache to chronic are still unknown, but some factors, such as head trauma and other lifestyle factors--eg, cigarette smoking and alcohol intake--have been suggested as having a negative influence on the course of cluster headache over time.

PMID: 11749880 
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J Headache Pain. 2005 Feb;6(1):3-9. Epub 2005 Jan 25.   


Chronic cluster headache: a review.

Favier I, Haan J, Ferrari MD.

Department of Neurology, K5-Q Leiden University Medical Centre, 9600, 2300 RC Leiden, The Netherlands.

Cluster headache (CH) is a rare but severe headache disorder characterised by repeated unilateral head pain attacks accompanied by ipsilateral autonomic features. In episodic CH, there are periods of headache attacks with pain-free intervals of weeks, months or years in between. A minority of patients have the chronic form, without pain-free intervals between the headache attacks. Chronic CH can occur as primary or secondary chronic CH; the rarest form is episodic CH arising from chronic CH. In this article, we give a review of the chronic forms of CH and focus on demographics, clinical manifestations, social habits, predictive factors, head injury, genetics, neuroimaging and therapy. IT IS REMARKABLE THAT LITTLE IS KNOWN ABOUT RISK FACTORS THAT MAKE CH CHRONIC.

PMID: 16362185 

went from episodic to chronic 14 years ago dont know why

Episodic to chronic, about 5 or 6 years ago....reason? Hmmm, may be controversial but excess use of Imitrex and Verapamil.

But after some time you get over it. You live your life as normal as you can. I currently use Frova for its long half life. Most of the time half of one is enough to kill it. I chew on it and put it under my tongue for faster action.

How do you know? Well, you know when those 4-6 weeks have passed and it has been years since you were symptom free. You know.

In '97 I had an episode start and to date it just hasn't stopped.... No rhyme or reason -- it just kept on keeping on...

Don't bring on trouble -- wait a year and then worry..... if it's still going on then you'll know you're chronic.... You adjust and you live your life....

Most chronics I know have an attitude that this damn beast is tuff but we're a hellalot tuffer... I know I am....(most of the time).

Hugs BD

Grinner,

I have been clockwork episodic for 20 years--NEVER used to get any shadows between headaches--after my last cycle I now frequently do--I have even had some bad ones that kept me up at night and was 95% positive I was ready to go into cycle--but they have never evolved into headaches.  For me, the biggest trigger is when my sleep schedule gets thrown off--could be by only half an hour.  Don't know why I am no longer shadow free between cycles.  Anyway, if you are quitting smoking, maybe your sleep schedule is getting thrown off a little?  That is great you are quitting smoking though--keep going with that!!!  let us know how things go.

Chronic is much easier to handle, I did it for 31 years!

This beast has no rhyme or reason to it; I had one cycle back in late 1999 that lasted for 12 weeks & then had nothing for 5 years, it returned in late 2004 & belted me for another 13 weeks & quite simply never went away.

I agree with the others that being chronic is easier to handle, at least you know that at any time you can get belted again but you are prepared for the battle.

Cheers
Barry

Grinner,

aguess now it's the time to prepare for the worst, but most of all: wish for the best! 

Sanna

You're welcome.

PF days,
Sanna

maalstroom wrote on Jul 6^th, 2008 at 8:47am:


First, there are no doubts anymore if the beast will come back or not - to me this makes a big difference.
I still have some kind of cycle (less hits / more hits) but the overall number of hits per day and the intensity is (at least for me and contrary to my episodic past) far more constant.
Second, the average intensity of the hits seems to have dropped a bit (not sure if this is the case for other chronics as well).
Third, you simply "get used to it" since it becomes a part of your day to day life / a part of the daily routine.

Oliver

Episodic for 20 odd years, and then chronic for the last 8 or 9 (I'm getting too old and senile to remember! LOL)

When I went chronic, unlike others, mine got substantially worse.  Some of my worse hits and series of hits have been since going chronic.  BUT, I still think it is easier being chronic.  When you are chronic, you KNOW you are going to get hit many times, every day.  You adjust your mind around that, and if you are as pigheaded as Svenn and Cathi say I am, you refuse to let the beast ruin your life.  You adjust to it, and continue on.  It is NOT a death sentence, as so many of you episodics think it is.  ONCE you go chronic (IF you ever do) you just deal with it.  Life still goes on.

I KNOW that EVERY day, I am going to get nailed, some times up to 15 or 16 times a day.  But you know what?  I am STILL here (much to many's chagrin), and my life is STILL continuing.

Is it hard?  YES!  I won't lie to you, BUT, it IS doable, and still better knowing that you will get hit.  You have your weapons of destruction always at hand.  You have shifted your life so that you can take a pause, and deal with the hit, and then continue on as normal!

To me, and to most chronics, it is FAR harder to be painfree for a while, and then have the dread and fear of the cycle starting up again.  You get used to ignoring the beast, and then all of a sudden, the beast is back.

Hell, even cranky, cantankerous, ornery, and OLD Barbara (bless her heart) deals with it!  Heehee ..

One interesting benefit, of being chronic, is that MOST of us chronics CAN drink booze!  Most of us are not as sensitive to it like you episodics are!

Life can still be beautiful and fulfilling, even if you are chronic.

Chuck

The only triggers for me (that I'm aware of) are red wine, Aspartam and MSG and there wasn't any change at all when switching from episodic to chronic.

IMHO work and social life are better now - I guess it's because of the mentioned "routine".

Quote:
Hey, no problem.

Quote:

A ferret named Clusterchuck - that thought has something to it  

Oliver