Posted by Jack Boyd (205.188.193.46) on July 07, 1999 at 15:25:41:
In Reply to: CBS Report on cluster posted by Greg on July 07, 1999 at 09:43:23:
Forgive my pedantry but:
The pain mechanism in clusters, just like migraines is vascular - the blood vessels in our
heads dilate and cause pain - this is why vasoconstrictors work as abortives and why vasodilators, such as calcium channel blockers ( preventing the constriction in the first place) can work as preventatives. It is also why folks tend to lump clusters and migraines together when maybe they shouldn't.
There appears to be a lot of complexity in the causes for this vascular stuff. The hypothalmus,
which regulates all sorts of things including our circadian clock has been strongly implicated, along with brain chemicals ( nuerotransmitters ) such as serotonin. Serotonin is sort of the chemical of the 90s. It has been implicated as a fundamental agent in all sorts of things included depression, violence, sleep and eating disorders, you name it.
The recent breakthrough in the study of clusters that you referred to is all about the size of the brain around and in the hypothalmus. It appears that cluster patients have an abnormal amount of grey matter in this area of the brain. This finding is fascinating but at this point it only complicates matters and does not replace the other causes.
I would suggest that all of this stuff is sort of a chain of events that occurs in a cluster. Begin with some genetic predisposition, maybe add some head trauma, add a little pressure on the hypothalmus, the hypothalmus goes whacko at certain times of the year when there is a change in seasons and the amount of daylight, add a little serotonin depletion, add a little oregano ( just kidding, I think ) and finally constriction of blood vesssels followed by DILATION and you have the mother of all headaches.
I would very humbly add that all of this, including the most recent findings from our good English doctor, reinforces what I have always felt in my gut:
That clusters are completely physiological in nature - that none of us can help it - we do not bring this one by an inability to handle stress or from not receiving enough love from our mothers or any other such psychobabble.
Sorry for my diatribe but I can't help it.