Posted by Jack (188.8.131.52) on September 25, 2000 at 07:50:28:
Clusters, like migraines, are vascular headaches or if you prefer, nuero-vascular headaches.
I have read everything I can find on clusters for a long time. I have read something like this on more than one occasion:
"The pain of clusters comes from dilation of the blood vessels. This dilation follows a period of constriction."
Meds and therapies that constrict vessels work as abortives during an attack when the dilation has already begun.
Meds( such as verapamil) and therapies that prevent constriction in periods between attacks seem to work as preventatives by preventing the initial constriction.
It is also seems that during a cluster cycle relaxation after stress can bring on an attack. Hmmmmm.
Stress, excitement, etc equals constriction. Relaxation equals dilation.
REM sleep is probably the most universal trigger. We know that serotonin falls to almost ZERO during REM sleep. We also know that serotonin levels rise dramatically during an attack. We also know that serotonin acts as a regulator of blood vessels. Hmmmm.
Our blood vessels get wacky.
Why behind just one eye?
Why they occur only in episodes for most of us?
Wacky hypothalmus and circadian clocks.
PS - I am aware of the fact that I have over-simplified the mechanism of clusters. Oxygen, histamine, other nuerotransmitters, etc. are part of the deal. It seems to me though that the vascular component is the most important and most accesible for treatment.
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