Does anyone know what a cluster headache is?

Question

what causes them but more importantly is there anything that helps?

Answer 1

In most cases headache pain, even severe headache pain, isn't the result of any underlying disease. In fact, the vast majority of headaches are primary headaches — headaches that aren't caused by a specific medical condition. These include migraines, tension-type headaches and cluster headaches.

Cluster headache is distinctive in ways other than the severity of the pain. A striking feature of cluster headache is that the attacks occur in cyclical patterns, or clusters — which gives the condition its name. Bouts of frequent attacks, in what's known as cluster periods, may last from weeks to months, followed by remission periods when the headache attacks stop completely. Although the pattern varies from one person to another, most people have one or two cluster periods a year. During remission, no headaches occur for months, and sometimes even years.

Cluster headache is one of the most painful types of headache. Fortunately, cluster headache is rare, affecting less than 1 percent of the U.S. population. The condition is more common in men. Cluster headache can affect people at any age but is most common between adolescence and middle age.

Although cluster headache attacks are extremely painful, they're not life-threatening. Several treatments are available to help make the attacks shorter and less severe. In addition, preventive medications can help reduce the number of headaches.

There's no cure for cluster headaches. The goal of treatment is to help decrease the severity of pain and shorten the headache period.

Acute medication
The purpose of acute treatment is to stop or reduce pain after a cluster headache starts. Because the headache peaks quickly, acute medications must be fast-acting and delivered quickly, using an injection or inhaler rather than oral tablets. You must be ready to take the medication as soon as an attack starts. And you may want to teach family members about your medications so that they'll be able to help you when you have an attack.


Because the cause of cluster headache is unknown, you can't prevent a first occurrence. However, a preventive strategy is crucial for managing cluster headache because trying to treat it only with acute drugs can seem hopeless. Prevention can help reduce the frequency and severity of the attacks and the risk of rebound headaches. Preventive medications can also increase the effectiveness of acute medications.

Preventive medications for cluster headache are generally used for either a short-term (transitional) strategy or a long-term (maintenance) strategy. The short-term medications work quickly but may have undesirable side effects. Long-term medications take effect more slowly but can be used safely throughout the cluster period.

Whenever a cluster period starts, you'll likely start taking a long-term medication, many times accompanied by a short-term medication. After a couple of weeks, you'll discontinue use of the short-term medication but continue with the long-term drug.

Short-term prevention
Short-term medications can prevent headache attacks during the period of time it takes for one of the long-term drugs to become effective. The main short-term preventive medications are corticosteroids and ergotamine. A nerve block may also be effective, particularly for some people who can't tolerate the other medications.

Corticosteroids. Inflammation-suppressing drugs called corticosteroids, such as prednisone (Deltasone, Sterapred, others) and dexamethasone (Decadron), are fast-acting preventive medications. They belong to a general family of medicines called steroids. Corticosteroids may be prescribed if your cluster headache condition has only recently started or if you have a pattern of brief cluster periods and long remissions. While corticosteroids are an excellent treatment for several days, serious side effects make them inappropriate for long-term use.
Ergotamine. Ergotamine (Ergomar), available as a tablet that you place under your tongue or rectal suppository, can be taken before bed to prevent nighttime attacks. Ergot medications are effective for short periods but shouldn't be used for more than two to three weeks.
Nerve block. Injecting an anesthetic (numbing agent) into the fibers around the occipital nerve, located at the back of the head, can prevent pain messages from traveling along that nerve pathway. The occipital nerve converges with the trigeminal nerve, which connects to all the pain-sensitive structures in the skull. An occipital nerve block can be useful for temporary relief until long-term preventive medications take effect.
Long-term prevention
Long-term medications are taken during the entire cluster period. Some of people with chronic cluster headache don't respond well to the use of one long-term medication. In this situation, your doctor may recommend that you take two or more long-term medications simultaneously.

Calcium channel blockers. The calcium channel blocking agent verapamil (Calan, Covera, Isoptin) is often the first choice for preventing cluster headache, although the way verapamil works with cluster headache isn't well understood. The medication may be used from the start of a cluster period until three to four weeks after the last headache. Then its use is gradually tapered and discontinued under your doctor's direction. Occasionally longer term use is needed to manage chronic headache. Constipation is a common side effect of this medication, as well as dizziness, nausea, fatigue, swelling of the ankles and low blood pressure.
Lithium carbonate. Lithium (Lithobid), which is used to treat bipolar disorder, is also effective in preventing chronic cluster headache. Side effects include tremor, increased thirst, diarrhea and drowsiness. Your doctor can adjust the dosage to minimize side effects. While you're taking this medication, your blood will be drawn at regular intervals to check for the development of more serious side effects, such as liver or kidney damage.
Preventive medications under evaluation
Promising preventive medications for cluster headache include the hormone melatonin, capsaicin (Zostrix) — a cream that affects nerves near the skin — and anti-seizure medications such as divalproex (Depakote), gabapentin (Neurontin) and topiramate (Topamax). Injections of botulinum toxin type A (Botox), a wrinkle-smoothing drug, may provide relief for some people with cluster headache who don't respond to conventional medication.

Answer 2

Faith is almost undoubtedly right. However, severe, chronic migraines can also be a symptom (often the first symptom) of some more serious neurological conditions which CAN be treated effectively if caught early enough. I would definitely ask my doctor for a referral to a neurologist to be safe.