RECURRING NIGHTMARE
Cluster headaches tend to occur on one side of the head and can return for days or even weeks,
CLUSTER headaches may be more common in men, but are more severe in women, according to new research.
These short, painful headaches occur in a row – sometimes for days or weeks, lasting between 15 minutes and three hours.
A new study from the Karolinska Institutet in Stockholm, Sweden, surveyed 874 people diagnosed with cluster headaches, with 66% male and 34% female. It found 18% of women were diagnosed with chronic cluster headache, compared to 9% of men, with attacks also lasting longer for women.
Here’s everything you need to know about these headaches...
What are cluster headaches?
“Cluster headaches are, for most people, an extremely severe headache disorder,” explains Dr Nicholas Silver, consultant neurologist at The Walton Centre NHS Foundation Trust (thewalton centre.nhs.uk).
“It typically causes unilateral attacks – on just one side of the head – with severe pain, a sense of restlessness and agitation and prominent puffy, droopy, red eyes, tearing, stuffy or runny nose, flushing, sweating, a sense of fullness in the ear or tinnitus.
“The condition often causes severe mood disturbance and can lead to suicidal thoughts.” Speak to your GP if you are concerned about any of these symptoms.
Do they follow a pattern?
“Cluster headaches may be episodic, causing recurrent attacks over weeks to months,” says Dr Silver. They are often classed as chronic when “attacks are ongoing without a significant break for over a year”. He also suggests the time of the year could play a part, as bouts “are more likely to occur at certain times of the year – for example, spring or autumn”.
He continues: “It is thought that an area of the brain called the hypothalamus is involved in generating the symptoms of cluster headache, and this area has clock-like functions – which may explain why cluster bouts may be seasonal.”
Who might get them?
“Cluster headaches tend to affect men more than women, with 70% of those affected being male,” suggests Dr Simon Erridge, head of research and access at Sapphire Medical Clinic (sapphireclinics.com).
“The peak of onset of cluster headache is between 20-40, reducing in incidence in later years.”
How can they be treated?
“It is always important to consult a health professional for a full evalua tion,” says Dr Erridge. “Whilst awaiting this, it is really useful to consider if there are any triggers or exacerbating factors. Two key factors are reducing or stopping smoking and drinking alcohol.”
According to the NHS, over-thecounter medication like paracetamol isn’t effective in treating cluster headaches. “Patients with cluster headaches should be referred to a neurologist,” advises Dr Silver. “To treat individual attacks we give sumatriptan 3mg injections – up to four injections a day using a special auto-injector into the thigh. A high flow 100% oxygen through a sealed mask may be helpful.
“As neurologists, we also have a number of other therapies which can be very effective. Patients [may] need mental health support.”
However, Dr Erridge adds: “There [may be] a need for further options for patients as a number of patients still suffer.
“These include surgical options and emerging medications, such as medical cannabis.”
Why might people struggle to get a diagnosis?
Cluster headaches are rare. Dr Silver says: “Most GPS will only see one or two patients with this in their whole career. Patients are not usually in attacks when seen, but seeing a patient in an attack makes it far more obvious, as doctors can then see the typical severe restlessness and agitation and the prominent cranial autonomic signs affecting eyes or nose.”