Cluster headache is a rare form of headache that is marked by unilateral debilitating pain. Cluster headaches derive their name from their occurrence in groups (clusters). They are also known as “suicide headaches” because of their reputation for making the suffering person exhausted and exhausted after an attack.
However, neurologists like Dr. James Berheimer, who is also certified in clinical neurophysiology and has worked in the field for almost two decades, consider this condition to be largely “non-threatening” because it does not cause any health problems. long-term. complications.
Cluster headaches involve the trigeminal nerve of the face. The hallmark symptom of cluster headache is deep, burning pain around the eye (the site of the trigeminal nerve). This period of intense pain is the attack that can occur several times during the day/week (s) / month (s), hence the name of the cluster.
Cluster headaches tend to occur five to six times more in men than in women and are more common between 20 and 40 years of age.
Cluster headaches affect approximately 0.1% of the population. These headaches can be familial and have an autosomal dominant genetic basis in some cases.
This is also supported by Dr. Bernheimer, who served as the program’s medical director. Mercy Medical Center and Greater Baltimore Medical Center. According to Dr. Bernheimer, “There is a genetic component to the headache, and often there will also be a family history of migraine.”
Cluster headaches are different from migraines in both the intensity of symptoms and the frequency of events.
According to Dr. Bernheimer, “I wouldn’t say that cluster headaches are necessarily worse (or better) than migraines. Simply different: different pattern of occurrence, slightly different treatment, and cluster headaches are less common in general and more common in men than in women, while migraines are much more common in general but affect twice more women than men.
There is no concrete evidence regarding the exact cause of cluster headache, which makes the complete treatment or prevention of a cluster headache all the more difficult. There is literature that suggests a role for part of the hypothalamus as a cause of cluster headache. Certain substances, habits and environments are also known to trigger cluster headaches.
Although over-the-counter pain relievers are often ineffective in easing the intense pain of a cluster headache, it can be prevented or reduced by using prescribed medications, abstaining and avoiding predictable triggers, and trying alternative therapies.
Let’s look at the different aspects of a cluster headache.
Cluster headaches can follow a specific pattern in each individual. This can wake a person up in the middle of the night. Several people can experience more than one attack per day, at about the same time each day. These headaches can also occur at the same time each year, especially during the fall and spring months. The model differs from person to person.
Each attack can last for days, weeks, or months before symptoms improve or go away. This period when the individual may not experience any symptoms can extend from a few months to several years before the onset of a cluster headache.
A small 10 to 20 percent of people can suffer from chronic cluster headaches that can last a lifetime or take a month or less for the symptoms to go away or go away.
Dr. James Bernheimer sheds new light on the pathology of cluster headaches. “Each headache usually lasts no more than 30 to 60 minutes, but they can recur several times during the day or usually at night. However, a patient may have a group of several brief headaches a day, daily, for several weeks, followed by intervals without any headache, “said the doctor.
What can trigger a cluster headache?
The main reason behind a cluster headache is not yet known. It is suggested that this is the result of a sudden release of biochemicals such as serotonin and histamines which act as an irritant / trigger on the trigeminal nerve.
Common triggers include:
- Physical activity, especially exercise in hot weather
- Intense light, including sunlight with high heat / temperature
- High altitudes during air travel or trekking
- Certain foods such as shellfish, smoked fish, and canned meats
- Certain medications including nitroglycerin
Dr. Bernheimer clears up any doubt about the causal relationship between eyestrain and the onset of cluster headache. According to him, “eye strain is not recognized as a possible trigger for cluster headaches.”
Signs of a cluster headache
The associated signs and symptoms that indicate a cluster headache include:
- Severe excruciating pain around one eye, radiating to the forehead, cheeks, temples and upper gum on the same side of the face.
- Nasal congestion and / or rhinorrhea.
- Agitation and agitation.
- Unilateral sweating on the forehead.
- Painful drilling which may be severe around one eye, which may become liquid or bloodshot with drooping eyelids.
- The affected side of the face may be red or reddened.
- Regular painful attacks one to three times a day, lasting from 15 to 180 minutes. Attacks can occur consecutively for 6-8 weeks.
- Photophobia may occur.
Diagnosis of a cluster headache
Your doctor will diagnose your case based on the pain, the type of attack, and the symptoms you experienced during a headache. He will physically examine your pupils and your eyelids to see if they seem different from normal.
Keeping track of your triggers can help you identify them and avoid an attack in the future. It is advisable to keep a log book and write down the details of the attacks you feel, including the severity, frequency and type of pain and anything that could be a possible trigger for your episode of headache.
Standard treatment for cluster headache
Cluster headaches cannot be resolved with over-the-counter pain relievers.
You can significantly reduce your chances of having a cluster headache episode by avoiding triggers such as alcohol, stress, high altitude, and insufficient sleep.
Your doctor may recommend the following medicines or therapies so that you can survive a cluster headache:
- Sumatriptan injections – These work by constricting the blood vessels in the brain which help block the transit of pain signals. Also used to treat migraines, injections of sumatriptan are given into the skin of the upper arm or thigh, but never into a muscle or vein. Always get these injections under the supervision of a doctor.
- Oxygen therapy – Inhaling pure oxygen can help reduce cluster headaches. A face mask is used to provide at least 7 to 10 liters per minute of oxygen for a short period of 15 minutes. You and your doctor will need to sign a home oxygen order form (HOOF) if you want a small unit at home. NOTE: Oxygen at such high concentrations is toxic to the lungs and can damage lung tissue. It should only be used for short periods (<15 minutes) once or twice a day. In fact, Dr. Bernheimer believes that “the best treatment for quickly relieving cluster headaches is oxygen, which is usually given through a nasal cannula.”
- Nasal sprays – Nasal sprays such as lidocaine can relieve the acute pain of cluster headache.
- Biofeedback ttechnical – Biofeedback has been used as therapy to reduce the frequency and severity of headaches with a positive result of 45 to 60%. Its effectiveness is supported by evidence from research conducted over the past 25 years. This alternative therapy aims to control involuntary bodily functions such as blood pressure, heart rate, muscle tension and brain wave activity.
- When combined with conventional medications, biofeedback can help control a headache.
- It includes relaxation techniques such as meditation, yoga, relaxation exercises, and concentration and focus imagery exercises.
- For most patients with headaches, a combination of electromyographic feedback (EMG) and temperature feedback is preferred.
Tips for managing a cluster headache
In addition to standard prescribed medications, you can incorporate certain lifestyle, diet and daily routine changes to overcome a cluster headache.
1. Apply a cold / hot compress
An easy solution to your cluster headache is a cold compress. The cold temperature of the ice has a numbing effect on the pain.
- Take a bag of frozen vegetables or wrap ice cubes in a washcloth. Apply this to the back of your neck. Alternatively, you can dip a washcloth in cold water and place it on your head for 5 minutes. Repeat the application several times if necessary.
The heat will help relieve muscle tension and relieve the pain of a pulsating headache.
- Take a hot shower and let the water run down your neck. This will help relax the muscles in your neck.
- Keep a cotton cloth at the back of your neck and place a bag of hot water over it. Keep it for 10 to 15 minutes.
Note: You can do any of these remedies depending on what relieves you.
2. Consider acupressure
Acupressure is a technique widely used in Chinese medicine.
Pressure is applied to specific points on the fingers and hands, called acupuncture points. Stimulating these points with pressure can help reduce pain and several other health problems.
A 2014 study published in Nursing for pain management corroborated the use of acupressure as an alternative therapy for people with chronic headaches and other traumatic pain.
Another 2010 study published in the American Journal of Chinese Medicine has demonstrated the effectiveness of acupressure therapy in reducing chronic headache compared to muscle relaxant therapy. The study was conducted for a period of one month and the acupuncture points commonly used to relieve pressure were BL2, GV20, GB20, TH21 and GB5.
Make sure acupressure is performed by an expert or under the supervision of a professional.
3. Get a massage
A gentle head massage can help ease your headaches by promoting serotonin activity and triggering serotonin receptors to reduce the frequency and symptoms of a headache.
It can also help relieve a headache by blocking the headache-induced pain signals sent to the brain.
- Using your first two fingers, gently massage your head in a circular motion. By properly pressing the pain relieving pressure points located at the base of the skull, in the corner of the eyes and between the eyebrows, you can relieve the pain.
- Alternatively, you can prepare a massage oil by mixing 2 tablespoons of hot sesame oil and ½ teaspoon of cardamom powder and cinnamon powder. Use this mixture to massage your forehead. Leave the oil mixture for a few hours.
4. Opt for chiropractic therapy
Cluster headaches can be relieved by chiropractic care by tending to the areas where the headache originates.
Chiropractic therapy is a treatment in which a practitioner helps relieve tension around the bones, joints, and muscles in the cervical area by using his hands.
The chiropractor will use different techniques to relieve the pain. These include:
- Stretch or pull muscles in various directions
- Short and clean pushing movements
- Moving joints in different positions
- Apply force in the spinal region
Note: Although this therapy is not painful, any discomfort experienced should be reported to the practitioner.
5. Think about essential oils
Essential oils are accredited with antispasmodic and anti-inflammatory properties which can have a soothing effect on your nerves and help soothe your headaches.
Note: Avoid oral consumption of essential oil to relieve cluster headaches.
5.1. Marjoram oil
The fresh and dried leaves of marjoram (Origanum majorana) give an essential oil which has analgesic properties. The oil, when massaged on the temples, has the ability to circulate blood flow.
It relaxes and calms the mind and body and helps reduce stress and anxiety.
- Add it to your bath water or use it to massage your head.
5.2. Rosemary oil
Rosemary oil contains soothing and anti-inflammatory properties due to its main bioactive ingredient – rosmarinic acid. These properties can help relieve a headache.
A 2013 study published in food chemistry said rosemary has anti-inflammatory and pain relieving properties, making it an appropriate choice for treating headaches.
- Mix a few drops of rosemary oil in 1 tablespoon of carrier oil and use the oil mixture to massage your temples.
Note: Rosemary oil is not recommended for people with high blood pressure or epilepsy.
5.3. Peppermint oil
Peppermint oil has a rich composition of menthol which is known to have an analgesic effect on headaches. It works by opening blocked blood vessels which are known to cause a cluster headache.
A 2016 study pointed out that a 10 percent solution of peppermint oil in ethanol can effectively treat headaches in children over 6 years of age as well as in adults.
- Add 3 drops of peppermint essential oil to 1 tablespoon of almond oil or olive oil. Use this oil mixture to massage your temples.
- You can also put coarsely ground peppermint leaves on your forehead.
- Otherwise, inhale the vapor. In a small pot of boiling water, add a few drops of peppermint essential oil. Inhale the vapors from the pan for a few minutes.
5.4. Lavender oil
Lavender essential oil is a soothing remedy to relieve a cluster headache.
A 2013 study published in Complementary and evidence-based alternative medicine accredited lavender oil with analgesic properties.
- Coat a handkerchief with a few drops of lavender essential oil. Smell this fabric throughout the day.
- You can also do steam inhalation. To 2 cups of boiling water, add 2 drops of lavender essential oil. Inhale the vapors.
- In 1 tablespoon of carrier oil such as almond oil or olive oil, add 2 to 3 drops of lavender essential oil. Use this oil mixture to massage your forehead.
5.5. CBD oil
The application of CBD oil (Cannabidiol) can influence the vast network of an individual’s endogenous endocannabinoid system to improve many types of headaches, including cluster headaches.
6. Lifestyle changes
6.1 Drinking sufficient amounts of water
Drinking little or no water is associated with headaches. If you are used to not drinking enough water a day, you may become dehydrated, which can lead to headaches.
A 2015 study published in the Journal of Evaluation in Clinical Practice links the role of chronic mild dehydration as a possible trigger for headaches. Such headaches can be prevented by increasing a person’s water consumption.
If you have a headache, be it a migraine or cluster headache, be sure to drink plenty of water.
- In addition to drinking the 8 glasses of water required per day, you can also consume coconut water, lemon water and ORS to avoid dehydration.
- Eat fruits and vegetables that contain a huge percentage of water like watermelon, spinach and cucumber, to name a few.
6.2 Avoid food triggers
Some people may have a headache when eating certain foods. Once you have identified these food triggers, you can easily avoid their consumption to avoid a headache. These triggers include:
- Alcoholic beverages
- Artificial sweeteners
- Monosodium glutamate
- Foods rich in nitrite in wine, deli meats, aged cheeses and certain medications
- Caffeinated drinks like tea, coffee and cola
Many people use caffeine to cope with a bad migraine episode, but Dr. Bernheimer says, “I’m not sure caffeine helps migraine.”
Several other common foods that can cause headaches in sensitive people include dairy products, chocolates, meat, wheat, shellfish, nuts, peanuts, bananas, onions, eggs and citrus fruits.
6.3. To do yoga
Yoga is an alternative therapy practiced for centuries to manage chronic pain. It is a combination of various postures and deep breathing exercises that promote an individual’s overall health.
A 2015 study published in the Journal of Physical Therapy Science corroborated that yoga should be used as an adjunct therapy to help relieve the frequency and intensity of headaches.
Yoga has no side effects as a treatment for headache relief. You can include the following simple yoga poses for a few minutes each day to relieve your headaches and prevent them from happening:
- Marjariasana (Cat Stretch)
- Paschimottanasana (two-legged front elbow)
- Adho Mukha Svanasana (Downward Facing Dog Pose)
- Setu Bandhasana (bridge laying)
- Shishuasana (child’s pose)
- Padmasana (Lotus Pose)
- Hastapadasana (forward turn)
- Shavasana (dead body)
6.4 Stop smoking
Smoking can trigger a headache.
In addition, exposure to second-hand smoke is harmful and can have side effects such as narrowing of blood vessels and triggering a headache.
People with cluster headaches should avoid second-hand smoke or quit smoking completely. This can reduce the onset of headaches.
7. Food supplements
7.1 Include magnesium in your diet
Magnesium is an essential nutrient that helps regulate various metabolic processes and the nervous system.
The recommended dose of 300 to 400 mg / day of magnesium is sufficient for your daily intake.
Magnesium deficiency has been associated with headaches and migraines.
According to a 2015 study published in Nutrients, lower magnesium levels may be linked to several illnesses.
- Enrich your diet with foods rich in magnesium such as sesame seeds, sunflower seeds, almonds, oatmeal, eggs, peanut butter and milk.
- Magnesium supplements can have side effects on digestion; therefore, consult your doctor for approval.
7.2 Take melatonin
Melatonin is the hormone that helps regulate your sleep cycles and hormone levels. Sleep hygiene and its disturbances are linked to the initiation and recurrence of cluster headaches.
Some studies have also reported that people with cluster headaches may have decreased melatonin levels. However, melatonin can only help when taken before the onset of the cluster headache episode.
Melatonin can improve the quality of your sleep. People who have trouble sleeping are often recommended to take melatonin supplements. It can be useful as an adjuvant treatment for cluster headaches.
Since cluster headaches tend to occur at night, peaceful sleep can help prevent them from happening.
7.3. Think cayenne pepper cream / capsaicin
Cayenne pepper contains a compound called capsaicin which can stimulate blood circulation and relieve the pain of a headache.
Bioactive capsaicin can also help relieve cluster headaches by reducing the associated inflammation.
- Consider taking capsaicin supplements after your doctor’s approval.
- Alternatively, you can make a cayenne pepper drink by mixing ½ to 1 teaspoon of cayenne pepper powder, a few drops of lemon juice and ½ teaspoon of honey to 1 cup of warm water. Drink this solution to reduce the pain of a cluster headache.
7.4 Consult your doctor for vitamin supplements
About 80 percent of people with existing cluster headache experience an increased incidence of cluster headache due to seasonal changes.
Weather changes with a decrease in the availability of sunlight can lead to a decrease in vitamin D synthesis. Researchers have suggested that depleted levels of vitamin D may play a role in inducing chronic headaches, including cluster headaches.
Incorporate a large dose of vitamin B2 in the diet has been reported to reduce the incidence of headaches. Administer 500 mg of vitamin B2 every day for a month would have avoided headaches.
- Include foods rich in vitamin D, including milk, eggs and fish such as tuna, salmon and mackerel.
- Eat foods rich in vitamin B2, including beans, seeds, nuts, organ meats, legumes and green leafy vegetables.
- Otherwise, watch your vitamin D and vitamin B levels. Low levels of these vitamins can be taken care of with supplements approved by your doctor.
7.5 Consume psilocybin mushrooms
Psilocybin mushrooms can help reduce the intensity and even wipe a cluster headache for weeks or months.
The positive effect of psychedelics, such as psilocybin mushrooms, on people with cluster headaches is pretty clear.
Psilocybin mushrooms act like a hallucinogen and can help treat a cluster headache. However, do not consume them in excessive amounts and avoid them if you suffer from a mushroom allergy.
There are several remedies that have not been studied enough to be supported by evidence, but that require mention because of their popularity among people as a solution to their health problems.
Although doctors do not appreciate the use of the options listed below, they have been widely used as a remedy for older women to calm an existing headache and stop a cluster headache.
1. Inhale the steam from the apple cider vinegar
Apple cider vinegar has been used for centuries for its varied health benefits.
You can soothe your nagging headaches by inhaling the fumes of apple cider vinegar.
- Fill half a bowl with boiling water and add ¼ cup of apple cider vinegar.
- Use a towel to cover your head, lean over the bowl and inhale the vapors while breathing deeply. Make sure to keep your face at a safe distance to avoid burns.
- Do this for 5-10 minutes.
2. Apply a sandalwood paste
Sandalwood paste has been used as an age-old remedy to help soothe a cluster headache. It can help alleviate headaches by soothing tense nerve endings in the optic region.
- Using a little water and ½ teaspoon of sandalwood powder, make a paste. Apply a thin layer of this paste on your forehead. Keep it for 20 minutes before rinsing it off with cold water.
3. Drink a cup of herbal tea
Chamomile has anti-inflammatory, antispasmodic and soothing properties that help relieve headaches. Drinking chamomile tea regularly can also help prevent the problem.
- Soak 2 to 3 teaspoons of dried chamomile flowers in 1 cup of hot water for a few minutes. You can also add lemon juice and honey. Strain the liquid and drink this tea three or four times a day to relieve the symptoms of migraine.
- Another option is to infuse equal amounts of chamomile, horse chestnut and meadowsweet in 1 cup of hot water for at least 5 minutes. Filter the liquid and drink it. Repeat as needed.
Ginger contains bioactive compounds called gingerols. These have potential anti-inflammatory and antioxidant properties that have a therapeutic effect on pain.
Ginger can help relieve pain and nausea, which are signs of an impending cluster headache.
- Drink ginger tea twice a day to help reduce the symptoms of a cluster headache.
Types of cluster headaches
Cluster headaches can be classified into two distinct types depending on the model:
- Episodic cluster headaches – These are marked by sudden attacks that last for short periods, ranging from 15 minutes to 3 hours. Although these attacks are short-lived, the frequency can range from 1 to 8 attacks per day, which last from weeks to months. Headaches can be predicted by keeping in mind when the headache usually strikes. Each attack can be separated by a symptom-free period.
- Chronic cluster headaches – These headaches are chronic and are marked by long durations of severe headaches. The individual suffers from a continuous bunch of cluster headaches with no symptom free periods in most cases. In some cases, the symptom-free periods are very short and last less than a month over a period of one year.
When to consult a doctor
Seek immediate medical help when you experience the following warning signs:
- Vision changes
- Engourdissement ou incapacité à bouger
- Envie de dormir
- Nausées ou vomissements prolongés
- Augmentation de la fréquence, de la durée et de la gravité des céphalées en grappe
Bien que les céphalées en grappe soient incurables en soi, vous pouvez prendre des mesures pour réduire l’inconfort associé et prévenir leur récurrence.
Il est conseillé de garder un œil sur les déclencheurs et d’être attentif aux symptômes.
En plus des médicaments conventionnels prescrits par votre médecin, développez de saines habitudes de vie, suivez des thérapies alternatives, obtenez un massage et incorporez des changements dans votre alimentation pour limiter l’inconfort et la gravité d’un mal de tête en grappe.
Réponses d’experts (Q&R)
Répondu par le Dr Ajeet Sodhi, MD (neurologue)
Combien de temps dure un mal de tête en grappe?
Les maux de tête en grappe sont l’une des formes de maux de tête les plus douloureusement graves, qui peuvent durer de 10 minutes à plusieurs heures.
Quels sont les déclencheurs les plus courants pour les maux de tête de cluster?
Les déclencheurs courants des céphalées en grappe comprennent l’alcool, certains médicaments vasodilatateurs tels que la nitroglycérine et l’exposition à la fumée de tabac.
Les céphalées en grappe peuvent-elles endommager le cerveau?
Les maux de tête en grappe n’endommagent pas le cerveau. Cependant, ils sont généralement parmi les pires syndromes de douleur aux maux de tête qui existent, et pour cette raison, ils sont souvent appelés «maux de tête par suicide».
La caféine peut-elle aider à soulager un mal de tête en grappe?
La caféine peut être utile pour les migraines mais n’est généralement pas utile pour les céphalées en grappe.
Veuillez fournir quelques conseils importants à retenir lorsque vous souffrez de céphalées en grappe.
Les céphalées en grappe ont certains traitements disponibles. Il est important de rechercher un neurologue qualifié dans le traitement des maux de tête. Les personnes souffrant de maux de tête en grappe se rendent souvent pendant de longues périodes sans diagnostic confirmé, ce qui peut entraîner des souffrances inutiles. Il est également important d’éviter les déclencheurs.
À propos du Dr Ajeet Sodhi, MD: Le Dr Sodhi est directeur des soins neuro-critiques au California Institute of Neuroscience. Il a suivi une formation en neurologie après avoir obtenu son diplôme du Medical College of Virginia et s’est spécialisé dans les accidents vasculaires cérébraux et les maladies vasculaires, les soins neurocritiques et la chirurgie endovasculaire neurointerventionnelle.
En plus de sa formation en surspécialité neurologique, le Dr Sodhi a un intérêt significatif dans le nouveau domaine de la neurorégénération et des thérapies peu orthodoxes, en particulier pour les conditions dans lesquelles les traitements actuels sont limités.
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