Headache Types

Question 1

What is the frequency of cluster headaches?

Answer 1

Typically occur in clusters lasting several weeks, with clusters typically once a year.

Question 2

What is the epidemiology of cluster headache?

Answer 2

Men 3 > 1 Women
Smoking
Alcohol can trigger attacks

Question 3

What are the features of a cluster headache?

Answer 3

Pain 1-2 TD, episodes lasting 15m-2h.
Clusters typically last 4-12 weeks.

Intense sharp, stabbing pain around one eye (recurrent attacks around same eye)
Restlessness and agitation
Eye redness, lacrimation and lid swelling
Nasal stuffiness
Miosis and ptosis in minority

Question 4

What is the acute management of cluster headaches?

Answer 4

100% oxygen (80% response rate in 15 minutes)
Subcutaneous triptan (75% response rate in 15 mins)

Question 5

What is the prophylactic management of cluster headaches?

Answer 5

Verapamil
(Potentially tapering dose of prednisolone)

(Neuroimaging may be suggested)