Neurology - Cluster Headaches Flashcards
What are cluster headaches?
Severe and unbearable unilateral headaches, usually centred around the eye
Why are they called cluster headaches?
They come in clusters of attacks and then disappear for extended periods
What is a typical pattern of cluster headaches?
3-4 episodes a day for weeks or months, followed by a pain-free period lasting several years
How long do cluster headache attacks typically last?
Between 15 minutes and 3 hours
What is the typical demographic for cluster headache patients?
30-50 year old male smokers
What are common triggers for cluster headaches?
Alcohol
Strong smells
Exercise
What is the severity of pain associated with cluster headaches?
Severe pain, sometimes called ‘suicide headaches’
What are some associated symptoms of cluster headaches?
Typically unilateral symptoms including:
* Red, swollen and watering eye
* Pupil constriction (miosis)
* Eyelid drooping (ptosis)
* Nasal discharge
* Facial sweating
What are the treatment options during acute attacks of cluster headaches?
Triptans (e.g., subcutaneous or intranasal sumatriptan)
High-flow 100% oxygen (can be kept at home)
What is the first line treatment for prophylaxis of cluster headaches?
Verapamil
What are other options for prophylaxis of cluster headaches?
- Occipital nerve block
- Prednisolone (e.g., a short course to break the cycle during clusters)
- Lithium
