How to tell if it's cluster headache

To know if it is cluster headache, one must pay attention to the characteristic symptoms of this disease and be evaluated by a neurologist. Because it is a rare disease, not all doctors know or know how to treat cluster headaches and therefore the diagnosis may take time to arrive.

Informing the doctor exactly what you feel is essential so that the headache is not treated as a simple migraine, because the treatment of these two diseases is different.

Symptoms and characteristics of cluster headache

The signs and symptoms of cluster headache are:

• Excruciating pain on one side of the face, which appears overnight; Redness in the eye on the affected side; Nose running down the nostril on the affected side; Excessive tearing of the eye on the affected side; Swelling around the eye on the affected side; Difficulty opening the eye completely on the affected side; The person's expression is of intense pain; the pain can be throbbing and the person complains that it looks like there is a knife in the head; it is not known when a crisis period will start; the pain can last from 15 minutes to 3 hours, but more common is that it lasts up to 40 minutes; the headache is disabling and, therefore, the patient is unable to engage in any type of activity; the pain is more frequent during the night and appears 1 to 2 hours after bedtime; after the decrease in pain, discomfort remains for some time in the affected region.

Before being diagnosed the person may doubt whether he is having a stroke or a brain tumor, due to the intensity of the symptoms. No painkiller is effective and can relieve this headache, only the medications indicated by the doctor can be useful to shorten the time of a headache episode and shorten a crisis period that can last for 20 days.

Cluster headache manifests itself through a fundamental characteristic, which is the onset of symptoms, 2 to 4 times a day, for a period of 2 to 3 weeks a year. After the last headache ceases, the crisis goes away for months or years. Thus, the person may have 3 or 4 moments of intense headache, totally incapacitating, per day, for about 20 days and then the pains can disappear completely for 1 year or more, until there is a new outbreak.

Differences in migraine cluster headache

Migraine	Cluster headache
Affects more women	More common in men
Food and light get worse	Do not interfere
Being quiet helps to improve	The person cannot be quiet
The pain remains for days	Pain ceases after 40 minutes
Pain is diffuse	Pain affects only 1 side of the face
It appears in adolescence	It appears around the age of 30
Pain relievers fight pain	Painkillers do not cease the pain
It may appear several times a year	Seizures are 2 to 3 times a year
Sleep relieves pain	Pain can start during sleep
Redness in both eyes	Redness in only 1 eye
There is no nasal discharge	One nostril always runs during pain

What to do to fight pain

There is no treatment that is completely effective and that completely eliminates the pain, nor the period of crisis, but there are remedies and strategies that can help you feel better:

At the time of pain you can resort to:

• Use 100% oxygen mask for about 10 minutes when the pain starts, this reduces the pain time to less than 10 minutes, bringing great relief to the person; Use medications in the form of nasal spray or tablet that dissolves in under the tongue because they are more effective than ordinary pills. Some examples are ergotamine or lidocaine hydrochloride in nasal drops; Put an ice bag on your head and keep moving or sitting with your feet in a bucket of hot water;

During the days when you are in crisis:

Take the remedies indicated by the neurologist, such as:

• Sumatriptan; Prednisone + verapamil; Methysergide; Lithium or valproic acid.

Acupuncture can be a good option to combat stress, anxiety and rebalance the person during crises, improving how they feel between each episode of pain. The sessions can be held on alternate days or daily and depending on how the person is doing, several needles located on the head, trunk and feet can be used. Some hurt more than others but it is bearable and the treatment improves well-being.

When the seizures are very close to each other and the person cannot maintain a good quality of life and cannot work, if he has not found improvement in symptoms with all these drugs, the neurologist may indicate that brain surgery is performed which can be useful to end crises. However, this must be the last approach because it is risky.