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HeadWay, Issue #036 -- Focus on Cluster
July 21, 2006

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In this month's issue:

Focus on Cluster

Our first community article!

Say what?! Clusterhead

Correction: Special thanks to Dawn, a HeadWay subscriber, who caught a mistake in the last issue. I called tyramine an amino acid, which it is not. It's actually called an amine or monoamine, an organic compound which helps to make up the various kinds of amino acids. In this case, as Dawn said, tyramine "is actually a breakdown product of Tyrosine, which IS an amino acid". For more, read this migraine news entry.

Focus on Cluster

It's about time we stopped and focused on cluster headaches again. For years I had no idea what they were, or what the word "cluster" referred to, and I know there are many in the same boat. This mysterious debilitating condition impacts the life of the sufferer in ways most of us can't even imagine.

What is a cluster headache?

As with migraine, it's believed that cluster "headache" is a bit of a misnomer, because the headache is only one symptom. In fact, you could say it's only a possible symptom, though it seems at this point more common for a cluster sufferer to have a headache than a migraine sufferer. Also as with migraine, we need to talk in general terms - everyone is different, and symptoms vary a great deal.

The term cluster doesn't refer to where the pain is, as I once thought, but to the cycles in the time line. Cluster attacks are usually short, reaching their peak within 5-10 minutes, then lasting only about an hour. They're called clusters because the attacks come in clusters - you may get 1-8 attacks a day, for days or weeks, then nothing for months or even years. Chronic clusters can develop, when the attacks go on for a year or more with 2 weeks or less total time without attacks.

That may sound bad enough, but cluster headaches are generally more painful than migraine. The pain is one-sided, on the temple or around they eye or jaw. The eyes water, you sweat, your eyelid may droop, or even swell up. While a migraineur typically likes to lie down in a quiet room, a cluster sufferer becomes agitated and would rather walk around. As I write this is all sounds so peaceful - I can't describe in words the incredible agony of the cluster attack. They have been rightly called suicide headaches.

Where do they come from?

Causes of cluster are not totally understood. We do know that more men than women have cluster (the opposite of the migraine statistics). Cluster has been associated with some of the natural cycles of the body, and so, like migraine, have been connected to sleep patterns and serotonin. The hypothalamus, the body's clock, has been a prime suspect because of the way clusters come in cycles. Various parts of the nervous system are activated during an attack, causing some of the crazy symptoms that go along with cluster. Check out this article for more on the causes of cluster.

Treatment of cluster

Drs Young and Silberstein write in Migraine and Other Headaches,"Cluster headache is a medical emergency. Because of the incredible pain and the desperate knowledge that the pain will recur again and again, people need rapid and effective treatment."

Treatment includes giving oxygen, triptans (such as sumatriptan), Dihydroergotamine, capsaicin cream, and lidocaine. There is also preventative treatment for cluster, which include corticosteroids (often given to reduce swelling and suppress the immune response) and ergotamine, though these are still only short term solutions. Also used are verapamil, lithium, divalproex sodium, topiramate, and melatonin. Surgery may also be considered, which involved implanting some types of stimulators. (read more about cluster treatments)

More on cluster

For more on cluster, visit the Worldwide Cluster Headache Support Group. Right on the front page you can read stories from actual sufferers. We also have some cluster bloggers on our migraine blogs, headache blogs page. These include A ClusterHead's Life and Doc's Cluster Headache Journal.

Our first community article!

Our first community article is off to a running start, thanks to the response of so many of you from all around the world! I've already posted a few of your responses to the question, What non-drug methods help you get to sleep when you're having a headache/migraine attack?

The question is still online, so if you have some more ideas you call still stop by. Soon I'll be posting a new question, and a new community article will be started! Check out the main community articles page here.

By the way, sleep can be an added problem for a cluster sufferer, because the pain often starts after an hour or two of sleep. Check out this post about one experience with cluster and sleep.

Say what?! Clusterhead

Clusterhead is what cluster sufferers often call themselves. Clusterhead is to clusters what migraineur is to migraine.
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