Why must I just read this?
Somebody has most likely given you this note to describe just a little in regards to acondition they are afflicted by known as Cluster Headache Syndrome. Chances are thatbefore you decide to met them, you'd never heard about this problem, which, in the end,affects under 1% from the population.
Since it is so rare, sufferers frequently feel isolated, especially through misunderstanding by individuals who don't fully appreciate its effects. This short explanation is supposed to assist with that.
What exactly is it?
The word “headache” is extremely misleading. Your friend or colliege isn't
going through the normal signs and symptoms of familiar primary head aches, for example Migraine and Tension. Cluster Headache (CH) includes a prevalence of
roughly 69 cases per 100,000 people, even though it might be much greater.
The reason and cure of Cluster Headache Syndrome are unknown. Cluster
Headache sufferers fall under two groups: Episodic and Chronic. Episodic
sufferers experience head aches in groupings for a time of typically six days to
six several weeks be going into periods of remissions typically lasting from six several weeks to three years. Chronic sufferers experience no periods of remission staying longer than two days at that time of 1 year.
A CH attack is unilateral (one on the sides). Discomfort can start around one eye, “Like a nail or knife stabbing and piercing” the attention, or as though someone “were tugging out”your skills. It might be supported with a tearing or bloodshot eye, drooping eye lid,dilated pupil and nasal congestion or runny nose along the side of the attack. It may radiate in the eye towards the temple, temple, ear, oral cavity, jaw and neck about the same side. The discomfort of the CH continues to be referred to as piercing or boring and thus excruciating that many sufferers cannot sit still and feel compelled to rock inside a chair,
walk backwards and forwards, or bang their heads against something. The discomfort is really extreme that Dr. Peter Goadsby, Professor of Clinical Neurology at College College, London, and also the mobile phone industry's leading investigator on CH has said,“Cluster headache is most likely the worst discomfort that humans experience. I understand that’s a significant strong remark to create, but when you request a cluster headache patient if they’ve were built with a worse experience, they’ll globally say they haven’t. Women with
cluster headache will explain that the attack is worse than having a baby. To help you suppose these folks give birth without anesthetic a couple of times each day, for six, eight or ten days at any given time, after which possess a break. It’s just awful.” Most CH sufferers experience these attacks 2 to 10 occasions daily. The discomfort rapidly gets worse from no discomfort to intolerable discomfort within 5 minutes. The discomfort subsides within the
in an identical way. Attacks lasts between half an hour to three hrs or even more.
Individuals bald details, though, don't do justice towards the discomfort experienced. A far more sinister reputation for a CH is “suicide headache” - for apparent reasons. A lot more than 1 / 2 of all sufferers have thought about this.
A curiosity of Cluster Headache Syndrome is the fact that both individual attacks and the groupings themselves might have a nearly metronomic regularity - attacks beginning in a precise time are normal.It's a headache, for the reason that the discomfort is incorporated in the mind, but that's where the similarity finishes. The title itself results in confusion, as people immediately think
from it as something that may be cureby going for a pill, or by considering it as being a migraine.
Selasa, 24 Mei 2011
Cluster Headaches
Pathogenesis and Pathophysiology The pathogenesis of cluster head aches is not fully determined.Cluster occasions might be associated with modifications within the circadian pacemaker,which might be because of hypothalamic disorder. Attacks increase following the start and finish of daylight savings time, and there's a loss of revenue of circadian rhythm for bloodstream pressure, temperature, and the body's hormones, including prolactin, melatonin, cortisol, and beta hormones. Neurogenicinflammation, carotid body chemoreceptor disorder, central parasympathetic and supportive tone discrepancy, and elevated responsiveness to histamine happen to be suggested as the reason for cluster discomfort.
Epidemiology and Risk Factors.
By having an incidence of .01 to at least one.5 percent in a variety of populations, cluster headache prevalence is gloomier compared to migraine or Tension Type Headache (TTH). Prevalence is greater in males compared to ladies and in black patients in comparison with whitened patients. A mans-to-female ratio is all about 6:1. A household good reputation for cluster headache is rare. The most typical type of
cluster headache is episodic cluster. The rarest form is chronic cluster headache without remissions, with no more than 10 % of patients struggling with this number of cluster. Cluster headache can start at any
age, however it generally starts within the late twenties. Cluster headache rarelystarts in early childhood, in support of about 10 % of patients develop cluster when they're within their sixties.
Epidemiology and Risk Factors.
By having an incidence of .01 to at least one.5 percent in a variety of populations, cluster headache prevalence is gloomier compared to migraine or Tension Type Headache (TTH). Prevalence is greater in males compared to ladies and in black patients in comparison with whitened patients. A mans-to-female ratio is all about 6:1. A household good reputation for cluster headache is rare. The most typical type of
cluster headache is episodic cluster. The rarest form is chronic cluster headache without remissions, with no more than 10 % of patients struggling with this number of cluster. Cluster headache can start at any
age, however it generally starts within the late twenties. Cluster headache rarelystarts in early childhood, in support of about 10 % of patients develop cluster when they're within their sixties.
Clinical Features and Associated Disorders
Patients with cluster headache have multiple instances of short-resided but
severe, unilateral, orbital, supraorbital, or temporal discomfort. A minumum of ne from the following connected signs and symptoms must occur: conjunctival injection, lacrimation, nasal congestion, rhinorrhea, facial sweating, miosis, ptosis, or eye lid edema. Episodic cluster includes headache periods of just one week to at least one year, with remission periods lasting a minimum of fourteen days, whereas chronic cluster headache has either no remission periods or remissions that last under fourteen days.
The discomfort of the cluster attack quickly increases (within fifteen minutes) to excruciating levels. The attacks frequently occur simultaneously every day and frequently awaken patients from sleep. When the condition remains without treatment, the attacks usually last from 30 to 1 hour 30 minutes, but may last as much as 180 minutes.
The discomfort is deep, constant, boring, piercing, or burning in character, situated in, behind, or round the eye. It might radiate towards the temple, temples, jaws,nostrils, ears, neck, or shoulder. Throughout a panic attack, patients frequently feel irritated or restless and want to isolate themselves and move around. Intestinal signs and symptoms are uncommon. The attack frequency differs from one every second day to eight each day, occurring in cluster periodsthat serve you for a week to some year. Remission between cluster periods generally lasts 6 several weeks to two years. Most sufferers have a couple of cluster periods a year that last two to three several weeks, with one or two attacks daily.
Peptic ulcer disease may be the only known connected medical disorder. Secondary cluster-like headache may occur because of structural lesions near the cavernous head. Differential Diagnosis. The differential proper diagnosis of cluster eadache includes chronic paroxysmal hemicrania, migraine, trigeminal neuralgia
(TN), temporal arteritis, pheochromocytoma, Raeder's paratrigeminal syndrome, Tolosa-Search syndrome, sinus problems, and glaucoma. Raeder's syndrome has qualities much like cluster head aches. It might be connected with severe iscomfort, unilateral and supraorbital distribution, as well as an connected partial Horner's syndrome. It's distinct from cluster headache for the reason that you will find no distinct attacks and also the discomfort is onstant.Evaluation. You will find no studies that address the requirement for testing in cluster-like headache. Generally, a careful history is that's neededto create diagnosing. MRI from the mind is justified only in atypical cases or cases by having an abnormal nerve examination (except once the abnormality is really a Horner's syndrome).
severe, unilateral, orbital, supraorbital, or temporal discomfort. A minumum of ne from the following connected signs and symptoms must occur: conjunctival injection, lacrimation, nasal congestion, rhinorrhea, facial sweating, miosis, ptosis, or eye lid edema. Episodic cluster includes headache periods of just one week to at least one year, with remission periods lasting a minimum of fourteen days, whereas chronic cluster headache has either no remission periods or remissions that last under fourteen days.
The discomfort of the cluster attack quickly increases (within fifteen minutes) to excruciating levels. The attacks frequently occur simultaneously every day and frequently awaken patients from sleep. When the condition remains without treatment, the attacks usually last from 30 to 1 hour 30 minutes, but may last as much as 180 minutes.
The discomfort is deep, constant, boring, piercing, or burning in character, situated in, behind, or round the eye. It might radiate towards the temple, temples, jaws,nostrils, ears, neck, or shoulder. Throughout a panic attack, patients frequently feel irritated or restless and want to isolate themselves and move around. Intestinal signs and symptoms are uncommon. The attack frequency differs from one every second day to eight each day, occurring in cluster periodsthat serve you for a week to some year. Remission between cluster periods generally lasts 6 several weeks to two years. Most sufferers have a couple of cluster periods a year that last two to three several weeks, with one or two attacks daily.
Peptic ulcer disease may be the only known connected medical disorder. Secondary cluster-like headache may occur because of structural lesions near the cavernous head. Differential Diagnosis. The differential proper diagnosis of cluster eadache includes chronic paroxysmal hemicrania, migraine, trigeminal neuralgia
(TN), temporal arteritis, pheochromocytoma, Raeder's paratrigeminal syndrome, Tolosa-Search syndrome, sinus problems, and glaucoma. Raeder's syndrome has qualities much like cluster head aches. It might be connected with severe iscomfort, unilateral and supraorbital distribution, as well as an connected partial Horner's syndrome. It's distinct from cluster headache for the reason that you will find no distinct attacks and also the discomfort is onstant.Evaluation. You will find no studies that address the requirement for testing in cluster-like headache. Generally, a careful history is that's neededto create diagnosing. MRI from the mind is justified only in atypical cases or cases by having an abnormal nerve examination (except once the abnormality is really a Horner's syndrome).
Senin, 23 Mei 2011
Classification of Cluster Headache
sumatriptan or DHE mesylate provide significant relief for about 80 percent
of patients. An intranasal local anesthetic may provide relief for some
patients.
Classification of Cluster Headache
According to its duration, the International Headache Society (IHS)
classifies CH into episodic and chronic.
Episodic CH occurs in periods (clusters) lasting in duration from 7 days to
1 year, but separated by pain-free intervals lasting at least 2 weeks in
duration. Typically, a cluster lasts 2 weeks to 3 months.
Chronic Cluster Headache
Chronic Cluster headache is defined as that occurring for more than 1 year
without remission or without remissions lasting less than 2 weeks. It is
subdivided into chronic CH from onset and chronic CH evolving from
episodic. Chronic CH is notoriously difficult to treat and resistant to
standard prophylactic agents.
of patients. An intranasal local anesthetic may provide relief for some
patients.
Classification of Cluster Headache
According to its duration, the International Headache Society (IHS)
classifies CH into episodic and chronic.
Episodic CH occurs in periods (clusters) lasting in duration from 7 days to
1 year, but separated by pain-free intervals lasting at least 2 weeks in
duration. Typically, a cluster lasts 2 weeks to 3 months.
Chronic Cluster Headache
Chronic Cluster headache is defined as that occurring for more than 1 year
without remission or without remissions lasting less than 2 weeks. It is
subdivided into chronic CH from onset and chronic CH evolving from
episodic. Chronic CH is notoriously difficult to treat and resistant to
standard prophylactic agents.
Systemic cluster-like headache
Systemic cluster-like headache should be suspected if the presentation is
atypical. Atypical features may include Absence of a periodic pattern
Residual headache between exacerbations Incomplete or minimal response
to standard therapy Presence of lateralizing findings on exam (except for
those of CH-related Horner's syndrome)
Most patients with cluster headache require preventive treatment because
each attack is too short in duration and too severe in intensity to treat with
only abortive medication. In addition, ergotamine, DHE, sumatriptan, and
oxygen may just postpone rather than abort the attack. Preventive therapy
for episodic cluster, in order of preference, includes ergotamine, calcium
channel blockers, methysergide, lithium, corticosteroids, divalproex, and
capsaicin. Occasionally, indomethacin is effective. If medical therapy fails
completely, surgical intervention may be beneficial for the psychologically
stable patient with strictly unilateral chronic cluster. The surgery consists
of neuronal ablation procedures directed toward the sensory input of the
trigeminal nerve and autonomic pathways, and is generally effective in 75
percent. The prognosis of cluster headaches is guarded; it is a chronic
headache that may last for the patient's life. Drug therapy may help convert
some patients from chronic to episodic cluster.
Cluster headache is a vascular condition related to migraines. It relates to
migraine in certain aspects of it pathogenesis and, consequently responds
to some of the same medications. It differs from migraine in other aspects
of its pathogenesis as well as in many apspects of its clinical presentation.
Cluster headache is also, by far, not as common as migraine and,
according to a population study, affects less than one out of 1,000 people.
As opposed to migraine, it affects mostly men with a male to female ratio of
at least 10 to 1. The age of onset of cluster headache is usually between 20
and 40 which is much later than in migraine. The clinical presentation of
cluster headache is relatively easy to diagnose.
A trial of the Hinz amino acid method is worthwhile and highly effective for
migraine headaches. It is also safe if followed according to professional
protocol. It value in cluster headaches has not been verified due to the fact
that the latter are more uncommon than ordinary migraines.
atypical. Atypical features may include Absence of a periodic pattern
Residual headache between exacerbations Incomplete or minimal response
to standard therapy Presence of lateralizing findings on exam (except for
those of CH-related Horner's syndrome)
Most patients with cluster headache require preventive treatment because
each attack is too short in duration and too severe in intensity to treat with
only abortive medication. In addition, ergotamine, DHE, sumatriptan, and
oxygen may just postpone rather than abort the attack. Preventive therapy
for episodic cluster, in order of preference, includes ergotamine, calcium
channel blockers, methysergide, lithium, corticosteroids, divalproex, and
capsaicin. Occasionally, indomethacin is effective. If medical therapy fails
completely, surgical intervention may be beneficial for the psychologically
stable patient with strictly unilateral chronic cluster. The surgery consists
of neuronal ablation procedures directed toward the sensory input of the
trigeminal nerve and autonomic pathways, and is generally effective in 75
percent. The prognosis of cluster headaches is guarded; it is a chronic
headache that may last for the patient's life. Drug therapy may help convert
some patients from chronic to episodic cluster.
Cluster headache is a vascular condition related to migraines. It relates to
migraine in certain aspects of it pathogenesis and, consequently responds
to some of the same medications. It differs from migraine in other aspects
of its pathogenesis as well as in many apspects of its clinical presentation.
Cluster headache is also, by far, not as common as migraine and,
according to a population study, affects less than one out of 1,000 people.
As opposed to migraine, it affects mostly men with a male to female ratio of
at least 10 to 1. The age of onset of cluster headache is usually between 20
and 40 which is much later than in migraine. The clinical presentation of
cluster headache is relatively easy to diagnose.
A trial of the Hinz amino acid method is worthwhile and highly effective for
migraine headaches. It is also safe if followed according to professional
protocol. It value in cluster headaches has not been verified due to the fact
that the latter are more uncommon than ordinary migraines.
Senin, 09 Mei 2011
Overview What are cluster headaches?
Cluster headaches are a rare type of headache. Cluster headaches usually occur once or more every day at the same time each day to 12 weeks, until the "cluster period" is over.
Cluster headaches are more common in men and usually starts very suddenly. The pain is usually located behind or around one eye and very severe. The eyes and nose on the same side pain may become red, swollen and watery. Cluster headaches also cause restlessness. These headaches can be frightening for patients and those around him.
Cluster headaches can last several minutes or several hours, but usually lasts for 45 to 90 minutes. The most common time for cluster headaches appear to be 1:00 to 2:00, 1:00 and 3:00 pm and approximately 21:00 Cluster periods usually last 4 to 8 weeks and may occur seasonally, such as in spring or autumn. Then, there is no cluster headaches will occur for weeks, months or even years.
Cluster headaches are more common in men and usually starts very suddenly. The pain is usually located behind or around one eye and very severe. The eyes and nose on the same side pain may become red, swollen and watery. Cluster headaches also cause restlessness. These headaches can be frightening for patients and those around him.
Cluster headaches can last several minutes or several hours, but usually lasts for 45 to 90 minutes. The most common time for cluster headaches appear to be 1:00 to 2:00, 1:00 and 3:00 pm and approximately 21:00 Cluster periods usually last 4 to 8 weeks and may occur seasonally, such as in spring or autumn. Then, there is no cluster headaches will occur for weeks, months or even years.
What is Cluster headaches?
Although cluster headache ("migrainous neuralgia") has been recognized for over 100 years (von Möllendorff, 1867), Sir Charles Symonds' (1956) lucid account of this disorder was brought into focus. Recognition of the clinical entity almost certainly hampered by a confusing variety of names given to this condition, such as erythroprosopalgia, Raeder's syndrome, neuralgia spenopalatine, ciliary neuralgia, neuralgia vidian, and cephalalgia histamine (Sjaastad, 1986; Grimson and Thompson, 1980). Cluster headaches are now well established as a distinct syndrome (Table 6-1) that recognition is important, as they may be responsive to treatment. Episodic type, the most common, marked with 1-3 short-lived attacks periorbital pain (Fig. 6-1) per day over a period of 4 to 8 weeks, followed by pain-free interval is an average of 1 year. Chronic form, sometimes called chronic migrainous neuralgia, which may begin de novo or a few years after episodic pattern has become established, characterized by the absence of sustained periods of remission. Each type can turn into another. Cluster syndrome is genetically, biochemically, and clinically different from migraine; propranolol is effective in treating migraine but has not been proven effective in cluster headaches. Lithium is beneficial for cluster headache syndrome and not effective in migraine. However, both disorders occasionally blend into one in an occasional patient (Solomon, 1986), indicating that the mechanism they bear some degree of similarity.
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CLINICAL
Cluster headaches have a prevalence of approximately 69 cases per 100,000 people, and therefore much more common that migraine (D'Alessandro et al, 1986). Men are more often affected than women in a proportion of 06:01. Although most patients begin experiencing headache between the ages of 20 and 50 years (mean, 30 years), the syndrome may begin as early as the first decade and as late as the eighth decade (Fig. 6-2). Clearly, age alone is not sensitive diagnostic criteria (Krabbé, 1986). Women with cluster headache is more likely than male started to have attacks after age 50, among women, headache is usually not associated with menstruation, tend to quit during pregnancy (Ekbom and Waldenlind, 1981), and can begin using oral contraceptives (Peatfield et al , 1982).
Back to top
CLINICAL
Cluster headaches have a prevalence of approximately 69 cases per 100,000 people, and therefore much more common that migraine (D'Alessandro et al, 1986). Men are more often affected than women in a proportion of 06:01. Although most patients begin experiencing headache between the ages of 20 and 50 years (mean, 30 years), the syndrome may begin as early as the first decade and as late as the eighth decade (Fig. 6-2). Clearly, age alone is not sensitive diagnostic criteria (Krabbé, 1986). Women with cluster headache is more likely than male started to have attacks after age 50, among women, headache is usually not associated with menstruation, tend to quit during pregnancy (Ekbom and Waldenlind, 1981), and can begin using oral contraceptives (Peatfield et al , 1982).
Medical information about cluster headaches
which gives the condition its name. cluster headache is one of the most painful headache. Cluster headaches are sometimes called "alarm clock headaches" because often wake you up at night with pain in or around the eyes on one side of the head.
Frequent attacks - known as cluster periods - can last from weeks to months, usually followed by periods of remission when the headache attacks stop completely. During remission, no headaches occur for months and sometimes even years.
Fortunately, cluster headaches are rare and not life-threatening. Treatment can help create a cluster headache attacks are shorter and less severe. In addition, preventive medicine that can help reduce the number of cluster headaches.
Frequent attacks - known as cluster periods - can last from weeks to months, usually followed by periods of remission when the headache attacks stop completely. During remission, no headaches occur for months and sometimes even years.
Fortunately, cluster headaches are rare and not life-threatening. Treatment can help create a cluster headache attacks are shorter and less severe. In addition, preventive medicine that can help reduce the number of cluster headaches.
Cluster headaches and those that suffer
Cluster headaches are a rare type of headache. Cluster headaches usually occur once or more every day at the same time each day to 12 weeks, until the "cluster period" is over.
Cluster headaches are more common in men and usually starts very suddenly. The pain is usually located behind or around one eye and very severe. The eyes and nose on the same side pain may become red, swollen and watery. Cluster headaches also cause restlessness. These headaches can be frightening for patients and those around him.
Cluster headaches can last several minutes or several hours, but usually lasts for 45 to 90 minutes. The most common time for cluster headaches appear to be 1:00 to 2:00, 1:00 and 3:00 pm and approximately 21:00 Cluster periods usually last 4 to 8 weeks and may occur seasonally, such as in spring or autumn. Then, there is no cluster headaches will occur for weeks, months or even years.
Cluster headaches are more common in men and usually starts very suddenly. The pain is usually located behind or around one eye and very severe. The eyes and nose on the same side pain may become red, swollen and watery. Cluster headaches also cause restlessness. These headaches can be frightening for patients and those around him.
Cluster headaches can last several minutes or several hours, but usually lasts for 45 to 90 minutes. The most common time for cluster headaches appear to be 1:00 to 2:00, 1:00 and 3:00 pm and approximately 21:00 Cluster periods usually last 4 to 8 weeks and may occur seasonally, such as in spring or autumn. Then, there is no cluster headaches will occur for weeks, months or even years.