The causes and symptoms of cluster headache. Treatment and prevention of cluster headache

Closter headaches are recognized as the most intense type in the general classification of headaches. People who know firsthand, as the head “split” at this moment, call these sensations painful, prickly, tearing, hellish. The epicenter of unbearable pain is in the area of \u200b\u200beyeballs. The attack finds by surprise and holds at the mark of the “maximum” for a quarter of an hour. How cluster pains occur and whether it is possible to smooth out the moment of their exacerbation, we will tell in the article.

Closter headaches are extremely severe, but, fortunately, a very rare disease. The concentrated pain syndrome is also called bundle (associated with general symptoms). The number of victims of this pathology is slightly more than 1% of the population of the planet, and the strong half of humanity is more susceptible to illness than women. Pugs cluster headache is a source of suicidal behavior and severe depression.

General characteristics of cluster headaches

Closter headaches are considered as an initial state, since they are not a consequence of any disorder, like many other types of headaches. This anomaly is considered an independent disease.

Many people who have experienced the first attack of such a pain never face this phenomenon again. Approximately 80 - 90% of patients torment cluster headaches of a temporary nature. These are regular attacks with a “calm” interval of more than 1 month. 10 - 20% of patients suffer from chronic seizures of the disease, when the gap between terrible attacks is less than 1 month. This form of pathology is extremely difficult to treat. Interestingly, cluster headaches of left -handed people are not more common than that of right -handed people, that is, the dominance of the left or right hemisphere, apparently, does not have an effect on the pathology.

The cluster headache cycle is clear in nature:

• most often, the attacks of headaches are regular and occur at the same time. Basically, attacks begin between the evening and the early morning. The most “dangerous” gap - from 12 a.m. to 3 a.m.;
• a short attack (from 15 to 80 minutes), but very intense, and is accompanied by inhuman, according to the patients themselves, flour;
• a person experiencing an active cycle of the disease experiences from 1 to 8 painful attacks per day;
• the duration of the cycle of cluster pains is 1.5 - 3 months, then the period of calm comes, which lasts about 1 year. Most often, exacerbation reminds of itself in the autumn and spring season.

Causes of cluster headache

Doctors see a convincing explanation for such a severe disorder in functional failures of the nervous and circulatory systems. Among other factors in the development of cluster headache, they note:

1. The pathological work of the hypothalamus. This is a small area of \u200b\u200bthe intermediate brain, which is responsible for the neuroendocrine function of the brain. Scientists have found that during the attack of a cluster headache, the activity of individual parts of the hypothalamus increases sharply.
2. The influence of biorhythms. As a result of long -term studies, it was found that attacks occur mainly in a sleepy state, coinciding with one of the stages of sleep. Also, the frequency of pathological attacks increases against the background of seasonal warming. In addition, many patients recall that the most painful seizures occur in the light of day. Researchers of the problem associate the development of pathology with circadian rhythms.
3. The expansion of blood vessels and inflammatory damage to the nervous tissue, which is behind the eyeball. The result of such a state is stitching and twitching pains, which are usually localized in the area of \u200b\u200bone side of the face. Behind the eye passes the trigeminal nerve, moving away from the brain. Through it, microcurrents enter the skull and face. The reason for these events and its direct connection with cluster headaches has not yet been clarified.
4. Functional disorders of the sympathetic nervous system. She is responsible for the state of muscle tissue. There is an assumption that deviations in this nervous system cause the development of severe pain.

Cluster headache: who under the sight

Potential victims of a dangerous disease are:

• girls and boys. At the same time, the peak of incidence was observed in 40-year-old men and 60-year-old women;
• people dependent on drinking and cigarettes;
• a family where at least one of the relatives suffered or suffers from this disorder;
• people with chronic migraine;
• people who have suffered a head injury (for example, a CMT with a concussion);
• patients who treat sleep disturbances.

Cluster headaches: factors-dumplings

There are a number of factors that provoke the development of cluster attacks, and people who suffer from a rare pathology try to avoid them with all their might. In medical terminology, such factors are called triggers. Let's list them:

• addictions (alcohol, smoking, drugs);
• changes in weather conditions;
• sensation of height (for example, during air passage);
• pronounced smells;
• bright light (glare, flashing);
• excessive stress;
• products that include nitrites (greens, melons, watermelons, canned food);
• medicines, the effect of which is aimed at expanding blood vessels and normalizing blood pressure.

Provoking factors should be feared only during the period of relapse of the disease. When the pathology transforms into a “sleeping” form, triggers lose their relevance.

Clinic cluster headache

The cluster attack usually begins with a slight burning sensation in the localization area, as a rule, on one side. The intensity of unpleasant sensations grows very quickly: for a quarter of an hour, moderate pain becomes very severe. At this time, a person feels concern, he is visited by the desire to protect himself from others. Attacks are so painful that the patient is forced to take various poses in order to at least slightly weaken the pain.

Unbearable sensations are usually combined with other symptoms of a cluster headache:

• swollen watery eyelids;
• lacrimation;
• nasal congestion;
• strong sweating in the forehead;
• acute reaction to light and sounds;
• high degree of anxiety;
• nausea and vomiting;
• wide pupils.

From the beginning of the attack, the pain intensifies and acquires a pricking and penetrating character. It focuses on the back or slightly above one eye. After the end of the attack, all symptoms pass without a trace.

Determination of cluster headache

Treatment of cluster headache will be successful only after competent diagnosis of the patient's condition. Often a serious pathology is taken as a regular migraine due to the similarity of the signs-this is how erroneous diagnoses are multiplied.

Examination of the patient with complaints of severe headaches should be complex:

1. Creating an official and subjective anamnesis. The doctor records in a personal map all symptoms of disorder based on the patient's complaints. The patient, in turn, should also keep a headache diary with a detailed report on the frequency, duration and features of all cluster attacks. This information will also help the doctor make the correct diagnosis.
2. Inspection. To diagnose headaches, the doctor examines the patient’s head and neck, then conducts a number of neurological tests to the flexibility and speed of the reaction, clarity of orientation in space and the fullness of sensations. The program of diagnostic procedures also includes a detailed examination of the patient's eyes. Often the patient is asked various questions to check his short -term memory and other mental functions.
3. Information visualization tests: computed tomography and magnetic resonance tomography of the head.
4. Extensive tests in the presence of suspicions of headaches of a different type and other medical disorders.

How to treat a cluster headache

Today, doctors have developed effective treatment regimen for controlling a cluster headache. This is preventive therapy to prevent an attack and reduce relapse and acute therapy for its stop.

The most effective ways to get rid of painful seizures are:

1. Oxygen inhalations. To combat cluster attacks, Tryptan drugs, collapse (imitrex) were approved. The treatment is variable - for example, good results showed intranasal combination of summactan and zolmitriptan. In some cases, oxygen and a solution is injected in a complex. Also, at the time of an acute attack, nasal sprays of dihydroergotamine or lidocaine are used.
2. It is difficult to stop pain during the cluster attack during the cluster attack, so basically the patient’s treatment is aimed at preventing attacks at potentially dangerous cyclic periods. In most cases, complex therapy for each patient is developed individually.  The basis of any program for the treatment of cluster headaches is the use of verapamil, calcium channel blockers. However, about 2 to 3 weeks will pass before the drug begins to show the therapeutic effect, therefore, the initial transitional therapy in the form of the use of corticosteroids (prenyson) is practiced in this gap.
3. Behavioral therapy. The patient is offered to completely rebuild the lifestyle: to refuse smoking, drinking alcohol, to avoid triggers that provoke the beginning of cluster attacks.

How to get rid of the acute attack of a cluster headache

To facilitate the condition of the patient at the time of a burning attack, the following methods are used:

1. Oxygen therapy.  The patient inhales pure oxygen through the mask for 15 minutes. This is the fastest and safe procedure in the treatment of cluster headaches: the level of oxygen and blood vessels constrained by spasm are expanding sharply in the blood.
2. The use of triptans. Medicines of this group are usually used to treat migraines, but they turned out to be very effective in the fight against cluster attacks. During the attack, a summptor is injured (the duration of the action is 15 minutes) or the nasal aerosol is used to makeup or zolmititriptan (valid for half an hour).
3. The use of ergotamine injections (migranala). The drug helps block the seizure for several minutes. Depending on the severity of the symptoms, patients are prescribed nasal spray or tablets based on this active substance.
4. The use of local anesthetics. Basically, with a cluster pain syndrome, the nasal lidocaine spray is recommended, which begins to act in full force 40 minutes after spraying.
5. Capsaicin. A substance obtained by chemical processing of acute pepper. Intranasal use of capsaicin can be effective when patients do not receive relief through other drugs.

Prevention of cluster headache

It is possible to defeat terrible attacks completely or at least reduce their frequency exclusively with a medical way. Today there are standard treatment regimen that can be adjusted depending on the medical history of a particular patient. For preventive treatment of cluster headache, the following drugs are suitable:

1. Calcium channel blockers. The drugs of this group, in particular verapamil, show high efficiency in the preventive therapy of episodic and chronic cluster attacks. Before the therapeutic effect manifests itself, for 2 to 3 weeks, the patient is treated with corticosteroids.
2. Lithium preparations. Good results are achieved both through monotherapy and thanks to a combination of lithium with other drugs.
3. Corticosteroids. With their help, the patient's condition is stabilized after a cluster attack, before the use of other drugs. Steroids such as prednisone and dexamethasone are used to treat an episodic short -term cluster headache. They are taken within 7 days, gradually reducing dosage.
4. Antiepileptic drugs. Medicines (Dival Produce, Depic, Topamax) used to facilitate epileptic seizures are effective in the treatment of patients suffering from cluster attacks. However, this treatment point is in doubt among some doctors and requires additional research. In addition, it must be taken into account that anticonvulsants are able to provoke the appearance of suicidal mood and behavioral disorders on the basis of depression.
5. Botulinum toxin. We are used to believe that Botox injections are popular only in the field of cosmetic surgery, where they are used to combat wrinkles. However, the substance successfully blocks migraine -like disorders, so research is currently underway about the possibility of using Botox to eliminate cluster attacks.

Cluster headache: consequences and forecast

Regularly repeated cycles of painful pain leave a large imprint on the mental and emotional state of a person. People with such a violation often close themselves in themselves, become anxious and imaginary, and depressions are easily amenable.

Speaking of cluster headaches, doctors cannot give a clear forecast. Despite the fact that even the most powerful attacks are weakening with age and in the end pass completely, doctors do not know how long the disorder will be in the active phase and what will be its final stage.

Cluster headache. Video