Causes and symptoms of cluster headaches. Treatment and prevention of cluster headaches

Cluster headaches are recognized as the most intense type in the general classification of headaches. People who know no obstacle as "splits" at this moment of the head, call these sensations to painful, stitching, tearing, hellish. The epicenter of the unbearable pain is located in the field of eyeballs. The attack will cause surprise and holds at the mark "Maximum" for a quarter of an hour. How are cluster pain arise and it is possible to smooth out the moment of their exacerbations, tell me in the article.

Cluster headaches are extremely heavy, but fortunately, a very rare disease. Concentrated pain syndrome is also called bundle (associated common symptoms). The number of victims of this pathology is slightly more than 1% of the world's population, and the strong half of humanity is more susceptible to the disease than women. A bundled cluster headache is a source of suicidal behavior and severe depression.

General characteristics of cluster headaches

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

Many people who have experienced the first attack of such pain, never encounter this phenomenon. Approximately 80 - 90% of patients tormented cluster headacles of temporary character. These are regular attacks with a "calm" interval for more than 1 month. 10 - 20% of patients suffer from chronic attacks of the disease, when the gap between terrible attacks is less than 1 month. Such a form of pathology is extremely seriously treated. Interestingly, cluster headaches in Lefters are not more common than that of the right hand, that is, the dominance of the left or right hemisphere, apparently, does not affect the pathology.

The cluster headache cycle is clear:

• most often, the headache attack is regular and happen at the same time. Mostly attacks begin between the evening and early in the morning. The most "dangerous" gap - from 12 o'clock at night to 3 am;
• the attack is short (from 15 to 80 minutes), but very intense, and accompanied by inhuman, according to patients themselves, flour;
• a person who is experiencing an active cycle of the disease is experiencing from 1 to 8 painful attacks per day;
• the duration of the cluster pain cycle is 1.5 - 3 months, then the quiet period comes, which lasts about 1 year. Most often, the exacerbation reminds of itself in the autumn and spring season.

Causes of cluster headaches

A convincing explanation of such severe doctors see the functional failures of nervous and blood systems. Among other factors for the development of cluster headaches note:

1. Pathological work of the hypothalamus. This is a small portion of the intermediate brain responsible for the neuroendocrine work of the brain. Scientists have established that during the attack of cluster headaches, the activity of individual parts of the hypothalamus increases sharply.
2. Effect biorhythms. After long research it has been found that seizures occur predominantly in a sleepy state, coinciding with one of the stages of sleep. Also, the frequency of pathological attacks increased against the background of seasonal warming. In addition, many patients remember the most painful seizures originate in daylight. Researchers problems associated with the development of pathology with circadian rhythms.
3. Vasodilation and inflammatory damage of the nervous tissue, which is located behind the eyeball. The result of this state are jerking and stabbing pains that are usually located in the area of \u200b\u200bone side of the face. Behind the eye passes trigeminal nerve, extending from the brain. Through micro-currents coming to the skull and face. The cause of these events and its direct relationship with cluster headaches is not yet clear.
4. Functional disorders of the sympathetic nervous system. It is responsible for the condition of the muscle tissue. There is an assumption that the deviation is in the development of the nervous system causing severe pain.

Cluster headache: someone at gunpoint

Potential victims of dangerous diseases are:

• girls and boys. At the same time, the peak incidence was observed in the 40-year-old men and 60-year-old women;
• people addicted to booze and cigarettes;
• families where at least one family member has suffered or is suffering from this disorder;
• people with chronic migraine;
• people who have had a head injury (eg, head injury with concussion);
• patients who treat sleep disorders.

Cluster headaches: bait factors

There are a number of factors that provoke the development of cluster seizures, and people suffering from rare disease, by all means try to avoid them. In medical terminology such factors called triggers. Here they are:

• addictions (alcohol, smoking, drugs);
• it changes of weather conditions;
• height sensation (e.g., air travel);
• pronounced odor,
• glare (GLARE flashing);
• excessive stress;
• products, which contain nitrite (greens, melons, watermelons, canned);
• drugs that target vasodilation and blood pressure normalization.

Precipitating factors to be feared only in the period of recurrence of the disease. When the pathology is transformed into a "sleeping" form, triggers lose their relevance.

Clinic cluster headache

The cluster attack is usually beginning with a slight burning in the localization area, as a rule, only on the one hand. The intensity of unpleasant sensations is growing very quickly: for a quarter of an hour, medium-heavy pains become very heavy. At this time, a person feels concern, it is visited by the desire to protect them from others. The attacks are so painful that the patient is forced to take various poses to at least weaken the pain.

Unbearable sensations are usually combined with other symptoms of cluster headaches:

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

From the beginning of the attack, pain is enhanced and acquires a stitching and penetrating nature. It focuses back or slightly above one eye. After the end of the attack, all the symptoms pass without a trace.

Definition of cluster headaches

Treatment of cluster headaches will be successful only after the competent diagnosis of the patient's condition. Often, serious pathology is taken for ordinary migraine due to the similarity of the signs - so multiply erroneous diagnoses.

Survey of the patient with complaints of strong headaches must be comprehensive:

1. Creation of official and subjective anamnesis. The doctor records all the symptoms of the disorder in the personal map, based on the patient's complaints. The patient in turn should also keep a diary of a headache with a detailed report on frequency, duration and features of the flow of all cluster attacks. This information will also help the doctor put the correct diagnosis.
2. Inspection. To diagnose headaches, the doctor inspects the head and neck of the patient, then conducts a number of neurological tests on the flexibility and reaction rate, clarity of orientation in space and completeness of sensations. The diagnostic procedure program also includes a detailed examination of the patient's eyes. Often, the patient is asked various questions to check its short-term memory and other mental functions.
3. Tests based on visualization of information: Computed tomography and magnetic resonance imaging tomography.
4. Extensive tests in the presence of suspicion of the headaches of another type and other medical disorders.

How to treat cluster headache

Today, doctors have developed effective treatment schemes for controlling cluster headache. This is preventive therapy to prevent the attack and reducing the frequency of relapses and acute therapy for its stop.

The most efficient ways of getting rid of painful seizures are considered:

1. Oxygen inhalations. To combat cluster attacks approved the drugs Triptan, Sumatapan (Imitrex). Treatment is variable - for example, good results showed an intranasal combination of sumatriptan and zindriptan. In some cases, the oxygen and the solution of sudapptan are introduced in the complex. Also at the moment of acute attack uses nasal sprays of dihydroergotamine or lidocaine.
2. Pain syndrome in the cluster attack period is difficult to stop, so basically the patient's treatment is aimed at preventing attacks into potentially hazardous cyclic periods. In most cases, complex therapy for each patient is developed individually. The basis of any treatment of cluster headaches is the use of verapamila, calcium channel blockers. However, it will take about 2 - 3 weeks before the drug will begin to show the therapeutic effect, therefore, in this gap, the initial transitional therapy is practiced in the form of corticosteroids (prednisone).
3. Behavioral therapy. The patient is offered to completely rebuild lifestyle: to abandon smoking, drinking alcohol, avoid triggers provoking the beginning of cluster seizures.

How to get rid of the acute attack of cluster headaches

To facilitate the state of the patient at the moment of burning attacks, such methods are used:

1. Oxigenotherapy. Patient for 15 minutes inhales clean oxygen through a mask. This is the fastest and safe procedure in the treatment of cluster headaches: the blood level of oxygen sharply increases sharply and the blood vessels complicated.
2. Application of tryptans. Drugs of this group are usually used to treat migraines, but they turned out to be very effective and in combating cluster attacks. During the attack, it makes the injection of subpectapotan (duration of 15 minutes) or apply a nasal aerosol of sumatriptan or zindriptan (valid for half an hour).
3. The use of ergotamine injections (Migranal). The drug helps block the seizure within a few minutes. Depending on the severity of symptoms, the patients prescribe a nasal spray or tablets based on this actant.
4. The use of local anesthetics. Basically, with cluster pain syndrome, the nasal spray of lidocaine is recommended, which begins to act in full force 40 minutes after spraying.
5. Capsaicin. The substance obtained by chemical processing of acute peppers. The intranasal use of capsaicin is effective when patients do not make relief through other drugs.

Prevention of cluster headache

To defeat the terrible attacks at all or at least to reduce their frequency can be exclusively by medication. Today there are standard treatment schemes that can be adjusted depending on the history of the disease of a particular patient. For preventive treatment of cluster headaches, such drugs are suitable:

1. Calcium channel blockers. Preparations of this group, in particular verapamil, exhibit high efficiency in prophylactic therapy of episodic and chronic cluster seizures. Before the therapeutic effect manifests itself, for 2-3 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 stabilize after the cluster attack before the use of other medicines. Such steroids such as prednisone and dexamethasone are used to treat episodic short-term cluster headaches. They are accepted within 7 days, gradually reducing dosages.
4. Antiepileptic preparations. Drugs (Divzproekek, Deupacon, Topamaks) used to facilitate epileptic seizures, in rare cases are effective and in the treatment of patients suffering from cluster attacks. However, this treatment point is doubting some doctors and requires additional research. In addition, it is necessary to take into account that anticonvulsants are able to provoke the appearance of suicidal mood and behavioral disorders on the soil of depression.
5. Botulic toxin. We used to assume that Botox injections are popular only in the field of cosmetic surgery, where they are used to combat wrinkles. However, the substance successfully blocks migreen-like disorders, so there are currently research on the possibility of using Botox to eliminate cluster attacks.

Cluster headache: consequences and forecast

Regularly repeated cycles of painful pain impose a large imprint on the mental and emotional state of a person. People with such a violation often closed in themselves, become anxious and disrupted, easily succumb to depression.

Speaking of clustered headaches, doctors cannot give a clear forecast. Despite the fact that even the strongest attacks with age weaken and eventually pass at all, doctors do not know how long the disorder will be in the active phase and what will be its final stage.

Cluster headache. Video