Cluster headaches have been widely recognized for centuries. Only recently has the cause of these often brief, but excruciatingly painful episodic headaches begun to be better understood.
What medical researchers have discovered has been surprising to physicians, overturning previous assumptions about how brain biology was believed to be related to these headaches. The good news is that the new findings may soon be translated into treatments that provide more effective cluster headache relief.
There are two subtypes of cluster headache: episodic and chronic. The episodic type is more common, experienced by about 80 percent of sufferers. These are characterized by pain episodes or headaches that occur together in periods known as “a cluster.” Clusters may last from seven days to a year, but those of the episodic variety are separated by periods of 14 days or longer when no headaches occur.
As a general rule, the cluster periods of episodic attacks persist from one to three months, followed by periods of remission which may last for months or even years.
In the chronic form, the cluster of headaches occur for more than a year, without any remission lasting for as long as 14 days. Generally, cluster headaches that are chronic occur more often and are less responsive to treatment than episodic ones.
One of cluster headaches’ most unusual characteristics is that they tend to be seasonal—they can exhibit a very strong cyclical pattern. Often, an individual has such headaches every spring, fall, winter or summer, for decades on end. The pain is debilitating.
Like a Pencil in Your Eyeball
Cluster headaches are both rare and uncommonly painful. They affect less than one percent of the population, with an average age of onset between 27 and 30 years.
The intense pain usually is on one side of the head only and often described as a pain that is sharp, burning or boring into the head. It is s frequently focused in the region around or within the eye socket. One cluster headache sufferer described the sensation as “having a pencil pushed into your eyeball that just keeps being pushed further and further in.” The headaches come on rapidly and can last from 15 minutes to as long as three hours.
Worse Than Giving Birth
Peter Goadsby, M.D., professor of Clinical Neurology at University College, London, and head of the Headache Group at London’s Institute of Neurology, is a cluster headache expert. His patients have provided him with graphic descriptions of the pain they experience during cluster attacks.
“Women with cluster headache will tell you that an attack is worse than giving birth,” Goadsby says. “So you can imagine that these people give birth without anesthetic once or twice a day, for six, eight or 10 weeks at a time, and then they have a break. It’s awful.”