February 7, 2013
Beth Wolpman, Ed.D.
Cluster headaches vs. Migraine headaches
Two of the most painful headaches a person can suffer with are cluster and migraine headaches. Cluster headaches are the most painful headaches someone can have, the pain is worse than a women giving birth to a child or broken bones. As with a migraine headache, the pain is like your head has been squeezed in a vise. There are treatment and preventive options available to anyone who has cluster headaches as well as migraine headaches, and they will vary. Even though these two types of headaches have some similarities, they also are different. Cluster headaches are the most uncommon headaches. Only 0.1% of the population is affected by clusters (O.U.C.H, 2012) whereas; about 29.5 million people suffer from migraines (National Headache Foundation, 2013). Cluster headaches are sometimes referred to as “suicide headaches” because some people have taken their lives either during an attack or in anticipation of an attack (Cleveland Clinic Foundation, 2011). Migraines have been referred to as “the sick headache” because they are usually accompanied by vomiting and nausea. Doctor’s do not know the exact cause of cluster headaches, but according to Cleveland Foundation (2011),” the headaches occur when a trigeminal-autonomic reflex pathway in the brainstem is activated”. Although much about the cause of migraines isn’t understood, genetics and environmental factors seem to play a role (Mayo Clinic, 2011). Interactions with the Trigeminal nerve and changes in the brainstem may be involved as well as imbalances in the brain chemicals, including Serotonin. Serotonin levels seem to drop during a migraine, and this could trigger the trigeminal system to release substances called Neuropeptides. Cluster headache attacks, also known as cluster periods or cluster cycles, will usually last anywhere from weeks to several months and then the headaches suddenly stop for months at a time, which is known as a remission period. As for migraines, they do not have a remission period. During a cluster period the headaches will typically occur every day, and sometimes up to eight to ten attacks a day. However, a migraine suffer can get two to four headaches a month, or every few days, while others might only get a migraine once or twice a year. According to The Cleveland Clinic (n.d.), a single cluster attack can last anywhere from 15 minutes to 3 hours. Usually the attacks will happen at the same time each day during the cluster period. Most of the attacks will occur during the night, usually 1 to 2 hours after the person goes to bed. The type of migraine a person gets, migraine with aura or without aura, will depend on the amount of time that it lasts for, while a typical migraine can last anywhere from 4 to 72 hours. With a cluster headache, the pain will gradually subside as fast as it began, and most people are completely pain free, but exhausted after the attack. According to Mayo Clinic (2011), after a migraine attack, a person will feel drained and washed out, though some people report feeling mildly euphoric. The pain of a cluster headache sometimes is described as a severe burning, sharp, or piercing pain that will occur on one side of the head, and it could be throbbing or constant. As with the pain from a migraine it is also on one side of the head, and the pain might be pulsating or throbbing. A person with cluster headaches will appear restless and probably will prefer to pace or sit and rock back and forth to try to soothe the attack (Mayo Clinic, 2011). Unlike a cluster headache, a person having a migraine attack only wants a dark, quiet place to lie down. The pain with a cluster headache will spread out from the temple, to the eye of the effected side of the head. Most cluster patients report the effected side is the opposite of their dominate side of the...