The International Headache Society defines cluster headaches as being characterised by:
- Severe unilateral orbital/supraorbital/temporal pain
With one or more of
- Redness of eye
- Lacrimation
- Eyelid oedema
- Nasal congestion
- Facial sweating
- Miosis
- Ptosis
There must be at least 5 attacks, ranging from one every other day to eight per day.
Attacks last between 15 minutes to 3 hours.
Males are more affected than females
Smoking increases risk
Treatment acutely:
- 100% oxygen, at least 7l/min
- s/c Sumatriptan (note contraindicated in CAD, uncontrolled hypertension or angina)
- intranasal lidocaine
- s/c octreotide
Prophylactic treatments:
- Verapamil
- Prednisolone
- Lithium
References:
