Cluster headache

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: 

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