It is a “disorder producing extreme, strictly unilateral pain, localised in or around the eye.” Cluster headache (CH) sufferers deserve more attention, as the pain is often described as one of the most painful conditions known to mankind, with female patients describing the pain of attacks as worse than childbirth.
A study in the UK suggests between 1 and 5 sufferers per GP and between 34,000 and 150,000 sufferers in the UK with prevalence in men is 3 to 4 times higher. It usually begins between the ages of 20 and 40 years but can start at any age.
It is still not known why some individuals suffer from CH or why they exhibit the characteristic periodicity. However, progress is being made and a number of theories are plausible and may help progress with new treatments. First-degree relatives of CH patients are more likely to have CH than the general population. About 1 in 20 sufferers has another family member who also has CH.
The pain is centred around or behind the eye, temple or forehead, although the neck and other parts of the head can be involved. Pain is accompanied by nasal congestion, eyelid swelling, facial sweating and nausea may accompany the pain, but is much less of a feature than with migraine. Sufferers, unlike with migraine, cannot keep still and are described typically as restless. Patients pace around, occasionally banging their heads on walls and furniture.
Patients should be encouraged to have both acute and preventative treatments available. This may involve completion of Home Oxygen plus maintain a regular sleep routine and good sleep hygiene (avoiding tea, coffee, etc).
Oxygen – 100% oxygen, given for 15 minutes up to five times per day, is safe and effective in 80% of cases. It is given by a tight-fitting mask and is particularly useful for night attacks. Alternative therapies, such as acupuncture, have also been very helpful to some patients but in the majority home oxygen therapy is the most effective.