One of the best patient organizations, Clusterbusters, held their annual meeting for the past 4 days in Chicago. There were lots of talks by headache doctors and others, and cutting edge displays… there are two new studies starting, one on the ATI SPG implant device, the other a CGRP injection to prevent clusters. The ATI device has been in Europe for over two years, and has been very successful. It is a small (smaller than an almond) device implanted in the cheek (through the gum), and when the person has a cluster headache, a hand held stimulator is activated, stopping the attack.
The CGRP injection is also going on in studies for chronic migraine; this Lilly study is the only one for cluster as well, which is very exciting.
Clusters, sometimes referred to as “suicide” headaches are particularly severe, and ruin people’s quality of life.
Cluster headache is a relatively uncommon headache disorder. The prevalence is about 10 per 100,000 in male patients, which is about 19 to 25 times less than the prevalence of migraine headache in men. Most cluster headache sufferers are males, with the gender ratio varying from 3.5:1 to 6.7:1 in favor of males. No racial, ethnic or genetic factor has been documented. Cluster headache can begin at any age, but the average mean age of onset is during the late 20s and early 30s.
The acute attack of cluster headache occurs suddenly, without any warning. It peaks in intensity within 10 to 15 minutes, and lasts usually from 40 to 90 minutes. The pain is excruciating and described most commonly as boring, burning, piercing, sharp, knife-like, or “a hot poker in the eye.” A soreness of lingering dull pain may persist for hours after the main attack. The pain is strictly one-sided, and occurs on the same side at the same location during a cycle. It may change sides in the next cycle. The typical location is at the temple, above the eye, or behind the eye. The area of pain is small, and often the patient can point to the pain’s location with the tip of a finger. The headache has been described as the most severe form of pain a human can endure. It is not unusual for women who experience cluster headache to describe the pain as worse than the pain associated with labor and delivery.
More than 50% of cluster patients report that the attacks occur at night, most commonly about 2 to 3 hours after falling asleep. Many patients will have their attacks at a predictable rate. The number of attacks usually do not exceed three in 24 hours. However, some patients with chronic cluster headache may experience more than five attacks a day.
Headwise
Volume 4, Issue 3 2015