Cluster Headache
Definition
Aka migrainous neuralgia
Epidemiology
Clinical Features
Symptoms
Signs
Management
Acute ("Keep calm... carry oxygen")
Prevention
Source
OHCM 9th Ed 2014
Aka migrainous neuralgia
Epidemiology
- M>F 5:1
- Any age
- More common in smokers
Clinical Features
Symptoms
- Excruciating uniateral pain around 1 eye
- Eye: teary, injected, lid swelling
- Facial flushing
- Rhinorrhoea
- Each attack lasts 15min - 2.5h
- Clusters lasts 4-12w --> pain free months to 2yrs
- Alleviation by walking around
Signs
- Miosis/ (Horner's syndrome in some)
- Facial flushing
Management
Acute ("Keep calm... carry oxygen")
- 100% O2 ~ 15min via non-breathable mask
- Sumitriptan
Prevention
- Suboccipital steroid injections (many SEfx)
- Intranasal civamide (synthetic capsaicin)
- Verapamil, lithium, melatonin
Source
OHCM 9th Ed 2014