A new study by the Kiel Pain Clinic on 825 patients with cluster headaches shows: Cluster headaches can occur with considerable clinical variability. The inter- and intra-individual variability of the phenotype can contribute to the clinical headache phenotype being missed by too strict diagnostic criteria and the diagnosis and effective therapy being delayed.
In a current study by the Department of Neurology at the University of Lübeck and the Pain Clinic in Kiel, the severity of the clinical symptoms of episodic and chronic cluster headaches was analyzed with regard to their variability and compared with the criteria of the International Headache Classification ICHD-3.
The majority of patients with cluster headaches have clinical features that are reflected by the ICHD-3 diagnostic criteria. However, due to the variability of symptoms, there is a significant proportion of clinical courses that are not covered by the ICHD-3 criteria for cluster headaches. In addition, there are sequential side changes, pain locations and constant pain between attacks, which have not yet been addressed in the ICHD-3 criteria. At the forefront of comorbidity are psychological complications in the form of depression, sleep disorders and anxiety.
The variability of the phenotype of cluster headaches can exclude some patients from an appropriate diagnosis and delay effective therapy if diagnostic criteria are too strict. The occurrence of persistent pain between attacks should also be evaluated diagnostically with regard to the high frequency and intensity as well as the impact on the level of suffering. The care of patients with cluster headaches should carefully consider psychological complications.
Link to the complete study:
https://link.springer.com/article/10.1007/s40122-021-00267-8
I have severe cluster headaches 6-8 times a day. The pain usually comes from the eye, over the temple and to the upper right corner of the head. The eye and cheekbone then become so thick that my eye is almost closed. The eyelid is also thick and hangs down. There was pain in the entire right half of the head, from the eye, nose, carotid artery, teeth and shoulder. Everything convulses with pain. I am afraid of being vaccinated with Astrazeneka. That the cluster headache is then completely uncontrollable. I don't really know how to live with it.