Clinical features of cluster headache

Clinical features of cluster headache

Cluster headaches are characterized by severe pain attacks lasting 15-180 minutes that occur on one side of the eyes, forehead or temple. The attacks occur with a frequency of one attack every other day to eight attacks per day.

The pain is accompanied by at least one of the following symptoms occurring on the same side: redness of the eyes, watering of the eyes, nasal congestion, runny nose, increased sweating in the forehead and face area, constriction of the pupil, drooping of the eyelid, swelling of the eyelids and physical Restlessness with urge to move. The attacks occur periodically and frequently; one speaks of a cluster (cluster: English heap). In between there are headache-free periods of varying duration. The exact diagnostic criteria can be found in the International Headache Classification . You can check the symptoms directly with the rapid headache test

Cluster headache attack

Cluster headache attack in the left eye

Episodic cluster headache occurs in periods ranging from 7 days to a year in length, with an average duration of 4-12 weeks. The pain-free intervals are at least 14 days.

Chronic cluster headache is manifested by the occurrence of cluster attacks over a time interval of more than a year without headache-free periods or with only a short-term headache-free period of less than 14 days.

Previously used but no longer used terms for this headache disorder are: Bing's erythroprosopalgia, ciliary or migraine neuralgia according to Harris, erythromelalgia of the head, Horton's syndrome, histamine headache, Petrosus neuralgia according to Gardner, neuralgia of the sphenopalatine ganglion, Vidian neuralgia, Sluder neuralgia, Hemicrania periodica neuralgiformis.

The average age at first onset of cluster headache is 28 to 30 years. However, cluster headaches can also be observed for the first time in much later years of life. In children and adolescents, however, cluster headaches only occur in rare, exceptional cases. The incidence rate of cluster headache is 15.6 per 100,000 people per year for men and 4.0 per 100,000 people per year for women. The average incidence rate is 9.8 per 100,000 people per year. According to various studies, the frequency of cluster headaches in the general population is approximately 0.9%. According to a survey by the cluster headache self-help group (CSG) in Germany, on average it takes eight years until the correct diagnosis is made.

Cluster headache is the only form of primary headache disorder with a clear predominance in men. The proportion of men among patients with chronic and episodic cluster headache is between 70% and 90%.