What is cluster headache (Horton's headache)?

Cluster headaches, also known as Horton's headaches or cluster headaches, are severe bouts of headache in which the pain often sits behind or around one eye. Horton's headache is a relatively rare neurological disorder characterized by the very painful unilateral headache attacks. The seizures occur in most people in clusters, hence the name.

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Facts about Cluster Headache

Cluster headaches, also called Horton's headaches affect about 1 in 1000 and about four times as many men as women.

The cluster headache most often starts at the age of 20-40 years, but is also seen in children. There is, moreover, a certain heredity to Horton's headache.

The clusters typically last 1-3 months, with seizures several times a day. Months or years can pass between these clusters and you are usually symptom-free in between.

About every fifth person with cluster headaches develops a chronic form, with no longer breaks between seizures.

The pain during seizures is often described as unbearable, which has earned it the nickname “suicide headache”.

You may be bothered at times by so-called “shadow seizures”, which are a nuisance more than pain in the area where the seizures are usually localized.

Horton's headache cannot be diagnosed with blood tests, scans or the like, so the diagnosis is made solely on the basis of the patient's description.

It can be very debilitating to have cluster headaches, but it is not dangerous and the brain does not take damage.

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Symptoms of cluster headache

• Hyperintense, drilling, burning pain localized in or around one eye. The pain is often described as a “knife turning around”
• The pain is accompanied by runny or stuffy nose.
• The eye may turn red and run into water and the eyelid may droop.
• The pain is rapid onset and typically lasts 15-90 minutes, sometimes up to 3 hours or more
• You can have 1-8 seizures a day, some even more. Seizures often occur at night.
• During seizures, people often become restless, restless or sit, for example, rocking back and forth. You can become irritable or even aggressive.

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Treatment Options for Cluster Headaches

Although unfortunately no cure for cluster headaches has been found yet, there are several treatment options to alleviate the symptoms and reduce the frequency and intensity of the seizures.

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Seizure treatment for cluster headaches

• Oxygen inhalation via a tight-fitting mask, where inhaling 12-15 l of pure oxygen for 15-20 minutes can provide pain relief.
• Triptans, typically sumatriptan as an injection or nasal spray, can have a quick and relieving effect on the pain.
• There is usually no effect of painkillers such as panodil and ipren or morphine preparations.

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Preventive treatment for cluster headaches

Preventive treatment is used during clusters to mitigate and lower the frequency of seizures.

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• Verapamil is the medical first choice for the prevention of cluster headaches and is taken firmly every day during the seizure period. The dose is individual.
• Candesartan, Lithium and Gabapentin are also preparations that can have an effect in some cases.
• Prednisolone as a 10-day cure can be used in a transitional phase to achieve rapid relief before the effect of other preventive treatments sets in.
• Gon blockades can prevent seizures and in some may have an effect up to 3 months.

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Lifestyle Changes May Help Against Cluster Headaches

There is no research knowledge when it comes to the effect of lifestyle changes on cluster headaches, but experience shows that heat, alcohol and smoking can be provoking factors.

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If you experience symptoms of cluster headache, you should seek professional medical advice for targeted treatment.

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