Cluster Headache - key presentation features in 100 seconds

Cluster Headache - key presentation features in 100 seconds

#clusterheadache #clusterheadachepresentation #clusterheadachequestion

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[CatalogK]

It’s important to note that cluster headaches involve the trigimenal nerve, which not only runs behind the eye, but branches out from the temple to run along the cheek and upper jaw and along the lower jaw as well.nit appears that presentation can vary depending on which portion of the nerve is most aggravated; in my case, I get pain from my along this nerve from the temple through the lower two branches, but NOT through the top branch behind my eye except rarely. Because of this, I do not experience lacrimation, but I do get pain in my teeth, especially in my vulnerable (impacted possibly?) wisdom tooth. The pain varies in intensity and manner, sometimes presenting as if I am biting down on an exploding grenade in slow motion, other times, as if someone is grabbing my face by my cheek and jaws and crushing them inward; very often the inside of the nerve and my sinuses will feel an icy burning sensation, and it will often feel as though an ice pick is being stabbed upwards into my teeth, especially and most often that broken wisdom tooth (the pain is the same kind I feel when I bite down on something that jabs just right into the tender spot where the nerve is partially exposed, to give me a frame of reference).
Unlike my migraines, during a cluster, these headaches are always on the same side, do not respond to analgesics or oral sumatriptan, but do respond to ice applied directly to the affected area (which normally makes my migraines much more severe), and I can often feel the trigimenal nerve engorging, and can sometimes even apply pressure near the temple to stem the flow from reaching my cheek and teeth, which works until I lose my grip and the pain comes rushing in like floodwaters. Also in contrast with my migraines, with these headaches I am usually agitated and restless, with light and sound making no difference on pain; with migraines, it’s two Excedrin Migraine and nap time, in a dark, quiet room.
Cluster headaches are often referred to as “suicide headaches, ” as the pain is transcendent, eclipsing even my *traumatic* birth experience (you don’t want to know), and often leading to suicidal ideation (and even attempts and completed suicides) in many sufferers. They are also referred to as “alarm clock headaches, ” often striking at the same times throughout the day during a cluster, in many cases, waking sufferers in the middle of the night, being linked to the hypothalamus. Many CH sufferers have reported success with supplemental melatonin in the evenings, which tends to support this. This is one of the more important diagnostic criteria for differentiating between CH and migraine or other forms of primary headaches, and the final nail in the coffin of my own diagnostic denial as I lamented, “why couldn’t it just be cancer, damn it?”

[jroscoe]

Useful thank you! - I'm struggling to differentiate cluster headache from trigeminal neuralgia. Is it just that trigeminal neuralgia is seconds duration, triggered by touch/wind etc, and cluster headaches are longer duration?