Auras And Prodrome Phase
Some migraine sufferers will experience auras or go through a prodome phase.
Auras are sensations felt 10-30 minutes before a migraine attack. They include:
- Trouble thinking/focusing
- Vision problems
- Tingling/numbness of the face or hands
The prodrome phase occurs when one feels symptoms a couple of days before a migraine attack. However, these symptoms can be attributed to other issues, so they dont necessarily put migraine sufferers on alert. These symptoms can include:
- Depression/irritability
- Abnormal cravings
If you suffer from frequent and painful headaches, The Migraine Institute may be able to help. Call us today to schedule an appointment.
The Link Between Cgrp And Migraines
In 1982, scientists identified a neuropeptide they called calcitonin gene-related peptide , which they eventually suspected might be related to migraine.11
Scientists initially realized that CGRP levels were increased during a migraine attack, Dr. Largier says. Then they realized that, if patients were given treatment, such as triptans or ergotamine, during an attack, CGRP levels decreased in patients who responded to the medicines.
The U.S. Food and Drug Administration approved the worlds first anti-CGRP migraine medication in 2018.12
Are You In Motion Or Still
“Cluster headache patients tend to move around quite a bit during the headache. Migraine patients, moving around makes it much worse, so they try to stay still usually,” said Dr. Burish.
During a cluster headache attack, I prefer to rock back and forth and tend to moan or scream when the pain is peaking. That is uniform across the cluster headache patients I’ve met over the years. Laying down is like torture during an attack because the searing pain makes you move. Bob Wold, Founder of Clusterbusters, likened it to slamming your finger in a car door: You have to shake your hand to cope with the pain. It’s similar with cluster headaches.
Migraine attacks typically have you in a dark, quiet room because sound and light make it worse. I’ve had status migraines in the past, and they drained me for five days and had me wanting to stay in bed.
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Diagnosis Of Cluster Headaches
The term cluster headache should be used carefully, as people will sometimes use it to refer to headaches that occur in clusters. The term cluster headache is defined by diagnostic criteria outlined by the International Headache Society.
However, Brewer says misdiagnosis is a real problem, and instead of too many people being wrongly diagnosed with cluster headache, its actually a matter of people not being correctly diagnosed with the diseasesometimes being misdiagnosed with a migraine disorder instead. Brewer says this issue means people sometimes wait between 5-7 years to get a proper cluster headache diagnosis.
People suspected of having cluster headache should be carefully assessed by their doctor for an underlying cause, and imaging of the brain and vessels in the head should occur. They should also be evaluated to make sure they do not have a different primary headache disorder that can mimic cluster headache.
Examples of other primary headache disorders that mimic cluster headache include:
- migraine with prominent autonomic features
- paroxysmal hemicrania
- short-lasting unilateral neuralgiform headache with red eye and tearing
- hemicrania continua
What Causes Headaches And Migraines
While tension and cluster headaches may be caused at times by these factors, an important distinguishing factor is that those who suffer from migraine vs. headache will nearly always be triggered by their particular combination of factors. These migraine causes include the following:
- Gender and hormonal shifts
- Environmental causes
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When Should I See My Doctor
If you think you have cluster headache, its important to see your doctor so they can rule out other conditions, find the best treatment or refer you to a specialist. Treating cluster headache can be complex so it may be best done by a neurologist, a doctor who specialises in this and other areas.
Go to the hospital emergency department if you have any headache that:
- is an abrupt and severe headache, unlike youve ever had before
- comes with a fever, nausea or vomiting, a stiff neck, mental confusion, seizures, numbness, or speaking difficulties
- occurs after a head injury, even if it’s a minor fall or bump, especially if it worsens
- worsens over days and changes in pattern
Both Migraine And Cluster Headache Can Get Better With Age
Puberty is often the time when girls first have migraine attacks, and theyre most common between ages 18 and 44, according to Migraine Research Foundation.
About 2 out of 3 women with migraine will have significant improvement in their migraine attack frequency when they go through natural menopause, especially for women who have migraine with aura, according to American Migraine Foundation.
The average age of onset of cluster headache is between 20 and 40, according to American Migraine Foundation. People may not age out of cluster headaches entirely, but the amount of time between bouts of cluster headaches usually increases, leading to fewer headaches, according to the Migraine Trust.
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What Is A Cluster Headache
A cluster headache is a painful headache felt in cycles , with pain-free periods in between.
You can have up to eight cluster headaches a day, and this cycle can last for weeks.
Cluster headaches occur on one side of the head and are accompanied by symptoms such as tearing of the eye, eye redness, and nasal congestion or runny nose on the side of the face where the headache is occurring.
Theyre the most painful form of headache, with the pain described as stabbing, burning, or searing.
Cluster headaches are rare, affecting less than one in 1,000 adults across the world.
The cause of cluster headaches is not completely understood, but its believed to be linked to activation and pressure on the trigeminal nerve, a nerve that carries sensations from your face to your brain.
Episodic cluster headaches are the predominant form, affecting more than 80% of those who experience cluster headaches.
When cluster headaches are episodic, there are alternating pain and pain-free periods.
Pain-free periods last at least 3 months.
If pain-free periods are shorter than 3 months, the cluster headaches are considered to be chronic.
Cluster headaches can take place with little warning.
There is not usually a reason or special trigger for their attacks.
This is different from other types of headaches, where smells or bright lights can be triggering factors.
However, you should avoid any strong smells or alcohol while experiencing a cluster headache.
Summary Of Migraine Vs Cluster Headache
- Migraine and cluster headache are both neurological conditions that cause head pain.
- Migraine and cluster headache can often be treated with similar medications such as dihydroergotamine and triptans.
- Migraines affect more women than men and have various triggers.
- Cluster headaches affect more men than women and typically are not triggered by specific factors.
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What Other Symptoms Do I Experience
The only eye symptoms are a visual aura on some migraine attacks and always light sensitivity. I also experience sound and odor sensitivity. Nausea is my most hated symptom, even above the pain. The more hours and days my attack lasts, the more it feels debilitating. Falling asleep is difficult, but eventually, I can. Sometimes my migraine is gone when I wake up, other times it picks back up where it left off. I find myself wanting to take naps to escape the pain. In the day or so following a migraine, I am left with a migraine hangover. This includes brain fog, body fatigue, and other symptoms.
When And How Often Do You Get Headaches
Cluster headaches tend to happen around the same time every day for weeks or months, usually in spring or fall. During a cluster, you could have a headache every other day or up to eight in 1 day. Some may wake you up at night. But then you can have pain-free periods for weeks or years.
Migraine pain may go up and down throughout the day. But itâs rare to have more than one headache a day. And unlike cluster headaches, migraines are more likely to happen during the day and donât seem to follow a seasonal pattern.
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What Is A Headache
Headaches are typically characterized by the level of pain and how often they occur. For example, the says some people will experience a headache once or twice a year, but there are others that will have headaches for over 15 days a month. When it comes to pain, it can range from mild to severe, and come with a multitude of symptoms, like nausea or sensitivity to light. This is all contingent on the type of headache you develop.
Prevalence Age Sex And Habits
Cluster headache is believed to occur in approximately 0.4% of men and in one fifth of that number in women. The mean age of onset of cluster headache is 30 the mean age of onset for women and chronic patients is older. Onset in early childhood has been reported.
Curiously, nearly 80% of patients with cluster headache smoke or have smoked tobacco, and approximately 50% give a history of at least moderate alcohol intake. Patients with cluster headache are also more likely to have sustained head injury with loss of consciousness than control populations. The significance of these factors in cluster headache is unclear, but many have suggested that they are components of a “cluster personality.”
YOSHIKI IMAMURA, JEFFREY P. OKESON, in, 2002
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What Symptoms Are Related To Cluster Headaches
The pain of cluster headaches can be very severe much worse than a migraine. The headaches occur on one side of the face, often around or behind the eye. They can last from between 15 minutes and 3 hours. They can happen as often as 8 times in one day, or once every couple of days. Many people also experience other symptoms on the same side of the face such as:
- a red and weepy eye
- a drooping or swollen eyelid
- a runny or blocked nose
They might also feel restless or agitated.
Deep Brain Electrical Stimulation
Deep brain stimulation may relieve chronic cluster headaches that do not respond to drug therapy. A similar technique is approved for treating the tremors associated with Parkinson disease. The surgeon implants a tiny wire in a specific part of the hypothalamus. The wire receives electrical pulses from a small generator implanted under the collarbone.
Although only a small number of people have been treated, results to date are promising. Some people have remained completely free of pain for an average of more than 7 months when the device is switched on. When the device is turned off, headaches reappear within days to weeks. The procedure is reversible and appears to be generally safe, although a few cases of fatal cerebral hemorrhage have occurred. There are other risks of this surgery, such as infection. Patients with these implanted wires and stimulator may be at great risk of injury if subjected to an MRI scan.
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The Difference Between Cluster Tension And Migraine Headaches
To most of us, headaches are just momentary nuisance. We all get them, so well take an OTC pain medication and a nap, and its gone by the time we wake up. Not all of us have the pleasure of such an easy recovery, though, and because minor headaches are so common, many arent aware of the differences between headache types and the best ways to treat each.
Tension, cluster, and migraine headaches all have different symptoms, triggers, and even pain locations. Additionally, there are several different treatment options depending on the type of headache you experience. Some might even be indicators of something more insidious.
Abnormalities In The Hypothalamus
Evidence strongly suggests that abnormalities in the hypothalamus, a complex structure located deep in the brain, play a major role in cluster headaches. Advanced imaging techniques have shown that a specific area in the hypothalamus is activated during a cluster headache attack.
The hypothalamus is involved in the regulation of many important chemicals and nerve pathways, including:
- Nerve clusters that regulate the body’s biologic rhythms .
- Serotonin and norepinephrine. These are neurotransmitters that are involved with well-being and appetite.
- Beta-endorphins .
Circadian Abnormalities
Cluster attacks often occur during specific sleep stages. They also often follow the seasonal increase in warmth and light. Many people report an increase in attacks when daylight savings time changes occur in the fall and spring. Researchers have focused attention on circadian rhythms, and in particular small clusters of nerves in the hypothalamus that act like biologic clocks. The hormone melatonin is also involved in the body’s biologic rhythms.
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How Do You Feel During Your Headache
Cluster headache and migraine have some of the same symptoms. Thatâs one reason theyâre easy to mix up. But there are some factors that set them apart.
Cluster headaches often give you a sense of restlessness. You may feel better if you walk around. Your face or forehead may also start to sweat.
A cluster headache also causes continuous pain. And youâll usually have some symptoms on the same side as your headache. That may include:
- Watery or red eye
- Travel to high altitudes
Your doctor will likely approach each condition in a different way. You may need therapy to ease single attacks. Thatâs called acute or ârescueâ treatment.
If you get headaches a lot, you may need medication to lessen how serious they are or how often you have them in the future. Thatâs called preventive or âprophylacticâ treatment.
Treatment for migraine may include:
Over-the-counter medication. Painkillers like acetaminophen and ibuprofen, or other nonsteroidal anti-inflammatory drugs , may help with mild pain.
Injectables and nasal sprays. These drugs target brain chemicals and blood vessels that cause migraine pain and symptoms such as nausea. You can only get them with a prescription from your doctor. They work best when you take them at the start of your attack.
Preventive drugs. This is something your doctor might suggest if you have more than four migraine attacks a month. You may need oral drugs or shots.
You may need one or more of the following:
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Migraine More Common Than Cluster Headache
More people have likely heard of migraine than of cluster headaches because migraine is much more common. The National Headache Foundation reports that more than 37 million Americans have migraine. According to the Migraine Research Foundation, migraine is the third most prevalent illness in the world.
Cluster headaches, on the other hand, are rarer, affecting between an estimated 200,000 and one million Americans, according to Eileen Brewer, president of the patient advocacy group Clusterbusters, speaking to the American Migraine Foundation.
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Risk Factors For Migraines Or Cluster Headaches
Risk factors vary depending on if it is a cluster headache or migraine.
Migraine risk factors
- Age migraines seem to start in adolescence and peak in a persons 30s
- Gender women are three times more likely to suffer from migraines
- Family history if a family member suffers from migraines, you are also at higher risk of developing them
- Hormonal changes some women experience migraines right before menstruation when hormone levels are high
Cluster headache risk factors
- Gender men are more likely to suffer from cluster headaches
- Age most people develop cluster headaches between 20 and 50 years old
- Smoking if you are a smoker, you are more likely to suffer from cluster headaches
How Do I Know If My Headache Is Migraine Or Sinus Headache
So, how do you know if your headache is migraine and not sinus? Go beyond the nasal and sinus congestion and the facial pain and pressure look for a headache associated with the inability to function normally at work, school, home or social functions, nausea, sensitivity to light and triggers such as weather change, menstrual cycle, and stress . Significantly, it is commonly thought that weather change often causes sinus headache when weather change is a common trigger for migraine.
You can also ask yourself the following questions from the ID Migraine Questionnaire developed by Dr. Richard Lipton of Albert Einstein College of Medicine:
- In the past three months, how disabling are your headaches? Do they interfere with your ability to function?
- Do you ever feel nausea when you have a headache?
- Do you become sensitive to light while you have a headache?
If you answer yes to two of the above three criteria, migraine is likely 93% of the time. If you answer yes to all three, a migraine diagnosis is 98% likely.
The American Migraine Foundation is committed to improving the lives of those living with this debilitating disease. For more of the latest news and information on migraine, visit the AMF Resource Library. For help finding a healthcare provider, check out our Find a Doctor tool. Together, we are as relentless as migraine.
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When To See A Healthcare Provider
Home treatments and OTC medication are often enough to manage tension headaches.
Prescriptive migraine treatments are known to generally be effective as well.
However, seek medical attention if you experience:
- A headache that is different from your normal headaches
- A sudden, severe headache or the worst headache of your life
- Head pain after a fall or injury
- Numbness to the body or paralysis on one side of the body
- Headache that doesnt improve or worsens with OTC treatment
- Confusion or altered level of consciousness
- Seizure activity
- Vision changes or vision loss
- Dizziness or feeling like you are going to pass out
The presence of other symptoms such as a fever or neck stiffness
Not all headaches are migraines or tension headaches.
Your healthcare provider can diagnose the cause of your headaches, which can help you find effective ways to manage and treat them.