Cluster Headaches

Cluster headaches are one of the most intense and painful types of headaches, affecting many people in Singapore and worldwide. Though less common than migraines [link to MIgraine] or tension headaches [link to Tension Headaches], cluster headaches can be debilitating and significantly impact the quality of life. In this article, we’ll explore what cluster headaches are, what causes them, and how they can be effectively treated in Singapore.

What Is A Cluster Headache?

A cluster headache is a neurological condition characterised by severe, recurring headaches that occur in cyclical patterns, known as "clusters." These headaches typically present as intense pain on one side of the head, often around the eye or temple, and can last anywhere from 15 minutes to several hours. Cluster headaches tend to occur in bouts or "clusters" that last for weeks or months, followed by periods of remission where no headaches occur for months or even years.

Cluster headaches are sometimes referred to as “suicide headaches” due to the excruciating pain they cause, which is often described as one of the most severe types of pain a person can experience.

What Causes Cluster Headaches?

The exact cause of cluster headaches remains unknown, but they are believed to be linked to abnormalities in the hypothalamus, the part of the brain that regulates sleep, circadian rhythms, and some autonomic functions. Cluster headaches often occur at the same time each day, suggesting a possible connection to the body's internal clock.

Certain triggers can also set off cluster headaches, though they vary from person to person. Common triggers include alcohol consumption, strong smells (like petrol or paint fumes), high altitudes, and even weather changes. In Singapore, our hot and humid climate may exacerbate these headaches.

What Are the Symptoms of Cluster Headaches?

Cluster headaches are characterised by their distinctive symptoms, which set them apart from other types of headaches [link to Other Headaches]. These include:

• Excruciating, piercing pain on one side of the head, often centred around the eye
• Red, watery eyes or swollen eyelids on the affected side
• Nasal congestion or a runny nose
• Restlessness or agitation, as the pain is too intense to sit still
• Sweating on the forehead or face
• Sensitivity to light and sound, though this is less common than in migraines

The headaches typically come on suddenly and can occur several times a day during a cluster period. Each attack usually peaks within 5 to 10 minutes and can last for up to 3 hours.

Is a Cluster Headache Painful?

Cluster headaches are widely considered one of the most painful types of headaches. Patients often describe the pain as sharp, burning, or stabbing, concentrated behind one eye or in the temple. The intensity of the pain can be so overwhelming that it disrupts daily activities and sleep.

People experiencing cluster headaches are often restless and may pace, as lying down can worsen the pain. The extreme discomfort often leads sufferers to seek immediate medical help.

Who Is at Risk of Getting Cluster Headaches in Singapore?

Cluster headaches can affect anyone, but certain factors increase the likelihood of experiencing them. These include:

• Gender: Men are more likely to suffer from cluster headaches than women.
• Age: Cluster headaches typically have an onset between the ages of 20 and 50, though they can occur at any age.
• Smoking: Smokers are at a higher risk of cluster headaches. Many sufferers are heavy smokers, but quitting does not always alleviate the condition.
• Family History: A genetic link has been identified in some cases, so those with a family history of cluster headaches may be at higher risk.
• Environmental Factors: In Singapore, environmental triggers such as heat, humidity, and air pollution could increase the likelihood of a cluster headache episode.

How Is a Cluster Headache Diagnosed?

Diagnosing cluster headaches typically involves a detailed medical history and a physical examination by a neurologist. The diagnosis is often based on the pattern of the headaches, including their timing, duration, and associated symptoms. Imaging tests such as MRI [link to MRI] or CT [link to CT] scans may be ordered to rule out other causes of severe headaches, such as tumours or aneurysms.

A neurologist may also assess any potential triggers, such as alcohol consumption or changes in sleep patterns, to provide a more accurate diagnosis. Keeping a headache diary that tracks when the headaches occur, how long they last, and any accompanying symptoms can also help doctors make an accurate diagnosis.

What Are the Treatment Options for Cluster Headaches in Singapore?

While there is no permanent cure for cluster headaches, there are several treatment options available in Singapore that can help reduce the frequency and intensity of the attacks.

• Acute Treatments:
  • Triptans: These medications, often used for migraines, can also be effective in treating cluster headaches when administered via injection or nasal spray.
  • Oxygen Therapy: Breathing in 100% oxygen through a mask at the onset of a headache can provide rapid relief for many patients.
• Preventive Treatments:
  • Calcium Channel Blockers: Medications such as verapamil are commonly prescribed to help prevent cluster headaches during a cluster period.
  • Corticosteroids: Short courses of steroids can be used to reduce inflammation and prevent the onset of further headaches during a cluster phase.
  • Nerve Blocks: Some patients benefit from nerve block injections [link to Nerve Blocks], which can numb the nerves responsible for the pain.
• Lifestyle Modifications: Avoiding known triggers, such as alcohol, smoking, and exposure to strong smells, can reduce the frequency of attacks. Practising stress management techniques, engaging in Cognitive Behavioural Therapy and maintaining a consistent sleep schedule may also help prevent cluster headaches.

Cluster headaches are a severe and debilitating condition, but with the right treatment plan, they can be managed effectively. If you suffer from intense headaches that disrupt your daily life, it’s essential to seek professional medical advice to receive a proper diagnosis and treatment. Schedule a consultation with Dr Charles Siow today to discuss how we can provide personalised treatment for your cluster headaches to improve your quality of life.