Talk:Cluster headache

Misdiagnosis Article at WHA

I was researching cluster headaches and I found Vast Majoritjy of Cluster Headache Patients Are Initially Misdiagnosed. In short it says that most doctors were unable to properly identify cluster headache in the majority of patients. Some were led to unnecessary surgery or otherwise given improper therapy. It also states that 16% of the people in the study made their own diagnosis. I thought this would be good information for the article but I can't find a nice spot to put it. Hopefully someone in the future can integrate this. Triddle 19:23, 15 Apr 2005 (UTC)

Could you search Pubmed for the relevant reference? That makes inclusion much easier. JFW | T@lk 09:54, 17 Apr 2005 (UTC)

I can't find a reference to that article on pubmed but pubmed does reference the International Headache Society diagnostic criteria for cluster headache. The report is given to us by the World Headache Alliance which is linked to by IHS with the following qualification: Headache sufferers and their families, or any non-medical person with an interest in this topic, can find information more relevant to their needs at the World Headache Alliance website. That's the strongest reference I can find with my limited medical knowledge. Triddle 22:54, 17 Apr 2005 (UTC)

Being a Cluster head since 1991 (when the symptoms started) misdiagnosed for 6 years until I saw an ear, nose and throat specialist. My advise to everyone who suffers from any type of recurring headache is to seek out a neurologist who is familiar with headache sufferers. The Mayo Clinic has performed many studies on CH patients with no advancements in either a cure or treatment. I suggest visiting www.clusterheadaches.com. Not a medical site, but a good resource and a place Cluster Heads can realize we are not the only one out there suffering from this horrible pain. Good Luck to all and may we all be pain free one day. —Preceding unsigned comment added by 98.113.130.91 (talk) 02:02, 2 March 2010 (UTC)

Link Dispute

Why delete the link to the Cluster Headache Book at med-owl? According to the admin who has twice deleted this link, "let's not advertise other wikis unless very notable in the CH patient community (quod non))." Some thoughts: 1) the fact that another website is a wiki should be irrelevant - would it be better if I put the same information into plain html instead? 2) the page in question is in fact a unique and valuable source of information for the cluster headache community.

Floridian | Talk -- 13:27, July 6, 2005 (signed for the original poster by Wulf January 06)

Here's a quote from the "Cluster Headache Book": "One supplier that has been recommended by several people in the kudzu thread is Vitacost.com Their prices are excellent and they ship to over 50 countries. " The site appears to be nothing more than an "informational storefront" for a vitacost affiliate. Floridian is always on top of the current research on CH but the online book with plugs for vitamin shops worked into the text is inappropriate. The advertising and editorial content must be kept separate. I don't want to get into a revert war, so I'll leave it until Floridian can respond. THB 17:52, 24 February 2006 (UTC)

Wikipedia stated policy is to avoid "Links to sites that primarily exist to sell products or services" and Links to sites with objectionable amounts of advertising. (http://en.wikipedia.org/wiki/Wikipedia:External_links#Links_normally_to_be_avoided) The CH Book does not primarily exist to sell products or services. The term 'objectionable amount of advertising' is subjective, but comparable with other sites that have not been de-listed. In the case cited above, there have been many people in countries where kudzu is not easily available that have asked about that product, and the fact that a company will ship internationally is a practical issue for patients considering that treatement option.It is one of the largest collections of information on CH written by a patient. Floridian -- Dec 2006)

Not sure where to put this

I was diagnosed with cluster headaches, thought it was just a "go away" diagnosis, looked it up on internet and had most of the symptoms, one of the symptoms that isn't mentioned in the article is holding your head in your hands and rocking back and forward which I hadn't mentioned to doctor but I think is quite a good indicator. Think it should be mentioned as a symptom. http://www.cnn.com/HEALTH/library/DS/00487.html Also thought that smoking was related to occurence which is also not mentioned. http://www.webmd.com/content/article/46/1826_50688.htm ps it really really does hurt, but 100 times the pain of anything else seems non Wiki standards, why not 1000.

in regard to the "head in hands" suggestion, that would be a sign of a cluster headache, not a symptom. ie, it's something that people show, they don't say "dr i'm holding my head in my hands, what's wrong with me... "

I also suffer from Cluster Headaches. I too hold me head in my hands (often only one hand on the right side where the pain is). I also tend to close my right eye as much as posible during an entire attach. Mine last 1-2 hours. My right eye does tend to be sensitive to lite.—Preceding unsigned comment added by 200.66.111.98 (talk • contribs) 16:32, 9 April 2007

I recently had my first experience of a cluster headache (suicide headache). And I didnt hold my head in my hands - i squeezed my head in my hands because the pain and pressure were so intense. I seriously thought my head was going to explode. It lasted about 3hrs and in that 3hrs we tried everything to releave it. The only thing that did help was a cool shower and letting the water just run over the top of my head. My father has suffered for his entire life with this and I feel for him. I agree with the term suicide headache - cos all you want is for someone to put a pickaxe through your temple to releave it. —Preceding unsigned comment added by 41.185.163.123 (talk) 09:56, 13 September 2010 (UTC)

I am diagnosed with Cluster Headache and I too rock back and forth with my hands over my face, but I don't think this is a symptom of cluster headaches - it's something we do to try and handle the pain. Slamming my head in the wall over and over again was also something i did during attacks, until my wife put a pillow between my head and the wall. Then I just start punching my head with my fist. For all you sufferers out there i can say that altough it's controversial, eating silocybin mushrooms saved me. I eat shrooms every 2 months and i'm free from attacks. Just thought i would mention that. — Preceding unsigned comment added by 109.228.174.129 (talk) 14:45, 4 October 2012 (UTC)

Featured article

This article should be honed to a standard that would allow it to be the featured article on the front page of Wikipedia so that thousands of people will read it. It will need some illustrations.

Additional fact

A patient of Dr. Robert Nett, a headache specialist, reports that Dr. Nett has said that although CH's are not a commonly occuring condition, is still ranked as the 5th leading cause of suicide among adult males. Those sufferers are usually ones for whom the condition became chronic, without the periods of complete remissinon between clusters of attacks.

I could not find any stats about suicide causes in adult males to verify this.

—Preceding unsigned comment added by 65.174.156.30 (talk • contribs) 16:42, 30 March 2006

A search of PubMed for "cluster headache suicide" gives 5 hits. One of which reviewed world literature on prevalance rates (PMID 16856701). PMID 737393 makes interesting reading re treatment of patients who have suicidal ideation. PMID 16492244 has potentially relevant title of "Cluster: a potentially lethal headache disorder." but no abstract listed by PubMed (online version requires subscription). David Ruben ^Talk 01:22, 22 September 2006 (UTC)

A simple web search for "suicide headache" will provide the stats you are seeking. —Preceding unsigned comment added by 98.113.130.91 (talk) 02:08, 2 March 2010 (UTC)

Other names for cluster headache

According to Silberstein, Lipton, and Goadsby, Horton's Headache actually is an older term for cluster headache.

Older Terms for Cluster Headache • Erythroprosopalgia of Bing

• Ciliary neuralgia

• Migrainous neuralgia

• Erythromelagia of the head

• Horton's headache

• Histaminic cephalalgia

• Petrosal neuralgia ore spenopalatine neuralgia

• Vidian neuralgia

• Sluder's neuralgia

• Hemicrania angioparalyticia

Stephen D. Silberstein, Richard B. Lipton. Peter J. Goadsby. "Headache in Clinical Practice." Second edition. Taylor & Francis. 2002.

I believe that Sluders Neuralgia is a separate condition and not a different name for cluster headaches. This is alluded to (confusingly) where the article discusses treating them both effectively with lidocaine.

Also, the part about "septoplasty and splinting" is laughable and should be removed as these treatments are not effective for Clusters. The citation (number 10 doesn't even relate to cluster headaches and should also be removed IMHO) The fact that clusters "may" be helped with the administration of lidocaine, in no way indicates that septoplasty and splinting would have ANY effect. The lidocaine numbs the ganglion nerve bundle in the back of the sinus cavity.

Psiloscribe 05:07, 27 June 2007 (UTC)Psiloscribe

Since treatment for Sluder's stops a 15-year diagnosis (by several specialists)of Cluster, then what should we call it? Overweight(closes off the nasal passages) adult males (more prone to nose injury via breech birth, etc) experience "adhesions" between 2 or more nasal turbinates - this causes a short circuit of nerve endings that "backfeed" each other, causing intense unilateral "head" pain. Timing of attacks can be altered by smoking, exercise, temperature changes, alcohol, etc. - anything that can swell the membranes can temporarily intensify the pain. Pain killers (lidocaine, etc.)indicate a "pain signal" malfunction. Simple septoplasty and a tiny, temporary splint can separate the turbinates 'till the separated adhesions heal and the pain stops - for good!....This procedure has been used for years - it works. Any good, experienced ENT can confirm this. In short, Sluder's and Cluster are just 2 names for the same rose.

valde 13:21, 30 October 2007

Your statement: "Overweight(closes off the nasal passages) adult males (more prone to nose injury via breech birth, etc) experience "adhesions" between 2 or more nasal turbinates" is exactly correct for Sluder's Neuralgia. Without speaking for all neuralgias, of which Sluder's is only a percentage, I have probably discovered not only a treatment, but a permanent cure for Sluder's headaches beyond rhinoplasty.

The symptoms are not solely caused by turbinates pressing on the Sluder's nerve, but in fact are also caused by swelling causing blockage of the sinus, which results backpressure in the sinus cavities which then pushes the eyeball out of its orbit. (It was horribly amusing to me during my research to hear doctors say that the pain "felt like" the eyeball was being pushed out, when it clearly is being pushed out.) To check this in a Sluder's case, monitor the distance of the lower lid in relation to the pupil, you should see the displacement compared to the other eye, since Sluder's is usually unilateral in nature.

The cause of this occasional swelling and resulting backpressure was a moscollum/shingles or wart type virus that had spread into the nose. How I discovered this was during a cryotherapy treatment of a minor skin condition, my sinuses felt additional pressure as the antibodies recognized the virus and caused swelling in the area. Moscollum builds up fluid depending on diet and other factors, and this was what was swelling the sinuses. This explained the sinus swelling and breathing issues which interfered with sleep occasionally, explained why the minor moscollum skin condition would produce fluid corresponding (or soon after) attacks, explained the backpressure, eye pain, sensitivity to light, lacrimation, rhinorrhea, etc.

After some arguing and convincing, my GP was cajoled into prescribing Valtrex (Valaciclovir), an anti-viral, anti-shingle, anti-cold sore at 500 mg x 3 times daily for fourteen days. (I recommend four weeks minimum, however.) Within a few days I experience the same swelling in my sinuses and an induced headache which verified my theory that my immune system was finally recognizing the virus and thus the tissues were swelling.) Within a week there was a noticeable shrinkage even in the exterior of my nose and in the corners of my eyes as the virus was removed from my sinuses. (Sadly I didn't take before and after pictures.) After that I have not yet had a headache.

I'm on week five of this self-styled treatment and will let you folks know the status of my attacks, if any. So far, no attacks. Because of this sinusidal sinuses have shrunk, I am now able to sleep through the night and breathe through my nose. I would be interested in helping author, for any otolaryngologists, any papers to get the word out.

--Bigdavediode (talk) 06:42, 20 December 2007 (UTC)

Awesome illustration

That is an unbelievably awesome illustration. Please don't remove it. Ever. -Toptomcat 01:56, 6 October 2006 (UTC)

• "KEEP" - I agree in full that this illustration should stay. When i am personally explaining the pain of a cluster headache i will refer to this site specifically for this illustration. For those of you who object to this, your argument being its graphic nature is not encyclopedic, I would say that an encyclopedia is meant and intended for the education of others. This picture does just that and thus is very encyclopedic. `Cluster Head Dan`

Remove the Illustration

I propose to remove that creepy illustration/ —The preceding unsigned comment was added by Hawaiianchief (talk • contribs) 08:25, 10 December 2006 (UTC).

It is an amazing illustration, but I would happily sign a petition to move it elsewhere on the page - not the main graphic. 82.40.75.55 12:34, 11 December 2006 (UTC)

• Keep - The illustration depicts an artist interpretation of a cluster headache, it's a image most of us sufferer recognise and can relate to. — Preceding unsigned comment added by 109.228.174.129 (talk) 14:49, 4 October 2012 (UTC)
• Keep - the illustration is fine and in its current location. It is no more creepy than anatomical pictures and gives a clear indication of the type & severity of the problem; indeed I suspect most sufferers would rate the picture as a somewhat gentile underplay of the real severity of an attack. Its location is I feel also appropriate for the same reasons - i.e. in forms an opening backdrop for the discussion that follows. David Ruben ^Talk 12:56, 11 December 2006 (UTC)
• Keep - the illustration "beautify" encapsulates what I feel when I get one. Jdanb 01:16, 25 January 2007 (UTC)
• Keep absolutely, unless someone has something better with which to replace it. Cluster headaches are creepy. t h b 01:19, 25 January 2007 (UTC)
• Remove. The illustration is thoroughly unencyclopedic. -- Earle Martin [^t/_c] 17:01, 12 February 2007 (UTC)
  • You are entirely entitled your own opinion in this straw poll, but I would be interested to know why you think the picture is "unencyclopedic" (vs a personal feeling of either not very good, or non-representative of the condition) ? David Ruben ^Talk 21:53, 12 February 2007 (UTC)
    • I forgot I'd commented here. You probably won't see this since two years have passed, but here goes anyway. Because articles on medical topics are supposed to explain them with science, not poetry or creative art. The only place an illustration like this should be in the article would be a section on subjective comments of the experience. The main illustration should be some sort of diagram. I also concur with everything Goophus says below. -- Earle Martin [^t/_c] 18:35, 3 March 2009 (UTC)
• STRONG KEEP. Typically I would agree that it should be deleted. But, consider this (and anyone suffering from CH please chime in). When trying to help others understand various conditions people try to give anaolgies or such. For my asthma I tell non-asthmatics to close their nose and breath for 5 minutes through a normal drinking straw. That helps. This illustration is far better than the cliche "ice-pick in the temple". I saw that illustration and cringed because it made the pain's severity and horrid nature very easily understandable to my co-workers (they are CH-free). It is not strictly encyclopedic on the surface...but it is in the spirit of encyclopedic because that picture can let the non-CH sufferer visualize them. All it needs now is that guy jabbing a spike through the eye--but that may be too over-the-top. -- Tony 19:15, 28 March 2007 (UTC)
• VERY strong keep. Despite being a lifelong sufferer of severe headaches, I could only laugh when I saw the image. It perfectly represents the pain that I have felt.PiccoloNamek 12:43, 12 April 2007 (UTC)
• VERY strong keep. I agree with everyone who said to keep it, however, I can see it being a potential problem with various people of different religions. Maybe that "devil" creature can be replaced by some other 'object' stabbing the eye, although I personally do not care because we all know that the devil is a bad thing. It just makes it very clear that cluster headaches are BAD. But like I said, if there's another picture that replaces the devil creature with some other object or something similar, then that would probably be better to use, just for neutrality's sake (if there's such a word). —Preceding unsigned comment added by 64.180.85.99 (talk • contribs) 08:21, 24 April 2007
• REMOVE. Who cares how evocative it is? You wouldn't find this illustration in a printed encyclopedia, so it doesn't belong here.Goophus 05:09, 11 May 2007 (UTC)

But Wikipedia is not a print encyclopedia. Wikipedia is not paper. Besides, there is precident for this sort of thing. The images on the sleep paralysis page are a good example.PiccoloNamek 06:15, 11 May 2007 (UTC)

Wikipedia certainly hopes to emulate print encyclopedias; otherwise much of the mission statement makes no sense. I agree that artists' interpretations of disorders like this can have a place on a page, but they look bad at the top (particularly in this instance IMO.) And I did not know about the image on this page till a friend (who suffers cluster headaches) made fun of the picture to me, which suggests I'm not the only one who thinks it looks cheesy.

I don't think a drawing inspired by a King Crimson album cover (to say nothing of the misplaced religious iconography) encourages much trust in the general internet public. Instead it makes wikipedia look horribly amateurish (again IMO.)172.129.213.68 09:13, 11 May 2007 (UTC)

That's me above. Somehow logged out during my post.Goophus 09:25, 11 May 2007 (UTC)

You should read WP:PAPER.PiccoloNamek 13:31, 11 May 2007 (UTC)

You should too, because your citation is obnoxious and utterly irrelevant. The gist is contained in the second sentence: "This means that there is no practical limit to the number of topics we can cover, or the total amount of content, other than verifiability and the other points presented on this page." This doesn't mean Wikipedia wants fan-art at the top of its pages, nor does it mean Wikipedia eschews the influence of paper encyclopedias. If it did, perhaps it would be called WikiCarta?

And certainly nothing is there in your citation to indicate that 'evocative' pics--- which in fact is the only ground on which this piece has been preferred in the above discussion-- should be privileged over descriptive pics, which indeed are already in the body of the article. Why should a wiki article prefer an interpretive image of pain over a far more objective one?

If you still prefer the page has a cheesy image at the top, that's your business. I'm bowing out of this conversation Goophus 11:27, 15 May 2007 (UTC)

• KEEP, for the reasons given above, or to restate; it perfectly illustrates a condition that has no outwardly visible indicators. Pjbflynn 06:01, 30 July 2007 (UTC)

• Definitely Keep, I have suffered from Cluster Headaches for over 20 years, and that drawing pretty much sums it up. I have used it to show to colleagues and managers, so they can better understand what I'm going through during a bout. —Preceding unsigned comment added by 76.200.158.56 (talk) 07:19, 27 October 2007 (UTC)

• KEEP, excellent illustration for this entry. A great illustration is a thousand times better than stock photography.

DCSB2005 (talk) 23:13, 1 October 2009 (UTC)

• REMOVING. The image is useful for some people who suffer with CH, but that's irrelevant to the question of the use of the image. Wikipedia is an encyclopedia (First Pillar). I'm boldly removing this image...please reinstate it if you feel the need to.

Slowmind (talk) 17:21, 29 March 2010 (UTC)

• 'KEEP. I am a female sufferer -- I have sent many people (friends, coworkers) to this page, to THIS graphic to try to get across how painful clusters are. It's a wonderful illustration that helps get the point across. Please keep as the primary graphic. 24.107.17.243 (talk) 19:40, 16 April 2011 (UTC)

• MOVE or REMOVE. While the picture is a fairly accurate graphical representation of a cluster headache I would advocate removing it for one reason alone: the little character on the top has horns suggesting a devil. As I also suffer from cluster headaches I understand the value of the horns on the character, but I wonder if the graphic is not blurring the line between science and religion. The graphic infers that cluster headaches can be remedied by exorcism. The Wikipedia for ‘physician’ does not feature leaches as the main graphic. While I think most people know these remedies are ineffective for most maladies, it may reinforce the notion that refusing medical intervention is a viable option. — Preceding unsigned comment added by Atlrailfan (talk • contribs) 21:25, 11 January 2012 (UTC)

Currently in the news

Check out that BBC article [1]. Hugo Dufort 06:59, 24 November 2006 (UTC)

Question

The page http://www.webmd.com/content/article/46/1826_50688.htm says that cluster headaches can be 100 times more intense than migraines. Is that true? I seem to get migraines a couple times a year, and let's say they're about 10 times worse than a "regular" headache, or another example they're a couple times worse than a small burn. so cluster headaches would be a few hundred times worse than a small burn. If that's true then wow... 74.104.1.193 06:13, 16 December 2006 (UTC) Jordan

• As a sufferer i can say that 100 times more intense than migraines might seem like a exaggeration, but trust me - it's not. During a migraine i can function and talk, think and even do small stuff like getting some water to drink. During a CH attack this is impossible, all you can do is submit to the pain and hope that you will get through it alive. Chuck can demonstrate this pretty well: http://www.youtube.com/watch?v=UzpcPeoPnW0

• I get both, and I think the 100X stat is exagerated. At their worst, the cluster HA pain is very intense, probably several times worse tha worst migraine I have ever had. But Migraines last for hours and sometimes days, and the cluster is usually done in 30 minutes or less. --208.204.155.241 18:42, 29 January 2007 (UTC)

• I have suffered various severe burns over the years and also get CH. The only bad burn after getting CH is burning all the skin off my thumb. It happened perhaps a month after a long CH cycle. I didn't even flinch as all skin shriveled and shrunk before my eyes. I simply thought to myself this is going to burn a bit and proceeded to treat the burn. I don't think it is possible to accurately say one pain is x times worse than another. However if I had to rate it for comparison, there is a ranking system used by CH sufferers know n as the Kip scale. It isn't scientific at all but is definitely very relatable for CH sufferers. It is a simple ranking between 1 to 10 and the ramp ups in pain are certainly not linear. While it is a very different sort of pain, I would rate severe burns about a Kip 4. http://www.clusterheadaches.com/scale.html is a url to the scale. I apologise in advance if this is breaking some wikipedia rule. It should also be noted not every sufferer reacts the same way described on the scale, but I certainly think it helps them convey the severity of a particular headache. Anyway I hope that helps with a comparison, as trying to explain the intensity of the pain to someone without it is one of the biggest problems with CH. 59.167.119.92 11:30, 22 February 2007 (UTC)

• • I'd put getting a nasty steam burn or something as a Kip 7 or 8. I'd rather have a CH attack than hold my hand above a kettle while it boils for half an hour. I agree it's a very different type of pain though. The pain-stabs while at the plateau pain level are knee buckling.I was wondering if the Kip scale could be mentioned in the article, just not sure the best place to put it. Potkettle 22:13, 13 May 2007 (UTC)

• I have had cluster headaches for over 10 years now. I have suffered many things in my life including paralyzingly painful kidney stones

a fractured skull and a few other unmentionable experiences. Last night i suffered a 3 and a half hour attack that ,sadly, all of my best friends are witness to. The shock of last nights attack was so intense that i was in a state of physical collapse for the entirety of today. I had to be carried from place to place. Not to mention the shock my friends are still in from having seen someone in such pain. The pain from these attacks should be classified as at least top ten pains the human body can experience. But its not only the pain that needs to be discussed there is also something to be said of the constant state of fear, a fear that at any moment you will be suddenly and unexpectedly attacked by something you cant "fight or flight" from. A fear that those you love and care for will watch. A fear that during an attack you may hit your head too hard and cause brain damage or "worse". Then there is the intense rage that comes as a side note. In the depth of a true cluster headache you become the hulk. I only write this for the education of others seeing as how there are so few of us out there its really hard for others to understand our condition. My own brother doesn't believe me. I rate the over all pain including emotional as a kip 10. `Cluster Head Dan`

• I have CH and once in a while migraines strong enough to induce vomiting. I dread the CH, and comparatively I will continue with my yardwork with migraines (with d-a-r-k sunglasses, of course). I have many injuries and only had one thing worse my typical CH...a headache after a seizure. My sister-in-law also has CH and swears they are worse then the pain from delivering any of her children. -- Tony 19:01, 28 March 2007 (UTC)

• I have time to time (once in 2-3 years) CH attacks. They are killing me. I do not want to discuss about the pain, I just want to share my experience of how tosoft the pain which I discovered during last crisis (Sept’10). Once the CH strikes, beginning with 7 to 8 from 0 to 10 degree of pain, I mount the static bicycle and hardly turn pedals during 15-20 minutes with 25 km / h at level 5 (from 1 to 8). The first 2 minutes the pain is getting worse, at fifth minute I begin sweating hardly and after 8-9 minutes the pain disappears (in 90% of cases). I continue pedaling for 7 minutes more, at least. I do not say it can help you, but surely it made my attacks acceptable. —Preceding unsigned comment added by 213.68.144.90 (talk) 12:59, 27 September 2010 (UTC)

General Discussion

Personally, I have suffered from CH. At first, I was eating collard greens as temporary relief. I can't explain it but it did soften the pain. The doctor I saw, however, prescribed me beta blockers to take. It's been about 2 years since I've had ANY problems with CH's. Machpovii3...Holla Atcha Bezzle, Kid! 03:46, 4 March 2007 (UTC)

Glad the beta blockers helped you so much. Calcium channel blockers have, I believe, been shown to be effective more frequently than beta blockers, so if the beta blocker ever stops working for you, it would be worth checking with your doctor aobut a calcium channel blocker such as verapamil.

--TeriRobert 06:48, 4 March 2007 (UTC)

I had the calcium channel blockers (Verapamil) for several years, and for me, they worked okay at first, then grew less and less effective. By the time my CHs stopped, the Verapamil (the dose of which I had been forced to increase) was doing nothing positive, and might even have been contributing to the length of those last several headaches (they got up to several hours each by the end).

This brings up another point, somewhat related to misdiagnosis, as well: people suffer with CH for, on average, about 20 years before they remiss. For males, this is often a good chunk of their working life, and for me, it was from the time I was 10 to 32 years--when I should have been developing my mind, and then a career. CHs can destroy your best attempts to function in the world, and since most people don't get diagnosed right away, they suffer often without support. Public awareness of this affliction is extremely low. Sufferers should get disability insurance, but I don't think they do. Not sure how (or if) the article could address this. Seems like the worst pain known to man (and sometimes woman), happening five times a day for several months out of the year, warrants some kind of support.

69.109.122.108 (talk) 05:27, 19 December 2009 (UTC)Leha Carpenter

I'm 20 years old, and I've had them for my whole life. My neurologist suggested that there's a genetic factor to it, at least in my case. Beta blockers and calcium channel blockers haven't worked, neither have anti-inflammatory or anti-convulsion medication. However, they seem to disappear almost instantly when I use Sumatriptan injections. The side-effects are nasty, but not even near as disastrous as a CH. Luckily I only get them ~5 times a week though, so the injection is a viable method.

Robotlegs (talk) 23:15, 5 February 2012 (UTC) i suffer from CH and i am 11, i think i got when i was 8 it is hard when i get during school and Excedrin does not help at all — Preceding unsigned comment added by 76.239.27.34 (talk) 20:29, 31 March 2012 (UTC)

Imaging/Pictures

If somebody wants to use them for this article, I put some images into Wikimedia Commons today:

• PET: Activated brain areas during pain
• 
• 
• 

• Voxel based morphometry (VBM, structural)
• 
• 
• 

Click on images and see image description for more information.

--Friedrich K. 23:29, 23 March 2007 (UTC) (talk)

Done. --Friedrich K. 08:38, 26 March 2007 (UTC)

Anecdotal update to Signs & Symptoms

I am actually in the middle of a particularly bad bout of these this week and was describing it to a co-worker. They thought I was making this up (severity of pain, that arresting the pain early can stop them entirely but beyond a certain point nothing works for the pain, regularity of pain, etc). So I looked it up here for the first time (I usually referred to medical journals or the like). Thank God this article was in good condition...now my co-workers understand why my eye will shut involuntarily when I have "one of my headaches".

One thing I would like to mention (and I have read some journals mentioning this time frame as well, but I'm not looking them up). In the "Signs and symptoms" section it says, "Cluster headache sufferers typically experience...headaches...for fifteen minutes to three hours." Mine range from 15 minutes to several hours, typically, and I have had bouts where the headaches would last 3 or 4 days each. I offer that anecdotally, I have read some reports' findings corraborating that timeframe as well so someone can find that.

That said, I will be adding an edit (and a corresponding 'need source' tag) with this information. -- Tony 18:53, 28 March 2007 (UTC)

Unsure re your anecdotal offering of 3-4 days as there are two time frames here: the duration of each single headache and the duration of the overall cluster of headaches. Likewise there are two frequencies to consider - the number of headaches in anyone day, and the frequency of clusters (in say each year). David Ruben ^Talk 02:48, 13 April 2007 (UTC)

The mention in the article that "some lasting days," in the symptoms section, will only add to the number of people mis-diagnosed. If there are 5 people out of a million that have had ONE headache attack last days, those people would have been hospitalized and on suicide watch upon awakening from their morphine drip. To say some last days, is very misleading. If a sufferer has one attack last days, in their lifetime, they are very unlucky people. There is probably something else going on, such as "medication overuse headache". If you want to change some, to rarely....ok.

In addition, under the treatments section. "Percocet (Oxycodone with paracetamol) has had widespread success amongst some cluster headache patients, especially males."

Good luck finding a citation on this. First of all, how do the terms widespread, and some, coexist in the same sentence? Second of all, percocet does not have much, if any success treating cluster headaches. The article mentions how ineffective even morphine is. Popping a percocet will not even enter the bloodstream fast enough to help, in most cases (90%) let alone touch the pain.

If someone's clusters regularly last 3-4 days, and percocet helps, odds are this person does not have cluster headaches and is actually one of those mis-diagnosed people talked about early on in the article.

In addition, the line "In some cases, cluster headaches remain "steady" without cyclical ups and downs for days," found in the Cyclical recurrance section, is misleading and will again lead people to be mis-diagnosed. This describes a migraine and not a cluster attack. If "some" were changed to "rarely" as in 1/1,000,000 I'd accept the statement.

If I did not comment properly or post my comments properly, please excuse this wiki-virgin.

Psiloscribe 05:31, 27 June 2007 (UTC)Psiloscribe

HoneytrapI've had clusters for years but thought they were migraines. I first woke up at 3 a.m. with them, and then I became more aware of "one coming on" and sometimes did things to try to prevent them. However, they were/are very, very, severe. They were always right behind my eye (left side) and though I also had neck and shoulder tension on that side, the piercing steady pain behind the eye was the main pain. I would stick my finger under the eye bone and press very hard against a blood vessel or nerve there. Sometimes they spread to the base of my head, and I tried putting a rock on the floor and lying down against it, rubbing my head back and forth to press down on some point. I put my feet in scalding hot water in the middle of the night because I'd read it might redirect blood and pain to the feet instead of the head. They lasted days. I could barely speak, and my left eye was droopy and I was congested. Triptans did NOT work at all. They just made my heart race. I tried narcotics finally and with ENOUGH, plus a little muscle relaxant, they helped me to sleep and would go away. But it still took at least 8 hours of sleep, sometimes in the middle of the day. Also, I noticed the congestion cleared up with narcotics. I could breathe! Mine were around my period, always one before and one after, so I thought they were hormonal but birth control trials didn't work. Then later I was accused of being drug-seeking. I had a suicide attempt during a period when the headaches were very serious and more often and I was being refused treatment by ER.

I get at least 2 a month and they are very cyclical. Because I always got them on Friday night or the weekend, the ER thought I was looking for a party fix.

Because they last 3 days without treatment, I discounted cluster, though I have every other indicator for clusters. I had a pain contract for 10 ccs of morphine but it wasn't enough. I needed at least 20 ccs and when I asked for more because it wasn't enough, they thought drug-seeking again.

Then, just recently, a doctor said I had clusters. I said, how could that be bc I have them for a couple days and he said it didn't matter. I have to say I aGREE. I fit cluster more than migraine profile. What's interesting is they've been less severe since I went on narcotics everyday for chronic pain. I don't know if this affects the hypothalamus or what, but although I still get them, they are NOT as severe. Still debilitating though. So my doctor said to go to ER for oxygen.

THe ER people filed a legal action to block me from going to the hospital, bc they claimed I was going for non-emergent reasons and was "drug-seeking". NOW they don't want anything to prove them wrong. So I went for oxygen and they hooked me up to a little nose thing (not a face mask) and gave me less than 5 per liter (or however that works). I said I was supposed to have the face mask. I don't know if they did it right, but I thought I noticed a slight improvement, but, I told them, I really thought it was a placebo effect and I didn't feel the difference. Then I went in again, and they cranked it up to 25 per liter, and with a face mask, and I thought that DID make an improvement. When I got home, I still had to take one more painkiller, but the headahce was decreased significantly and it didn't go on for the regular 3-4 day course. I believe oxygen worked for me, which is further indication I have clusters. oxygen doesn't work for migraine.

I have suffered for a decade with clusters and didn't have appropriate treatment. I am a woman, so that was probably confusing, and I have them for a number of days. But they are far worse than migraine, and what other migraine sufferers say relieves their pain. I was told to take "tylenol" and "advil" by the ER. They gave me sedatives and antipsycotics, refusing to believe my symptoms. I had the droopy eyelid and pointed it out and they didn't care.

I think it's dangerous to make any statement that clusters are only for brief bouts and cannot last for a couple of days. Some people, like me, may be affected by inappropriate descriptors. Many things, in hindsight, make sense to me now. For example, why I got the headache after having alcohol (sudden and immediate onset) during a sensitive period.

Now, my chronic pain meds of Percocet actually have been giving me more stability. I take 10 mgs maybe 4 times a day and it has greatly decreaded the severity of clusters. I think it's because, I've read narcotics affect horomones, and horomones are regulated by the hypothalamus. Something is connected. Men, on chronic narcotics, have lowered levels of testosterone. There has been a lot of research about testosterone and clusters, bc it's a headache that affects men more than women. I think there's a possible link. Perhaps my chronic use of narcotics affects testosterone or some other horomone level that also was triggering the clusters to occur before and after my period (I also got the clusters more if I was under stress).

I would be so happy to volunteer for a clinical trial. If that LSD (one dose, bc I'd be afraid of warping my brain with more) really does cure clusters, I would sure like to try it. I'm a stay at home mom and it would help. I guess I'll have to look up Harvard's trial. But anyone with info can leave a msg here for me and I'll check on it.

I'm thankful for this wiki on clusters. It's evolving nicely, and as for the photo, I'm glad it was kept. It's perfect. I saw it and was shocked "that's me!" except I would have one of my fingers inside that eye, trying to crush the devil out.

Thanks. I am a 33 year old female with a 10 year+ history of cluster.

Hooray for self-diagnosing.

Honeytrap —Preceding unsigned comment added by Honeytrap (talk • contribs) 16:49, 3 September 2007 (UTC)

Uhm... so you got symptoms different from those listed for cluster headaches, like headaches not "clustering" at all. The treatment working for you is said to be completely ineffective on CH (because Percocet works via Paracetamol). And the common treatment (triptans) does not work. Also, you're female, therefore less likely to get CH. So: Why exactly do you believe it is cluster headaches? Not that I do not feel sympathetic to your problems, since I know how severe headaches suck, but I'd say anecdotal evidence by people who have not been professionally diagnosed will lead to even more misdiagnoses. In your case I wonder if you looked into other Hemicrania continua, which fits your descriptions better (continuous pain, affects females more than males)? Tierlieb (talk) 14:27, 16 April 2008 (UTC)

---

I have some more anecdotal updates to Signs and Symptoms, or possibly to Pathology (which I don't see). Not sure if others experienced these:

Intense attacks often followed by a brief period of deep sleep, then followed by pronounced sympathetic chills and experience of euphoria for about 10-20 minutes. This may be a byproduct of the body's pain drugs, which do not help during the attack, but may kick in afterward.

Episodic attacks typically begin as short, and sometimes escapable by violent physical exercise, occurring only once or twice a day, whereas deeper into the episode, when attacks occur multiple times per day, each attack tends to last longer and become impossible to eradicate.

Have observed the following triggers: alcohol (in any amount, including just the smell of it); perfume/cologne smell; postpartum (unseasonal CH episodes immediately following childbirth, twice); sleep/relaxation; sitting still for over an hour; morphine ingestion; smoke smell.

Have observed a shielding effect of pregnancy (twice) during what otherwise would have been a CH "season" for me.

Aside comment on above Percocet discussion: It is unlikely that this type of drug could do anything but make a CH worse, in my experience.

69.109.122.108 (talk) 06:27, 19 December 2009 (UTC) Leha Carpenter

Degree of Pain

Hi, one of the sections describes the headaches as "the most severe pain condition known to man." Is there any source for this? It seems as though it is grossely exagerated. Thanks alot. —Preceding unsigned comment added by 99.232.131.105 (talk • contribs) December 1, 2007

Quote: "Cluster headache (CH) is one of a group of primary headache disorders (trigeminal autonomic cephalalgias) of uncertain mechanism that are characterized by frequently recurring, short-lasting but extremely severe headache. " Source: http://www.who.int/mediacentre/factsheets/fs277/en/index.html --Friedrich K. (talk) 12:19, 25 April 2008 (UTC)

Peter Goadsby: "Cluster headache is probably the worst pain that humans experience. I know that's quite a strong remark to make, but if you ask a cluster headache patient if they've had a worse experience, they'll universally say they haven't." Source: http://www.abc.net.au/rn/talks/8.30/helthrpt/stories/s42434.htm --Friedrich K. (talk) 12:32, 25 April 2008 (UTC)

So the above 1st ref accepts as "extremely severe headache" and second ref has an important qualifier of "probably the worst pain that humans experience". Therefore neither confirm wording of "the most severe pain condition known to man." - anyway is this wording actually used in the article at the current time ? Second ref is poor source for such a claim, as I'm sure if one asks most cluster headache patients they wont individually have experienced the "hit by a hammer" sudden severity of a sub-arachnoid haemorrhage or the tearing ripping pain of an abdominal aortic aneurism. However clearly we can be reasonable confident that the 1st ref supports comparison to the commonly experenced pains (broken bones, tooth ache, child birth), but for "the worse", one would need a reliable source that systematically compared the pain in CH to all other severe causes of pain. David Ruben ^Talk 18:06, 25 April 2008 (UTC)

There is no real way of indicating the "worst pain you can ever feel". What hurts me the most may not be the most painful thing to you. —Preceding unsigned comment added by Judd515 (talk • contribs) 21:42, 27 May 2008 (UTC)

I am one of those rare females who had classic episodic CHs for 22 years before they finally stopped. Typical seasons were two months, twice a year, in spring and fall, with attacks occurring up to five/six times a day, lasting from 15 minutes to three hours. I also had two children during that time, naturally born, without drugs. The first was 8 lbs 8 oz. and a 36 hour labor (a day and a half) with *no pre-softening of the cervix*. The pain involved in that birth was so intense that my brain checked out during transition and I thought for a moment that I was somewhere else. The second child took only 3 hours to bear, and was 10 lbs 10 oz. Also pretty intense. But in no way would the pain of either of these births hold a candle to the typical cluster headache I experienced.

I believe that this is because most kinds of pain benefit from the release of endorphins (and whatever other opiate-like drugs our bodies typically release when we are in pain), but cluster headaches are made *worse* by these drugs. In fact, while I was in the hospital after my first baby was born, I went into an uncharacteristic CH season, getting attacks right there in the hospital. I was given morphine for the pain of the aftermath of childbirth, and when I took it, the morphine actually made the cluster headache I was having much more intense. I refused all pain killers after that, because I knew they would make the clusters worse.

The point being, the intensity of the pain of cluster headaches is made more unbearable by the very mechanism of the headache: that it grows in intensity in response to the very drugs our bodies use to shield us from pain. You might not want to stick your hand over a steaming kettle for a half hour, but I guarantee that if you did, your endorphins and whatnot would kick in and help you tremendously for at least the last 25 minutes of that experience (in fact, you would probably pass out). Not so with cluster headaches. The intensity of the pain is that brand of intensity that we might also experience in having our eyelids held open and being forced to watch while some horrid event unfolded before us. I can't tell you how many times I jumped out of bed and ran around the room, or sometimes even the neighborhood, flailing my arms and trying to wake my body up before an oncoming attack took hold when I was a teenager/young adult, because I knew that as bad as it might be when awake, if I got caught while sleeping (or even relaxing) it was going to be many times worse. There is something very chemically different about this kind of pain--something that truly makes it incomparable to other types of pain. I hesitate now to even tell sufferers who are only a few years into it that mine lasted 22 years.

69.109.122.108 (talk) 06:02, 19 December 2009 (UTC)Leha Carpenter

History

PMC 1813127 goes greatly into the history of the disease and its nomenclature. Descriptions from 1908 and 1926 predate Horton's paper. JFW | T@lk 20:43, 27 May 2008 (UTC)

The first complete description of cluster headache was given by the London neurologist Wilfred Harris in 1926. Added this to the article today. Early case reports have been found from Nicolaes Tulp - 1641 and from Gerard van Swieten - 1745. Please see http://ck-wissen.de/ckwiki/index.php?title=Geschichte_des_Cluster-Kopfschmerzes (German) for refs and more details on cluster headache history. --Friedrich K. (talk) 20:48, 13 August 2008 (UTC)

Insulin reactive?

As a severe episodic CH sufferer since puberty, I only recently was diagnosed with type II diabetes. While currently controlled, for a time the diabetes was not managed, and eventually resulted in my being prescribed insulin (glargine) for a time until it was. During this time, shortly after injection (Lantus Solostar, 20ml daily) I noticed both physical and visual aura consistent with migraine variant, and in my experience, initial onset of a period of cluster headaches.

After reading the current article in detail, I see mention of insulin in the list of "responsive substances" in relation to the hypothalamus, but not specifically classified as a trigger. Personally, I would add it as such, but I know of no other corroboration as being a common trigger. Perhaps there is other evidence of this? If so, please add it it to the article. The reaction of my PCP to my description of the side affect seemed to be taken as a sign of anxiety over self-injecting myself. (Which admittedly, is rather unenjoyable). Thanks. 24.47.149.167 (talk) 06:36, 29 July 2008 (UTC)

Treatment

I was diagnosed with Sluder Syndrome in 1994. I found cure in 1998.Pain was kept away for years. IT only comes back when I exercise too much or expose to another trigger, like cold air. My md, a brain medical researcher treated me with a repeated sound, at the beggining of which I had to put my palms to fist position; while lying down. The changes in noradrenaline mechanisms he said, provided the cure; or something like that; changes could be seen in eeg's made before and after the exercise; also in urine samples. I put this here so that someone may look into it. Because it works. —Preceding unsigned comment added by Dragospanaitescu (talk • contribs) 11:50, 19 August 2008 (UTC)

addiction

hi ive just been diagnosed with cluster headaches and my god the pain is quite special and i was wonderind can a cocaine addiction wich in turn has had an adverse effect on my nasal cavaty , and i was reading that nerve endings have somthing to with it is this true all the symptoms are exact —Preceding unsigned comment added by Munfish88 (talk • contribs) 19:42, 25 September 2008 (UTC)

IHS Classification ICHD-II

Cluster headache G44.0

Episodic cluster headache G44.01

Chronic cluster headache G44.02

Zouhair (talk) 17:34, 6 August 2009 (UTC)

High flow O2 works double blind

Goadsby and his people at Queen's Square have done an RCT with oxygen: http://jama.ama-assn.org/cgi/content/abstract/302/22/2451 JFW | T@lk 22:32, 8 December 2009 (UTC)

Why no discussion of Histamine Desensitization ?

  I was wondering why there isn't any mention of Histamine Desensitization therapy for the treatment of Cluster Headaches ? I don't feel that it will work for every cluster patient, but I KNOW it will work for some, as I have myself have reaped great success from the treatment. I also met others with Cluster Headaches which flew from great distances to Chicago's Diamond Headache Clinic to have this treatment with great success.
  The treatment failed for me a couple of times in a row at first, and then, it worked at stopping all of my attacks for approximately 9 weeks, then the process had to be repeated. I went through this for a few years before the attacks stopped (after taking a drug called "Savella", which may be just a coincidence, or may have stopped my chronic clusters).
  There are articles out there to support the claim the Histamine will help some sufferers and plenty of patients to support that claim, with the proper research. Dr. Seymour Diamond or his daughter, Merle Diamond, from the Diamond Headache Clinic can provide clinical result trial statistics, and other information that you may wish to know. 
  I strongly believe that Histamine Desensitization is worthy of at least a mention in the Cluster Headache Article. If illegal drugs, such as "Magic Mushrooms", is worth mentioning, this is well worth it too, and a legal thing to try as well. And by the way, I also strongle believe that the "Magic Mushroom" results provided by ClusterBusters are biased (BIG TIME) in hopes that it would lead to leagalization for those ready to become the main suppliers and/or consultants to drug companies on just how to grow them the 'proper way', including advising on dosage strengths, etc.(That's IMO after talking to some 'big suppliers' during an OUCH Convention. THese men were no street dealers, or drug addicts, these were very wealthy businessmen, CEO's, VP's, and Company presidents, etc of very big technology and banking companies) I am one of those that would've tried ANYTHING to stop the cluster attacks, so I also tried the CLUSTERBUSTER method with NO GOOD EFFECTS AT ALL !! (I tried plain looking mushrooms, capsules, powder, and candy bars complete with their own wrappers that No one could've detected!) I don't believe it's a total scam or anything, since it is closely related (chemically) to DHE45, which works well for many Cluster sufferers, it's just that the numbers of success that they report is what I am very skeptical of. I do believe it helps some, but I would bet that Histamine would help a comparable number of REAL CLUSTER PATIENTS ... a legal way too !! But if 'Magic Mushrooms" helps some, I hope that they can get it without fear of prosecution! Whatever it takes to help these sufferers is what they should be able to get! If it's illegal, it shouldn't be !!

To sum this letter up, I just ask that you include Histamine Desensitization Therapy as a treatment option that may help some Cluster Headache patients. this is not intended to "slam" any other treatments, although there are some that I find ridiculous. Please consider adding Histamine Desensitization Therapy as an option. It may help many people and change their lives for the better. Who knows, it could even save some lives !!

Thank You for your time in reading this and I hope you seriously consider my question.

A 21 year Cluster Headache sufferer. (13 years episodic & 8 more years Chronic)...I'm now cluster free for just over 100 days and I feel like I have a new leash on life !!

Respectfully,

09:28, 25 January 2010 (UTC) SOLVED 09:28, 25 January 2010 (UTC)

REFERENCES:

http://findarticles.com/p/articles/mi_7342/is_9_30/ai_63125273/

QUOTE: "Intractable cluster headaches have been successfully treated with intravenous histamine desensitization." FROM:http://diamondheadache.com/article_archives/cluster_headache.html

QUOTE IN PARTIAL:"Although it has been asserted that histamine desensitization therapy is of benefit patients with intractable migraine and cluster headaches (see, e.g., Freitag, 2004; Biondi & Mendes, 2004)" FROM:http://www.aetna.com/cpb/medical/data/600_699/0647.html

QUOTE:"One of the earliest descriptions of the different forms of cluster headaches (episodic vs. chronic) was given by Bayard T. Horton, M.D. (1895-1980), of Mayo Clinic. Doctor Horton treated many of his chronic cluster headache patients with intravenous histamine desensitization." FROM:(A BOOK)"Cluster Headaches:Treatment and Relief for Cluster, Cluster Migraine, And Recurring Eye-Stab Pain"; See URL:http://thinktwice.com/clusters.htm

Thanks !! —Preceding unsigned comment added by 74.142.185.27 (talk) 09:28, 25 January 2010 (UTC)

i am a former cluster headache sufferer. the headaches lasted on and off for 6or7 years. lasting 4 to 12 weeks. my headaches have bin gone for over ten years ever since pay attention! i removed my top wisdom teeth i recently got a root canal on a rear top tooth and got that same cluster headache for a few hours over ten years later .belive me theres no mistakeing it for something else.if you suffer from the living hell get those teeth closly checked mine where extra long and straight. lisen to me those headaches can go away and you can live your life agian dont ever give up your war! —Preceding unsigned comment added by 207.81.53.199 (talk) 19:26, 16 March 2010 (UTC)

Triggers

From the "Triggers" section, "Ingestion of alcohol or chocolate or banana are recognized as a common trigger". Alcohol, fine, nearly everyone agrees that alcohol is guaranteed to cause an attack. The others I've never heard of being common CH triggers, especially banana. Maybe they triggered a hit in someone, but they're not common. At any rate, it's uncited. Next, "Lahore or 'chinese salt' is nearly always a triger of migraines. Sexual frustration, Sex or Orgasms may trigger Cluster Headaches in some patients." First, we're not talking about migranes. And again, I can't find any external mention of any of these related to triggering CH attacks. Sexual frustration?? Seriously?

Really, nearly this entire section is anecdotal. I think the article would be better served mentioning Nitroglycerin (I believe subcutaneously), alcohol (since it is the most common and widely reported trigger), and beyond that just that vasodilators generally can be expected to trigger an attack when in cycle. Maybe keep the part "The role of diet and specific foods in triggering cluster headaches is controversial and not well understood." Right now, it sounds like a bunch of edits from people that got headaches after eating sushi, so they added "and sushi too!" Greghodg (talk) 17:49, 4 August 2010 (UTC)

Deep brain stimulation

Why is there no mention of deep brain stimulation on this page? Take a look at this link: http://www.bbc.co.uk/blogs/thereporters/ferguswalsh/2010/12/brain_surgery_to_relieve_headaches.html Reissgo (talk) 08:34, 18 December 2010 (UTC)

LSD

===Low-dose psychedelics===

There is anecdotal evidence that serotonergic psychedelics such as psilocybin (mushrooms), LSD, and LSA (d-Lysergic acid amide, contained by Rivea corymbosa seeds) abort cluster periods and extend remission periods. The doses needed to affect cluster headaches start below those needed to produce psychedelic effects. Melatonin, psilocybin, serotonin, and the triptan abortive drugs are closely-related tryptamines.

Researchers at McLean Hospital/Harvard Medical School investigated the ability of psilocybin ("magic mushrooms") and LSD to treat cluster headaches through medical record review and interview of 53 patients who had used either/both drug, reporting in Neurology that the majority described partial or complete relief from cluster attacks. A clinical study of these treatments under the auspices of Clusterbusters is the next intended phase of research at McLean Hospital, Harvard Medical School.

This needs to be based on review articles per WP:MEDRS Doc James (talk · contribs · email) 13:21, 19 January 2011 (UTC)

Here's one: Sun-Edelstein C, Mauskop A. (2011). "Alternative headache treatments: nutraceuticals, behavioral and physical treatments". Headache: the Journal of Head and Face Pain. 51 (3): 469–83. doi:10.1111/j.1526-4610.2011.01846.x. PMID 21352222. Sasata (talk) 05:22, 17 November 2011 (UTC)

Infobox image

At the moment, Clusterhead.jpg is the image in the infobox, visible at the very top of the page. While this image may be useful later in the article, I am of the opinion that as far as lead images go, this is actually worse than having no image at all. Quickly jumping from the article title to this image will lead the reader to believe that the article is about a piece of art, and certainly not a medical condition. I welcome arguments or suggestions, but if no one objects, I may just swap out the image myself. --Cryptic C62 · Talk 04:39, 17 November 2011 (UTC)

"Atypical Facial Pain Syndrome"

I was sent to an ONT who said I had "Atypical Facial Pain Syndrome". When I said "that doesn't really say anything other than what I just described to you" he said "it's also known as cluster migraines." Is this generally accepted? I ask because I see no reference to it here. --Richardson mcphillips (talk) 19:48, 14 March 2012 (UTC)

At best, that information was "sloppy," at worst, completely incorrect assuming your exact quote is correct. AFPS has been a catch-all category used when no other explanation of symptoms can be determined. It is possible that cluster or migraine headaches could be misdiagnosed as AFPS, but they are not AFPS; nor is there such a thing as a "cluster migraine."--Drbb01 (talk) 00:39, 20 April 2012 (UTC)

2012 review in the BMJ

[2] Doc James (talk · contribs · email) 08:15, 15 April 2012 (UTC)