Talk:Cluster headache

"Atypical Facial Pain Syndrome"

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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

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

Copyright

Copyright violating content is illegal and cannot be allowed in the articles. However, the following citation may be useful:

• The Treatment of Cluster Headaches Using 2-Bromo-Lysergic Acid Diethylamide. The Beckley Foundation

causa sui (talk) 18:33, 19 May 2013 (UTC)

A) The text you removed was the following sentence:

Although controversial, case reports suggest that ingesting psilocybin or LSD can reduce cluster headache pain and interrupt cluster headache cycles.

The abstract, located here, contains the following sentence:

Although controversial, there are some reports demonstrating the benefit of recreational drugs such as marijuana, lysergic acid diethylamide and psilocybin in headache treatment.

With the exception of the initial two words, "Although controversial", the two sentences are almost completely different. Your robust assertion of a "copyright violation" is baffling, when simply removing those two words would have done. See WP:LIMITED.

B) You clearly didn't bother to read the diff before blindly hitting revert, as I had fixed the problem while undoing your strange deletion. The text in my version read:

Some case reports have also suggested that ingesting LSD, psilocybin or cannabis can reduce cluster headache pain and interrupt cluster headache cycles.

Consequently I have now restored it. — Scott • talk 22:38, 19 May 2013 (UTC)

Psilocybin and LSD

As a casual reader, this section strikes me as odd, for this line: "For many sufferers, the legal risks pale in comparison to the pain caused by the condition.[citation needed]", specifically the need for the citation? As the article has already established several times that people are willing to commit suicide to end the pain, and those are cited. So I feel that there's no need for a source - it's just reasonable to assume that any legal problems would not be as big of a deal to plenty of people who are suicidal. — Preceding unsigned comment added by 50.124.52.204 (talk) 04:57, 1 June 2013 (UTC)

The source is necessary because conclusions drawn by the writer are agains WP:NOR PinkShinyRose (talk) 20:58, 28 July 2013 (UTC)

Bias: introduction of the "Management" section, third paragraph

Except for the first sentence this paragraph is only relevant to the US. I think the first sentence should remain (maybe rephrased to fit into a prior paragraph), but the remaining part of the paragraph should be separate and start out by explicitly stating that it is relevant only to the US (maybe by starting the paragraph by "In the US there are difficulties in treatment arising from the recent pressure of the DEA. Depending on the state...". Should the first sentence be rephrased or just appended to the previous paragraph? Does anyone disagree about clarifying the limited scope of the paragraph in the first sentence? PinkShinyRose (talk) 21:08, 28 July 2013 (UTC)

merger proposal: Cluster headache treatments

I don't see anything especially notable in the other page that isnt already here, and I don't see the point of this redundancy. It also tends to be a spam/NPOV attractor. -- [ UseTheCommandLine ~/talk ]# ▄ 17:59, 28 August 2013 (UTC)

I didn't know that existed. It should definitely be merged here. — Scott • talk 22:09, 28 August 2013 (UTC)

I have completed the merge. This page needs additional attention and I would be happy to collaboratively edit if there are any interested editors. LT90001 (talk) 03:05, 12 October 2013 (UTC)

Cleanup

• Edit: I refer to this edit, removing my cleanup tags.

I have marked this page for cleanup because it uses numerous primary sources, has excessive use of dated, experimental or primary sources, with conflicting advice; and requires general copy-editing. This is not a comment on a particular source or treatment methodology, just that this article needs some work overall. Kind regards, LT910001 (talk) 04:18, 13 October 2013 (UTC)

Cluster headache attack itself is not life-threatening

This is false as people who suffer from cluster headaches have been known to commit suicide to stop the intense pain. Therefore, a cluster headache attack could be considered life threatening as it could cause a reasonable person to commit suicide that otherwise would have not ended their life if they did not suffer from such a condition. Source: http://umm.edu/health/medical/reports/articles/headaches-cluster Quote: More than half (55%) of respondents reported experiencing suicidal thoughts. — Preceding unsigned comment added by 173.95.181.125 (talk) 08:16, 29 November 2013 (UTC)

Medical sourcing and content guidelines

Please review WP:MEDRS and WP:MEDMOS, including WP:MEDMOS#Sections. Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches helps understand how to apply Wikipedia's medical sourcing guidelines, and where/how to find secondary review sources. SandyGeorgia (Talk) 17:54, 2 January 2014 (UTC)

Primary studies

This article is rife with primary studies: see WP:UNDUE, WP:RECENTISM, WP:NOT (news or a support forum), and WP:MEDRS. I've removed this text for discussion. SandyGeorgia (Talk) 19:23, 2 January 2014 (UTC)

In 2012-2013, in an effort to reduce the amount of imaging, number of consults and number of admissions related to headache whilst maintaining pain relief for patients, pain physicians from the Cleveland clinic are working to refine an algorithm for use in Emergency Department (ED) headache presentations. Details of a report on implementation of the algorithm were presented at the 2013 International Headache Congress and showed an 82% reduction in the use of opioids in Headache presentations in ED. “We were astonished at how much we were able to diminish the use of opiates,” - lead investigator Cynthia Bamford, MD. Further validation of the algorithm will show whether it will hold up in various ED settings.

"Suicide" headache

Some of the sourcing in this article is extremely poor. This is a marginal review (appears to be only a partial review combined with a study on a small sample); nonetheless,

• Torelli, P; Manzoni, GC (2002). type=Review "What predicts evolution from episodic to chronic cluster headache?". Current pain and headache reports. 6 (1): 65–70. doi:10.1007/s11916-002-0026-5. PMID 11749880. {{cite journal}}: Check |url= value (help); Cite has empty unknown parameter: |1= (help); Missing pipe in: |url= (help)

mentions "suicide" headache. SandyGeorgia (Talk) 19:52, 2 January 2014 (UTC)

"Suicide disease" is also applied to trigeminal neuralgia... and the sourcing there for this term is poor too. It is known that a tiny fraction of patients with chronic and severe craniofacial pain conditions will commit suicide, but I would not say that they are commonly referred to as suicide headache or disease, at least in medical publications. Lesion (talk) 21:21, 2 January 2014 (UTC)

Thanks Lesion. SandyGeorgia (Talk) 21:52, 2 January 2014 (UTC)

Redundant, repetitive and off-topic prose

This article says the same things over and over and over, often based on primary sources, looking like individual researchers wanted to work their links in. I'm reducing some of the redundant prose, but by no means all of it; that should be done better when the article is thoroughly rewritten to reflect more recent secondary reviews-- since the article is so poorly sourced, it's hardly worth it at this stage to clean up all the prose. SandyGeorgia (Talk) 21:52, 2 January 2014 (UTC)

There are 2 cochrane reviews, one is already used, here is the other: [2]. Lesion (talk) 23:07, 2 January 2014 (UTC)

• Suggest structure the features of cluster headache according to Socrates (pain assessment), see for example Atypical facial pain for how this looks. Lesion (talk) 23:34, 2 January 2014 (UTC)

• I'm typically not a fan of listified prose, and another problem I have with the table at Atypical_facial_pain#Signs_and_symptoms is that the citations are disassociated from the text, and there's a whole long list of citations above the table where it's not apparent what is citing what. I guess here, whatever works and whatever others want, but I don't think something like at AFP would ever get through FAC (just saying), where prose is preferred to lists and tables, and citations should be attached to the text they verify. Best, SandyGeorgia (Talk) 00:01, 3 January 2014 (UTC)

Yes the table needs inline citation. That is a problem that needs fixing. It is not really MEDMOS to use socrates, in fact I recall there is something in there about not using mnemonics at all, but I think it is a nice structure to apply to the signs and symptoms section for conditions characterized mainly by pain. Lesion (talk) 00:13, 3 January 2014 (UTC)

Back to psilo/LSD

I would really like to improve the discussion that is there now, but I want to do it right. Maybe you can advise me. My concerns relate to these two elements: 1. Vasoconstrictors such as ergot compounds are sometimes used immediately at onset of attack. Cafergot, a vasoconstrictor combination of caffeine and ergot, has been demonstrated in some cases to abort cluster headaches within 40 minutes of ingestion. BOL (2-bromo lysergic acid diethylamide), a non-psychedelic form of the ergot-derived psychedelic LSD, has shown promise in the treatment of cluster headaches.[unreliable medical source?][48] 2. Some isolated case reports suggest that ingesting LSD, psilocybin or cannabis can reduce cluster headache pain and interrupt cluster headache cycles.[49]

Re #1, there really is no relationship between cafergot and BOL-148, except that they both contain ergots (as do some other CH meds mentioned elsewhere in the article). So, I would make a new topic. Re BOL-148, I can edit to provide a link to a peer-reviewed journal, Cephalagia, which published the results of a small trial of BOL-148 for people with CH. But I think that's a "primary source." Would it allow for removing the "unreliable medical source" note that there's now (deservedly so)? BOL-148 is different from cafergot, among other things because it seems to be not just an abortive (and not just an generally ineffectual abortive, as cafergot is) but also a possible preventive. For people with CH, the difference between maybe aborting an attack in 40 minutes and preventing attacks altogether is enormous.

And the fact that BOL-148 works is evidence that the next part -- about LSD, etc. -- is not some whackjobs taking drugs to escape their pain. BOL-148 works because it has LSD in it. So, Re #2. I don't know what "some isolated care reports" means. As far as I know, there is exactly one report of cannabis helping someone, whereas research conducted by medical professionals has shown hundreds of cases in which CH patients receive relief from psilocybin, LSA, and LSA. Yes, these are anecdotal self-reports collected by those medical professionals, and not clinical trials, but since the substances are scheduled, there's no more than that that can be done. I could cite several such reports (and I note that LSA, which is not mentioned in the current text, is the subject of some of them), but again I fear that this will be removed as "primary sources."

There are probably thousands of CH sufferers using LSA, LSD, and psilocybin to treat CH, with no lasting side effects (LSA, for that matter, is effective even without short-term psychedelic "side effects"). I understand someone's reluctance to give this treatment what I think of as its proper attention here -- it's not medically proven; it might sound weird or scary to some people; and the substances are scheduled. At the same time, it is saving lives every day.

If you're going to delete any edits I make, I guess I just won't bother doing so. But if there's a way to provide this information that is consistent with Wikipedia's policies, I would be happy to take a shot at it.~~chfather~~