Cluster headache is characterized by pain on one side of the head. It is usually accompanied by other eye or nose symptoms such as tearing, redness, congestion and/or nasal discharge. Although not the type headache more common, they suffer from it about 50,000 people in Spain, and 78% of them suffer from significant restrictions in their daily lives.
Paul Irimiacoordinator of the Headache Study Group of the Spanish Society of Neurology (SEN), explains that this disease “It is usually of relatively short duration, but the pain is experienced so intensely that many patients describe it as appalling or unbearable. In addition, they show great motor restlessness because they poorly tolerate being in a rest position”.
Another characteristic that defines this type of headache is that it usually occurs almost always at the same time, with an evening and/or night predominance in 73% of casesand crises often occur in certain times of the yearespecially with the changes of season early spring or late fall.
Although the vast majority of patients experience it episodic form -that is, fairly long periods of remission are combined, along with symptomatic periods-, in up to 20% of patients, cluster headache it can be chronified and, in these cases, the periods of remission practically disappear.
“Cluster headache is possibly one of the most underdiagnosed types of headache from Spain. In the first place, because if it does not become chronic, the periods of remission can be so long that there are few patients who, especially in the first years of their disease, do not go to see a specialist”, comments Irimia. “But, in addition, it is a type of headache in which, despite having such specific characteristics, since it is not a very common disease, more than 57% of patients receive previous misdiagnoses”.
Currently, in Spain, some 1,000 new cases of this disease. But still, there is a diagnostic delay which, in many patients, may be higher than 3 years. “The main consequence of not having a diagnosis is that, by not being able to access adequate control and treatment for this disease, headache crises will become more common and will tend to become chronic. And when patients already have a chronic cluster headache, their disease will not only be much more disabling, but they will also experience a reduced response to drugs. Because we also calculate that a 10% of chronic forms are refractory to drugs”, points .
The SEN estimates that more than 50% of patients are not receiving adequate preventive treatment and that more than 30% of patients do not have access to adequate symptomatic treatments, especially oxygen therapywhich is one of the main therapies of choice. “The usual treatment of patients is done with drugs, but resistant cases may benefit from surgical treatment,” indicates.
“It is therefore necessary to emphasize not only the relevance for the population of becoming aware of the importance of consulting headaches, but also to call on all medical professionals to improve their clinical identification, to prevent this disease from becoming chronic.” , Add.
At the moment the origin is unknown of cluster headache, although it seems that certain alterations have been identified in a brain structure called hypothalamus. On the other hand, and although there are cases of cluster headache in childhood, adolescence and in the elderly, it is a disease that especially affects young adults around 30 years old. And above all it affects malesin a ratio of 4:1.