Cluster headache - Causes, Symptoms and Treatment .MF .
Every person knows the painful condition of headache, and 0.1% of the population suffers from the same "infernal" - beam (or "cluster") headache.Most of them - it is smoking, well-built man with a "lion" face - with a square jaw and cleft chin, thick, wrinkled and pale blue eyes.The first attack can occur at any age - from 20 - 60. Women suffer extremely rare.
Symptoms of cluster headache
very strong, burning, lightning penetrating headache in one eye for an eye, with possible irradiation in the head, ear, cheek, forehead, accompanied by unilateral autonomic disorders - nasal congestion, watery eyes, rush of blood to the face, redness of the eyes, forehead sweating, - called cluster headache.Headache increases rapidly, the eye is red and the person to initiate looking for a place - torn, walking in circles, "wants to beat my head against the wall", holds his head in his hands, swaying, groaning, crying, screaming ... can often be present Horner syndrome - ptosis (droopingcentury), miosis (contraction
Cluster headache - there is lots of (beams, clusters) for several attacks, from 15 minutes to one and a half hours per day, with a few setbacks and subsequent increase of the pain to the most savage, in the weeks and months to follow-up duration of remission - monthsyears.There is a chronic form of cluster headache in which no remission.The most severe headache occurs at night, always appears at the same time.
Harbingers (aura) is not.The patient wakes up from severe pain.Side pain during one beam does not change, but in the future, in different episodes can change sides.At the beginning and at the end of the cluster period and less intense episodes may last for several minutes.Further attacks are becoming harder and the pain is very intense and painful.The intercluster period person feels healthy.
Puchkova headache can be called cyclic disorder associated with the human biological clock.In the mechanism of which has not yet been accurately studied, it plays a major role the hypothalamus, the pterygopalatine ganglion, the trigeminal nerve, vasoactive substances - serotonin and histamine.As a result, sophisticated neuroendocrine, and neurophysiological processes developing cyclic pathological vasodilation.It is at this phase of the development of pain and being treated - it is necessary to narrow the blood vessels and attack docked.The trigeminal nerve is the principal conductor of pain.Vegetative attack symptoms are provided by the parasympathetic nervous system - parasympathetic fibers from the upper salivary nucleus to the pterygopalatine ganglion and then provide innervation of cerebral blood vessels, glands and lacrimal glands of the nasal mucosa.During the episode of pain alcohol, nitroglycerin may provoke an attack.Changes in the habitual way of life can accelerate the emergence of a new cluster: shift work schedule, change of climate zone, neuro-emotional stress ...
Such severe headache immediately leads the patient to the doctor - neurologist.
The differential diagnosis is carried out with a migraine, a dysfunction of the temporomandibular joint, temporal arteritis.
is diagnosed clinically by describing in detail the patient specific, recurring at the same time attacks.For the diagnosis is important the presence of the above five episodes during the period of the episode and the presence of remission.Thus it is not detected focal neurological symptoms and other causes of headache.
The first time to avoid serious organic brain damage need magnetic resonance imaging.Symptomatic klasteropodobnye pain may occur in the pathology of the pituitary and parasellyarnoy area of the carotid artery aneurysm, nasopharyngeal carcinoma, pathology of the upper cervical segments (meningiomas).
treatment of cluster headache
cupping using inhalation of 100% oxygen for 15 minutes through a mask, triptans (sumatriptan nasal spray or parenteral administration, zolmitriptan) nasal spray dihydroergotamine, cold to the temple, acupuncture, sedatives andhypnotics.In the long term, and a cluster of heavy attacks prescribe steroid hormones.
Common analgesics and antispasmodics not help to remove seizure drugs only slightly reduce the intensity of pain.At the beginning of the cluster can be used NSAIDs in combination with caffeine.Perhaps the use of the intranasal application of 4% lidocaine.It can be used to prevent nocturnal attack ergotamine 2 mg one hour before bedtime.
Prophylaxis of cluster headache
For prevention, ie reducing the number and severity of attacks during acute use verapamil, steroids, lithium carbonate.Dosages and rates prescribed by the doctor because of a multitude of side effects.Suffice
effective use of topiramate from 25 to 200 mg, long-term use with a gradual increase and decrease in dose.
used in the treatment of:
- auditory training,
- sedatives for the normalization of the autonomic nervous system.
necessary to avoid smoking and drinking alcohol.Welcome the B vitamins, antioxidants.
Medical consultation for cluster headache
Question : what is the oxygen concentrator?
answer : Oxygen Concentrator generates oxygen from the air.The device is designed for oxygen therapy.
concentrator using special carbon rods separated by injected nitrogen air.Nitrogen is displayed in the side, and the output mask to obtain the required concentrated oxygen - 90-95%.Oxygen concentrators output power varies depending on the model and ranges from 3 to 10 liters per minute.Each unit is equipped with an output flow control, and you can configure the desired level.
neurologist Kobzev SV