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Suggest treatment for cluster headaches

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General & Family Physician
Practicing since : 2005
Answered : 2584 Questions
Hello there, My name is XXXX and I have what sounds to be cluster headaches every day at least 3 times daily. My first one ever was in late 2005 or early 2006. I was in 7th grade P.E. Class when I felt like someone was taking a sharp object and pushing on the back of my eye. Prior to that I had suffered from tension and migraine headaches since I was little. After that day in 7th grade I've gotten them for about 5-9 months everyday, starting with one per day and then had gotten to about 2-3 per day during the cycles of 5-9 months. Writhing the past year they have gotten much worse with the last 4 months noticeably worse than ever before. Last week I had my worst one to date with the almost shut eyelid, completely red and teary eye, my temple vein looks like it will burst it pulsates so much and my neck is affected as well. This is all only on the right side of my head. I know when I will get on because I feel a small, about a 1/4 of an inch knot right under the back of my skull start to get tighter and larger. Now when that happens I can let it come slower by leaving it or if I crack my neck it brings the pain on in 30-60 seconds behind my eye and the temple area. It is excruciating. It has been affecting me in many ways including my job, mood and relationships. I feel it's causing some sort of depression/anger at times. I can't find a doctor that will even diagnose me with anything so I turned here for help. I really appreciate any response from anyone here. I'm just trying to find what it is if it's not cluster, how I can manage it better and hopefully end it all for good. Thank you and have a great day.
Posted Tue, 25 Feb 2014 in Headache and Migraines
Answered by Dr. Prasad 8 hours later
Brief Answer: It's better to treat headache than diagnosis it... Detailed Answer: Hi, Identifying the cause of headache is much more difficult than treating it. I say this as symptoms of all chronic headache overlap with each other and you do not have specific investigations to isolate it. Moreover you have not mentioned about tests conducted during the course of last 8-9 years. Test are done to rule out other close possibilities. That being said, symptomatically I agree with your observation. It looks like cluster headache. Now that you are aware of the cause, I think it is easier to treat it. Some physicians have used methylphenidate to treat cluster headache with significant success, but if you were my patient I would start you on flunarizine, a calcium channel blocker. It has been effective in almost all my patients with cluster headache. You can discuss about both these options with your treating doctor. Besides that, if you haven't been investigated I would order a complete hemogram, ESR, MRI brain scan and a vision check up. A neurologist can write for the test as well as the medicines suggested above. You should fix an appointment as and when feasible. Hope this helps. Let me know if you need any other clarifications. Regards
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