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If you thought migraines were bad, pray you never get a cluster headache

If you’ve ever experienced the type of headache that leaves you wondering whether your eyes are about to fall out of your head, rest assured, you aren’t on your deathbed, no matter how bad you feel. There’s a name for this particular subtype of headache hell: cluster headaches. And their description alone might make you clutch your head in horror.

“Cluster headaches are one-sided, and patients describe feelings of their eyeballs being pulled out of their sockets,” says Clifford Segil, a neurologist at Providence Saint John’s Health Center. “They have also been described as ‘suicide headaches’ and a ‘hot poker in the eye’ headache. They are unilateral and retro-orbital with excruciating pains. They are often associated with eye watering and can be associated with eye swelling and nasal congestion.”

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Unlike migraine headaches, which occur more commonly in woman than men, cluster headaches occur more often in men between the ages of 20 and 40, Segil says. They do share a little something in common with the dreaded classic migraine: Both are believed to be caused by the blood vessels increasing in size or dilating. As they expand, they irritate the nerves around these vessels, causing pain, Segil says.

“If the vessels between your skull and brain get irritated, you get a migraine headache,” Segil says. “If the vessels surrounding your eye socket or orbit get irritated, you get a cluster headache. These are theories, and it is not fully understood how a patient’s eye and head pains are generated.”

So how do you treat these monsters?

If you have been experiencing these types of headaches, Segil advises patients to keep a headache journal so they can track any triggers that may cause their cluster headaches. Common triggers include life stress, specific foods or alcohol, lack of sleep, and too much computer use. Unfortunately, unlike migraine headaches, which may be treated with vitamins such as vitamin B-2 or riboflavin and can be prevented in women using oral contraceptives that contain more progesterone than estrogen, Segil says cluster headaches do not usually respond well to natural remedies, though oxygen inhaled through a mask can sometimes help.

“Cluster headaches are often very well controlled with mainstream pharmaceutical medications,” Segil says. “A daily medication called a calcium channel blocker, which is classically a blood pressure medication, often helps. Verapamil is the most commonly used medication in this family. Rescue medications called triptans, which many patients who suffer with migraine headaches use, may also abort or resolve patients’ cluster headaches.”

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If you’re not on board with taking drugs to control cluster headaches, you can try including regular naps into your daily schedule, which Segil says some patients find to be effective. Or you can simply shut out the world for a few minutes and come over to the dark side.

“I do advise patients with cluster and migraine headaches to go to a quiet, dark place when they feel one coming, and many patients find this to work well,” Segil says.

Well, all I can say is, at least there is hope.

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