>> yeah.
Well, nothing really makes it better, but you know like, I can easily.
I've, I've, I've taken the [INAUDIBLE].
>> Mm-hm. >> And, and it eases, eases the pain.
It doesn't take it away. >> Mm-hm.
>> But.
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>> Well I don't think you'll find a
better description of the experience of having cluster headaches.
This, this gentleman really provided you with all the, the the
classic symptoms that usually occurs in men ages 20 to 50.
It's characterized by unilateral periorbital pain, this kind
of like ice pick behind the orbit pain.
It has this remarkable circadian rhythmicity.
This patient's
headaches were occurring between about 10:30 and 10:35 at night,
every night while the headaches occurred lasting about an hour.
They oftentimes have autonomic symptoms or redness
or tearing of the eyes on one-side.
They can be quite sensitive to alcohol and the reason they're named cluster headaches
is because the attacks cluster over time and this is depicted here in
again our cartoon of the time course of headaches.
A cluster headache fairly abrupt onset usually at the same time of night or day
and the headache usually last only the, only an, an hour or a couple of hours.
And importantly, if you look at it over
the larger time scale, these individual daily circadian
headaches come in clusters of, of 3, 4, 5 or 6 over the course of a number of days
and then there's this delayed period, sometimes many, many weeks
or even months before another cluster appears and so forth.
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The treatment of cluster headache again as in all
these cases, I'm not going to go into any detail.
I just want
to have you appreciate the various approaches that can be used.
The Triptan drugs can be useful.
Prednisone during that short period of time
when the patient knows that they're at
risk of having successive headaches as part of the cluster, can be very useful.
Calcium channel blockers, Ergots, oxygen therapy often times at night
Lidocaine and Lithium have all proven to be quite effective in selected patients.