• DOI:10.1136/bmj.e2407
• Corpus ID: 5479248

Cluster headache

@article{Nesbitt2012ClusterH,
  title={Cluster headache},
  author={Alexander David Nesbitt and Peter J. Goadsby},
  journal={BMJ : British Medical Journal},
  year={2012},
  volume={344}
}

• A. Nesbitt, P. Goadsby
• Published 11 April 2012
• Medicine, Psychology
• BMJ : British Medical Journal

Few, if any, medical disorders are more painful than cluster headache. Previously termed migrainous neuralgia, it was last reviewed in the BMJ nearly 50 years ago. At that time, the authors stressed the importance of covering the topic in a general medical journal to aid recognition. Despite this remarkably prescient view, and the extreme and stereotyped nature of its presentation, cluster headache is still commonly misdiagnosed. Without a clear diagnosis, affected patients can wait many years before receiving adequate help, and they often endure unnecessary and unhelpful attempts at treatment before gaining any relief. Patients describe the pain of a single attack as being worse than anything else they have experienced, including childbirth. Many endure repeated attacks, lasting up to three hours, every single day. The severity of the pain has earned it the sobriquet “suicide headache,” although in our experience this is a rare occurrence in this exceptional patient group. The management of this condition differs from that of other headache disorders. This article will review the clinical entity of cluster headache by highlighting its unique and defining characteristics as an aid to correct diagnosis, before critically appraising current treatment methods. In doing so, we outline an up to date streamlinedmanagement strategy aimed at limiting the considerable burden that this condition places on patients. What is cluster headache?