Periodic Migrainous Neuralgia / Cluster Headaches

Question 1

Definition of cluster headache

Answer 1

Unilateral, excruciating pain in the maxilla or behind the eyes notably in the very early morning hours or recurring repeatedly over several days.

Question 2

What is periodic migrainous neuralgia often accompanied by?

Answer 2

Ipsilateral lacrimation, conjunctival redness, photophobia, nasal stuffiness

Question 3

Signs periodic migrainous neuralgia

Answer 3

Wakes from sleep, end suddenly, last 30-60 mins

Question 4

Cause of cluster headache

Answer 4

Vasodilation of extra cranial carotid arteries and increased in hypothalamic activity

Question 5

Precipitating factors for cluster headache

Answer 5

Alcohol, hypoxia in rem sleep, high altitudes

Question 6

Management of cluster headache

Answer 6

Neurology input
Oxygen therapy: 100% oxygen at 10-15 litres min for 10-20 mins
Sumatriptan
Prophylaxis: Verapamil, Nifidipine