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ASK THE EXPERTS: Q Is the sudden and permanent relief of cluster headaches common, or am I exceptionally fortunate? Also, after an attack I experienced an intense euphoric sensation. Is this common?


doi: 10.1097/01.NNN.0000389999.56459.43

Answers to your questions about cluster headaches, acromegaly, pesticides and ADHD, and treatment for pediatric brain tumors.

Kathleen B. Digre, M.D., is professor of neurology and ophthalmology at the University of Utah School of Medicine.

Figure. D

Figure. D

A Cluster headaches are a primary headache disorder associated with one-sided pain, feelings of restlessness, eye tearing, nasal stuffiness, and drooping eyelid (ptosis). Attacks typically last one to four hours and are excruciatingly painful. Most people experience episodic cluster headaches in bouts and then go for months without headaches before they recur again. Conversely, chronic cluster headache is experienced without remission for more than a year. In some cases pain-free intervals last less than a month and multiple attacks can occur in one day. There's a 30 percent chance episodic cluster headache can turn into chronic cluster. Onset is typically in early adulthood, and men are more commonly affected.

Some studies (such as one published in the journal Headache in 2010) suggest that only 12 percent of individuals with cluster headaches experience a remission and never experience them again.

Most people report a premonition prior to a cluster attack, and some also report sensations afterward. Most of these are twinges of pain or sensitivity to light. Although some patients experience a change in mood before the attack, euphoria is rarely ever described after the attack. However, endorphin levels have been shown to be elevated in some individuals after a cluster attack.

©2010 American Academy of Neurology