RICHARD LIPTON, MD: One issue is the quality of the pain. Is it throbbing? Is it a steady ache? Is it boring? Another feature is the location of the pain. Is it in the eye? On one side of the head? On both sides of the head? Another feature of the pain, again, is the frequency and duration. Do attacks last ten minutes? Do they last ten days? Do they occur every day? Do they occur only occasionally?
And then the features that go along with headache are very, very important.
ANNOUNCER: In fact each type of headache has a distinctive profile.
RICHARD LIPTON, MD: Individual clusters attacks last typically from fifteen to ninety minutes. Cluster periods, where you may have one or more attacks per day, in the average person, will last a month to several months.
Cluster attacks tend to be triggered by REM sleep. People with cluster quite often will awaken at a characteristic time every night with a full-blown attack. Three am is really quite typical.
ANNOUNCER: And, oh yes, they are extremely painful.
RICHARD LIPTON, MD: They're always one-sided. The pain is usually in or around one eye and the pain is accompanied by redness or tearing of the eye, drooping of the lid, nasal stuffiness and features of that kind.
Cluster affects perhaps two in every 100,000 people. And, given the severity of cluster attacks, that's a good thing. So patients who've had cluster and passed kidney stones will almost inevitably say, "Well, God, let me pass a kidney stone, the pain is much less severe than cluster."
ANNOUNCER: Treating cluster headaches is part preventative, part damage control.
