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9 out of 10

Cluster headache is characterized by all, except: (AIPG 11) (LQ)

A Affects predominantly females.

B Unilateral headache.

C Onset typically in 20-50 years of life.

D Associated with conjunctival congestion.

Ans. A

Affects predominantly females.

Cluster Headache (Ref. Hari-18th ed., Pg- 122)

1. It occurs in middle age (20 – 50 yrs) males

2. There is severe, throbbing, strictly unilateral headache accompanied by red eye and lacrimation but vision is not affected.

3. Associated symptoms:

These are typical and characteristic:

a. Homolateral lacrimation

b. Nasal stuffiness

c. Reddening of eye due to conjunctival congestion

d. Ptosis

e. Nausea

4. Headache occurs between 10 PM to 3 AM.

5. Alcohol consumption is an important predisposing factor.

6. Periodicity is the hall mark of cluster headache.

7. For acute attack best treatment is oxygen inhalation. Sumatriptan (Inj. S/C or Nasal spray) is also effective in acute attack.

8. For prophylaxis drugs used are: Valproate, Lithium, Amitriptyline.

9. Propranolol is not effective as prophylaxis drug.

Extra Edge:Verapamil and lithium are the best prophylactic drug for Cluster headache.


Cluster headache

1. Lateralized , usually frontotemporal may be generalized

2. All age groups are affected

3. Females are affected more than males

4. Family history present

5. Presentation : Pain

a. Often preceded by aura

b. Builds up gradually

c. May lasts for several hours or longer

d. Usually throbbing but may be dull

e. Onset is after awakening & quietened by sleep.

6. Associated symptoms include:

a. Nausea, vomiting, diarrhea

b. Photophobia and visual disturbance in the form of photopsia and fortification spectra

c. Paraesthesia with tingling and numbness

d. Other focal neurological symptoms such as clumsiness and weakness.

1. Lateralized, periorbital or less commonly temporal

2. All ages above 10 yrs with peak at 30-50 yrs

3. Male preponderance (90%). Men affected 7-8 times more than females.

4. Hereditary factors usually absent

5. Presentation: Pain (periodic attacks 1-2/day)

a. Excruciating, deep, explosive pain but only rarely pulsatile

b. Reaches crescendo within 5 minutes

c. Begins without warning

d. Lasts for 45 minutes

e. Commonly awakens the patients from sleep.

6. Associated symptoms :

These are typical and characteristic:

a. Homolateral lacrimation

b. Reddening of eye

c. Nasal stuffiness

d. Ptosis

e. Nausea

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