The pain of cluster headaches can be unendurable. In fact, an above average rate of suicide has been reported in men with these headaches. Eventually, the attacks cease with age, but doctors are unable to predict when or how they will end.
Cluster headaches are of two types:
- Episodic. Attacks occur regularly for 1 week to 1 year, separated by long pain-free periods that last at least 1 month. Episodic cycles are common with between 80-90 percent of patients. A significant percentage of people who experience a first cluster attack do not have a repeat.
- Chronic. Attacks occur regularly for more than 1 year, with pain-free periods lasting less than 1 month. 10-20 percent of patients suffer from chronic cluster headaches. The chronic form is very difficult to treat.
Typical Prognosis of Cluster Headache:
Timing of an Attack. Attacks, with acute headaches, tend to occur regularly at the same time of day. (For this reason, cluster headaches are sometimes known as "alarm clock" headaches.) About 75 percent of attacks take place between 9 p.m. - 10 a.m. Attacks may also peak between 1 - 3 p.m.
Duration of an Attack. A solitary cluster attack is usually brief but extremely painful, lasting about 15 minutes to 1.5 hours if untreated.
Number of Attacks per day. During an active cycle, individuals may experience as few as 1 attack every other day or as many as 8 attacks a day.
Duration of Cycles. Attack cycles typically last 6 - 12 weeks with a period of lasting up to a year. In the chronic form, attacks are relentless and there is little remission. Attacks cycles tend to occur seasonally, most often in the spring and autumn.
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