Q-After a siege of the most terrible headaches imaginable, I consulted a physician and was told I had a condition known as cluster headaches. It was more than a month before I was finally over the attacks. Where do these frightful headaches come from and what can be done to treat them besides antihistamines and pain pills?
A-This type of headache was named for the manner in which they occur, attacking the patient in episodes that come in groups or clusters. Their cause remains puzzling. We do know that they seem to be aggravated by substances that cause blood vessels to enlarge, such as alcohol, nitroglycerin and certain foods.
FOR THE RECORD - Additional material published Nov. 7, 1990:
Corrections and clarifications.
The ``Family doctor`` column in the Nov. 6 Tempo section incorrectly named indomethacin as a beta-blocker used to treat cluster headaches. Indomethacin, which is not a beta blocker, is prescribed primarily for arthritis, and 10 percent of those who take it experience headaches as a side effect. The column should have named propranolol, which is sold under the brand name Inderal, as the beta blocker used to treat cluster headaches.
These headaches affect men more frequently than women, and they usually appear first between the ages of 20 and 40. The headaches come on abruptly, creating a severe burning pain around the eye that can last from a few minutes to four hours, but usually 30 to 45 minutes. Sometimes they are accompanied by a drooping of the eyelid, a narrowing of the pupil, sweating, red eye and flushing of the face on the same side as the headache. In many cases, some but not all of these symptoms may occur. Most experience the pain a few times a day, and this may continue for weeks to months.
The two most commonly used therapies to decrease or relieve the pain are ergotamine and oxygen. The drug ergotamine can be taken under the tongue and is about the easiest to use. One hundred percent oxygen inhaled for about 15 minutes also seems to provide relief, but this treatment is cumbersome because it is not easy to carry the equipment. Various other therapies use beta-blockers (such as indomethacin) and calcium channel blockers. Lithium carbonate has been used to treat the chronic variety.
This disease is not easy to treat, and there are moments of frustration for both patient and physician. The best counsel I can offer is to understand your condition thoroughly and follow the advice of your physician carefully. You will want every possible factor to work in your favor to prevent the frequent recurrence of this distressing disease.
FYI: Almost any physician will tell you that the most important element in a correct diagnosis is a complete, detailed history. Many women, asked about their personal feminine history, cannot recall important details and certainly don`t remember or know their mother`s age at her first period. Yet such details often turn a difficult diagnostic problem into an easily solved one.
To help women record their personal feminine history, from puberty to menopause, the Vagisil Woman`s Health Center offers a free copy of ``Lifetime Passport to Feminine Health.`` The attractive passport-sized booklet includes basic information and a checklist of sound health practices. For a copy, send 50 cents for postage and handling to Vagisil Women`s Health Center, Box 328 LP, 1101 Westchester Ave., White Plains, N.Y. 10604. You also may request at no additional charge its insert pamphlets ``Feminine Hygiene: The Early Years,`` ``Feminine Hygiene and Pregnancy,`` ``Feminine Hygiene and Menopause`` and ``Yeast Infections and Other Feminine Irritations.``