What we mean by a migraine and cluster headache. Migraine headaches are common headaches that usually last for several hours. Cluster headaches are the sudden recurrence of unilateral and intense pain in the head for shorter durations. Surprisingly, about 12 percent of the total world population is affected by Migraine. According to Kingston and Dodick (2018) Migraine attacks are comparatively more common among women, occurring in almost 25% of the total women population, while a cluster headache is not that common, and only 1 in a 1000 people gets affected by it, it is extremely painful (Kingston & Dodick, 2018). The headache disorder of a cluster headache is a very painful condition which usually patients misdiagnose as a migraine. The inheritance patterns of a cluster headache are not clear yet, and further research is needed in this regard (Tfelt-Hansen & Jensen, 2012). The differences between a migraine headache and cluster headache are reflected in their symptoms, severity and the way in which both of them are treated.
The difference of a migraine and cluster headache is identifiable in its symptoms. The symptoms of a migraine headache range from cravings for certain foods to anxiety and from seeing blurred visions to constipation. The person starts feeling sensitive to heavy sounds and gets irritated by intense light. The person would feel lightheaded and would start getting blurred visions. Furthermore, one can also get nauseous and is displeased by perfumes and strong odors. The reason for experiencing such symptoms from a migraine can be traced to several factors including bright lights, loud noise, skipping meals and exposure to smoke. The author, Saima Ibrahim (2010), presents an explanation for these symptoms by saying migraines basically include an aura that causes a person to see flashes of light and spots that are generally bright spots. One might also feel ‘pins and needles’ pain in one’s legs and arms. One of the major reasons for migraines being so common is that numerous pathways lead to this headache.
The symptoms of a cluster headache would help identify its difference with a migraine. Signs of a cluster headache include eye redness, throat or eyelid swelling, and eye discomfort for instance grittiness, rhinorrhea, flushing, and aural fullness. Autonomic disturbances such as conjunctival injection, lacrimation, facial sweating, nasal secretion, and congestion are witnessed as well. The classic symptoms of ocular paralysis (a condition of constricted pupil resulting from the interruption of the sympathetic nerve supply to eyes) eyelid droops and pupil constriction on the painful side, have also been observed in the cases of a cluster headache. The symptoms of ocular paralysis along with the increased blood flow and sweating have different triggers. Drummond (2006) stated that the persistence of the signs of ocular paralysis in the patients of a cluster headache indicates injury in their cervical sympathetic fibers. Also, the increased sweating and the blood flow in the face are triggered by the trigeminal – parasympathetic discharge (Drummond, 2006). It is true as various symptoms of the cervical sympathetic deficit are observed in the patients having a cluster headache from throbbing pain in the head to sweating, flushing and pupil constriction.
The severity of a migraine and cluster headache would also show their differences. A migraine might give birth to some serious health conditions ranging from depression to asthma or even worse, heart disease. Migraines can make a person suffer emotionally by causing severe depression. The patients who have episodic migraines possess greater risks of depression (Guidetti, Rota, Morelli, & Immovilli, 2014, p. 4). Migraine with aura can increase the risk of stroke in patients, especially in men. The severity can be judged from this fact that patients with migraine are more exposed to fatal diseases. The article ‘A migraine and stroke: “Vascular” comorbidity’ (Guidetti, Rota, Morelli, & Immovilli, 2014) shows that the increased risk of stroke can cause a person to have heart disease, particularly heart attack. It can become the cause of diabetes and high blood pressure. A migraine headache can also cause numerous pain disorders such as fibromyalgia. It shows that the aftereffects of a migraine can be very severe if not treated properly.
A cluster headache leads its patient with a sense of agitation and restlessness. Cluster headaches develop a sense of anxiousness in the patients. The patient can experience a specific level of severity which ends after some time. Furthermore, this headache may also have a particular pattern. These authors (Wei, Ong, & Goadsby, 2018) explained that a cluster headache is episodic, so the person gets pain free once an attack ends. The attack is observed to happen at the same time every day, which proves that the cluster headaches possess a circadian pattern. A migraine headache makes a person want to lie still while a cluster headache makes him restless.
A migraine is treated through pharmacological or non-pharmacological methods of treatment. Pharmacological therapies include medications while non-pharmacological treatment does not involve any medicines. The difference lies in the use of variant methods for the treatment of the root cause of migraine. Research showed (Martelletti & Jensen, 2016) that non-pharmacological therapy focuses on avoiding the use of pharmacological drugs, controlling the symptoms and trigger avoidance. While Pharmacological treatments include a non-steroidal anti-inflammatory drug (NSAIDs) or Paracetamol. It is true as a migraine is mostly caused by stomach sickness that might be associated with eating disorders causing the wrong diagnosis.
A Cluster headache can be treated with any of the three strategies: abortive, transitional or preventive treatment. The treatment of a cluster headache can be done in three ways. The first one is called an abortive treatment in which only a single attack of a cluster headache is treated. The second strategy focuses on reducing the frequency of its attacks and the third one, also known as a preventive treatment, tends to reduce the severity of the cluster attacks (Kingston & Dodick, 2018). Treatment of a cluster headache would be more effective if done by the preventive method. With little occurrence of a cluster headache, it is possible that it is normally not diagnosed immediately. Kingston and Dodick stated (2018) that a cluster headache is not a common disease; there also exists the possibility of misdiagnosis. Various techniques for its treatment are not based on authentic proofs and pieces of evidence. Techniques for its correct diagnosis should be developed so that it can be well-treated to improve the patients’ overall quality of life.
It is concluded that a migraine and cluster headache have quite a lot of differences. People having a migraine might feel sensitive to light and sound, while the patients of a cluster headache are mostly feeling pain on one side of their heads. The severity of a Migraine is greater as it may lead to fatal diseases like stroke and heart attack while a Cluster headache tends to be episodic. For a migraine, patients mostly take drugs and NSAIDs while a cluster headache involves high-flow oxygen and injectable triptans. Correct diagnosis is important for the correct treatment of the disease; for this reason, the difference in a migraine and cluster headache is important to be known.
References
Drummond, P. D. (2006). Mechanisms of autonomic disturbance in the face during and between attacks of cluster headache. Cephalalgia, 26(6), 633-641.
Guidetti, D., Rota, E., Morelli, N., & Immovilli, P. (2014). Migraine and stroke: “Vascular” comorbidity. Frontiers in Neurology, 1(2014), 1-11.
Ibrahim, S. (2010). How to treat Migraines. Economic Review, 1(2010), 11-13.
Kingston, W. S., & Dodick, D. W. (2018). Treatment of cluster headache. Annals of Indian Academy of Neurology, 21(Suppl 1), S9-S15.
Martelletti, P., & Jensen, R. (2016). Pharmacological management of headaches. New York: Springer Cham Heidelberg.
Tfelt-Hansen, P. C., & Jensen, R. H. (2012). Management of cluster headache. CNS drugs, 26(7), 571-580.
Wei, D., Ong, J., & Goadsby, P. (2018). Cluster headache: Epidemiology, pathophysiology, clinical features, and diagnosis. Annals of Indian Academy of Neurology, 21(5), S3-S8.
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