Continuous Cluster Headache Story
If I had not listened to the 21 year-old university student with continuous headache carefully, I could have considered his symptoms as tension headaches. Besides, tension headache treatment had previously been applied to him. Even though him having constant headaches brought tension headache to mind, his attacks ongoing for 45 minutes were specific to cluster headaches.
“ I have been having severe headaches for three years, which has aggravated in the last one year. I have constant headaches every day for 365 days. The intensity of headaches increase and decrease throughout the day. Normally, I have it on my left side. However, it can move to the right side as well. I reckon, I haven’t had a pain free month in the last three years. On the days when I don’t suffer from pain, I get a strange feeling on the left side of my head.
When I first started to have pain, I was in high school preparing for university exams. With the first onset of pain, everything in my life took a nosedive. I had a sore throat as well, so I consulted an ENT and was prescribed antibiotics. My throat became more sore when my headache aggravated on these days. The pain also spread to my nape and neck. I was able to wake up pain free. However, I had this strange feeling like pain or burning inside my ear, in my nape or around my eye. Even this sensation sometimes prevented me from listening to the lesson. The pain sometimes gradually increased or started slowly or suddenly and stayed there for 45 minutes. When I chewed rigorously or food particles were stuck between my teeth, my pain worsened. I wasn’t able to sleep some nights because of the pain. On some days, I would get ten severe pain attacks per day.”
There are some patients whose headaches continue in mild severity during the day following their cluster headache attacks. The condition of this young man was similar to theirs. To make matters worse, his attacks didn’t develop as episodic cluster headache, occurring every month, but a chronic one extending over one year. It was beyond endurance to suffer from cluster headache every day.
Chronic cluster headache is rarely seen among young people. Generally, middle-aged men have continuous cluster headaches extending over a year. The treatment was not different from the treatment of other patients’. Dental-jaw complex had to be examined. Since this patient had bilateral pain, teeth in both sides were examined. As he suffered from sore throat as well as other symptoms, it was necessary to include his lower teeth in his treatment too.