Hello and welcome to the zero to finals podcast.

My name is Tom and in this episode I'm going to be talking to you about cluster headaches.

Then you can find written notes on this topic at zero to finals.com slash cluster headaches

or in the neurology section of the second edition of the zero to finals medicine book.

And you can find flashcards and questions to train your knowledge and help you remember the

information for longer at members.0tofinals.com. So let's get straight into it.

Cluster headaches are severe and unbearable unilateral headaches,

usually centered around the eye. They are sometimes called suicide headaches due to their severity.

They're called cluster headaches because they come in clusters of attacks and then they disappear for extended periods.

For example, a patient may suffer three to four headaches a day for weeks or months,

followed by a pain-free period that lasts several years.

Headaches last between 15 minutes and three hours.

The typical patient is a 30 to 50 year old male smoker.

They may have triggers such as alcohol, strong smells or exercise.

Let's go through the symptoms.

The symptoms are usually unilateral, including pain centered around the eye, a red, swollen

and watering eye, pupil constriction or meiosis, eyelid drooping, or tosis, nasal discharge,

and facial sweating. Let's go through the management. Treatment options during

acute attacks of cluster headaches are triptans, for example subcutaneous or intranasal

sumatriptan, and high flow 100% oxygen, which may be kept at home ready for attacks.

Verapamil, which is a calcium channel blocker, is the first line for prophylaxis to prevent attacks.

Other options for prophylaxis are occipital nerve block, prednisolone, for example, a short course of prednisolone to break the cycle during clusters,

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