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03 Apr 2006

cluster headaches
I have been exoieriencing severe headaches the past couple of weeks. I saw a doctor and after explaining the symptoms my doctor informed me that it might be cluster headaches. I did some research and am convinced that it is indeed cluster headachesas i have all the symptoms ie terrible thumping headaches on one side of my head around the temple and eye area. The headaches usually come on at night between the hours of 1 and 3 and last about ten to fifteen minutes. During the day the only occur if I exert myself. The same thing happened to me about the same time last year, My doctor has prescribed trepeline and i am currently taking 10mg at night. Is this the correct medication? She has told mr that I should stay on trepeline for the rest of my life. Is this correct? Please advise as to whether or not there are any alternative medications available. I have been takinfg trepeline for 5 days now and the headaches are still occuring and increasing in intensity. Surely there must be something i can take when the at the onset of the headaches. Thanking you in advance for your assistance in this matter.
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Expert
Headache expert
Headache expert

01 Jan 0001

Dear Berti,

If your headaches are indeed cluster headaches, then I am afraid that trepiline is unlikely to help you. But from your description, it is not certain that you have typical cluster. Headaches are very difficult to pigeonhole, because the different types overlap to a great extent.

The first thing to do is to get a positive diagnosis, so that we know where the pain is coming from, and the correct treatment follows.

If you are indeed suffering from typical cluster headache, then you need a combination of treatments to break the cycle. Once the cycle is broken, you don’t need treatment until the next cycle starts.

If your headache is not a typical cluster, then you need what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.
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