Headaches come in all shapes and sizes, but many of them have similarities that make it difficult to distinguish them. For example, migraines and cluster headaches are very different types of headaches, but they have many similarities that make it difficult to make an accurate diagnosis. How do you tell the difference between the two?
Cluster Headaches vs. Migraines
For years, research indicated that migraines were caused by changes in the blood flow to the brain. But recent studies have shown that it’s actually overactive neurons that trigger the trigeminal nerve. This nerve supplies sensation to the head and face. When the trigeminal nerve is activated, certain chemicals like CGRP, or calcitonin gene-related peptide, and serotonin are released. These neurotransmitters cause the blood vessels in the brain’s lining to become inflamed.
This inflammation causes a vicious cycle. More inflammatory neurotransmitters are released which cause the pain and characteristic symptoms of a migraine headache. But migraines are more than just the typical pain and light sensitivity associated with them. In fact, migraines have four stages:
This is the early warning sign that a migraine is coming but frequently goes unnoticed by most migraineurs. The prodrome can occur hours or days before a migraine. Symptoms of a prodrome typically include:
- Feeling thirsty
- Food cravings
- Super energetic
- Fatigue, frequent yawning
- Frequent urination
The aura of a migraine is probably as well-known as a migraine itself. Most people think of the visual aura that many migraineurs experience which involves some kind of visual disturbance like sparkling lights, seeing everything like it is in a heat wave, blind spots in the vision (called scotomas), or flashing arcs of light.
Visual auras vary wildly from person to person and often can be mistaken for an ocular migraine, which occurs in only one eye, or a visual migraine which occurs in the occipital lobe of the brain but is not accompanied by the pain of a typical migraine headache.
But auras can also be something completely different like aphasia which is a difficulty understanding language or speaking to other people. Many people experience aphasia as the inability to find the right word or difficulty reading or writing.
Most people describe the pain as a throbbing or pounding sensation usually on one side of the head although the pain can move to the other side or involve the entire head. The pain usually gets worse with movement and can cause nausea or vomiting, sensitivity to light or sound, and lightheadedness or fainting. A migraine can last a few hours to several days.
After a migraine headache, many people feel “hungover.” You may still have “remnants” of the migraine itself, getting head pain when bending over or moving quickly. You may also feel very tired and confused. The postdrome usually lasts up to 24 hours.
Migraine Triggers and Treatments
Many things can trigger a migraine headache. Some of the most common triggers include:
- Hormonal changes (especially common in females around their period)
- Changes in weather or barometric pressure (or both)
- Foods like chocolate or MSG
- Fatigue or changes in sleep patterns
Medications like Sumatriptan (brand name Imitrex) are the go-to medications for a migraine in progress. They cause the blood vessels in the brain to constrict, decreasing inflammation and pain. There are also medications to prevent migraine headaches like beta blockers or anti-seizure medications. A migraine clinic can help you determine the best course of treatment for your migraines.
As its name suggests, cluster headaches tend to occur in clusters. Headaches occur several times a day with the pain peaking within 45 minutes of onset. This usually happens daily for up to 16 weeks at a time, and then the cluster headaches may vanish for months or even years.
The pain of a cluster headache is usually a sharp stabbing pain located behind one eye extending to the temple. Many people experience a runny nose or watery eye on the same side as a headache. Unlike a migraine, cluster headaches can also cause irrational behaviors such as banging your head against a wall to relieve pain. But once the pain is relieved, these behaviors subside.
Cluster headache treatment is more difficult than with migraines. During a cluster attack, injectable sumatriptan and inhaled oxygen can be helpful. As for prevention, calcium channel blockers like verapamil can help decrease the frequency of cluster headaches.
If you think you have cluster headaches or migraines, visiting a headache treatment clinic can help you get your life back. Both cluster and migraine headaches can be debilitating and make even routine tasks impossible. But the National Headache Institute can help. Contact us today to schedule your appointment at one of our convenient locations.
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