Your QuestionMy sister was recently diagnosed with Horner syndrome. Last year I was diagnosed with cluster headaches. Are these two condition related?
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People with cluster headaches describe the pain as piercing and unbearable. The nose and the eye on the affected side of the face may also get red, swollen, and runny, and some people will experience nausea, restlessness and agitation, or sensitivities to light, sound, or smell. Most affected individuals have one to three cluster headaches a day and two cluster periods a year, separated by periods of freedom from symptoms.
Alcohol (especially red wine) provokes attacks in more than half of those with cluster headaches, but has no effect once the cluster period ends. Cluster headaches are also strongly associated with cigarette smoking. Glare, stress, or certain foods may also trigger an attack.
Horner's syndrome, a rare condition that affects the nerves to the eye and face, may present during a cluster headache attack. The condition is not present between episodes. However, this fleeting presentation can evolve into persistent Horner's syndrome.
Horner's syndrome can be caused by any interruption in the sympathetic nerve fibers, which start in the part of the brain called the hypothalamus and run to the face. Sympathetic nerve fiber injuries can result from migraine or cluster headaches.
To read more about the association between cluster headaches and Horner's syndrome, you can visit PubMed, a searchable database of medical literature. Information on finding an article and its title, authors, and publishing details is listed here. Some articles are available as a complete document, while information on other studies is available as a summary abstract. To obtain the full article, contact a medical/university library (or your local library for interlibrary loan), or order it online using the following link. Using "cluster headaches AND Horner syndrome" as your search term should locate articles. Click here to view a search.
The National Library of Medicine (NLM) Web site has a page for locating libraries in your area that can provide direct access to these journals (print or online). The Web page also describes how you can get these articles through interlibrary loan and Loansome Doc (an NLM document-ordering service). You can access this page at the following link http://nnlm.gov/members/. You can also contact the NLM toll-free at 888-346-3656 to locate libraries in your area.
There are medications available to lessen the pain of a cluster headache and suppress future attacks. Oxygen inhalation and triptan drugs (such as those used to treat migraine) administered as a tablet, nasal spray, or injection can provide quick relief from acute cluster headache pain. Lidocaine nasal spray, which numbs the nose and nostrils, may also be effective. Ergotamine and corticosteroids such as prednisone and dexamethasone may be prescribed to break the cluster cycle and then tapered off once headaches end. Verapamil may be used preventively to decrease the frequency and pain level of attacks. Lithium, valproic acid, and topiramate are sometimes also used preventively.
More detailed information on medications can be found in the treatment and management sections of Medscape Reference's article on cluster headache.
- Luc Jasmin. Cluster headaches. MedlinePlus. November 2, 2012; http://www.nlm.nih.gov/medlineplus/ency/article/000786.htm. Accessed 11/1/2013.
- Headache: Hope Through Research. National Institute of Neurological Disorders and Stroke (NINDS). July 2, 2013; http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed 11/1/2013.
- Horner syndrome. MedlinePlus. February 13, 2008; http://www.nlm.nih.gov/medlineplus/ency/article/000708.htm. Accessed 3/27/2009.