Researchers look for cluster headache causes

They attack without warning. The pain they inflict has been likened to a poker in the eye or a nail through the temple.

For the estimated 100,000 Americans who suffer from cluster headaches - a particularly excruciating variety - relief may be on the way.

University Medical Center researchers Ronald Chervin and Sarah Nath are trying to find out whether abnormal sleeping habits are the culprits behind the headaches.

"I couldn't get out of bed," said Cindy Chang, an LSA first-year student who suffers from cluster headaches. "I couldn't move. There's no way you can describe it. It wasn't that I felt lethargic. It was just that there was nothing I could do because it would just hurt more."

However, Chang said she is lucky.

"My doctor had another patient who also suffered from clusters," she said. "She used to take ridiculously high dosages of pain killers. But they didn't take away any of her pain. So, in her foyer, there's this ceramic tile floor. She'd bang her head...until she knocked herself unconscious."

Such stories are not uncommon, Chervin said.

"The one I've heard more commonly is to beat their heads on the wall. But I had another patient who used to get a big metal bucket, fill it with ice water and dip his head into it. This pain is worse than migraines," he said.

Cluster headaches are easily distinguished from other kinds of headaches. They come on very quickly, within 15 minutes, Nath said. The pain subsequently spreads out, covering the area between the upper cheek and temple. The pain is always localized to one side of the head.

There are a host of other symptoms, including tearing and reddening of the eyes, drooping of eyelids, a smaller pupil on the affected side of the head and a runny nose. The headaches get their name from their persistence. They often come at the same time of day, each day or for a week or two and then vanish for long periods of time.

The suspicion that cluster headaches might be caused by abnormal sleeping patterns has a clinical basis.

"In previous studies, we noticed that a substantial percentage of people with the headaches also had diagnosed sleeping disorders," Chervin said. "Most of those people whose sleep disorders were corrected lost their headaches."

Nath and Chervin are pioneering research that focuses on the relationship between sleep and cluster headaches.

"We're comparing (cluster headache sufferers) with sleep disorders to those without sleep disorders," Nath said. "For those with sleep disorders, we will attempt to stem the pain by treating their sleep patterns, or if they have an actual sleep disorder, treat that."

"(The group is) not a really good scientific control. The ideal thing would be to have some people with cluster headaches and sleep disorders and treat half of them and let the other half suffer for two years. But I don't think too many people would want to be in the study," Chervin said.

If Nath and Chervin are able to cure study participants of their cluster headaches by correcting their sleeping disorders, their findings would represent a breakthrough in cluster headache treatment, which has little to offer its patients beyond drug therapy.

The prospect of a happy ending for cluster headache sufferers is exciting, Chang said.

"That would be great. The headaches have really plagued me. They've changed my study habits. They've affected my life."

Individuals who suffer from cluster headaches and are 18 years or older can volunteer to participate in the study by calling (313) 936-9158.

MARGARET MYERS/Daily
LSA first-year student Cindy Chang suffers from cluster headaches. Cluster headaches generally come on quickly and are extremely painful.

09-10-97