chronicclusterheadaches.co.uk

Annette

Neurology 1999;53:543
© 1999 American Academy of Neurology

--------------------------------------------------------------------------------
Articles

Cluster headaches

Association with anxiety disorders and memory deficits

Ricardo E. Jorge, MD, Jorge E. Leston, MD, Stephan Arndt, PhD and Robert G. Robinson, MD
From the Department of Psychiatry (Drs. Jorge, Arndt, and Robinson), University of Iowa Hospitals & Clinics, Iowa City, IA; and the Department of Neurology (Dr. Leston), Hospital de Clinicas, Buenos Aires University, Buenos Aires, Argentina.

Address correspondence and reprint requests to Dr. Ricardo E. Jorge, Department of Psychiatry, University of Iowa Hospitals & Clinics, 2887 JPP, 200 Hawkins Drive, Iowa City, IA 52242-1057.

OBJECTIVE: To estimate the frequency of mood and anxiety disorders and to assess memory and executive functions among a representative group of patients with episodic cluster headache (ECH) during the course of an acute episode.

METHODS: We compared 21 patients with ECH with 21 patients with tension headache (TH) matched for age, sex, and educational level. Psychiatric diagnosis was made by a semi-structured interview and Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria. Quantitative measures of depression and anxiety were obtained using the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale (HARS). In addition, all patients received a neuropsychological evaluation to assess basic memory and executive functions.

RESULTS: Of the 21 patients with ECH, 5 (24%) met DSM-IV criteria for an anxiety disorder during the year before the episode. Panic disorder was diagnosed in two patients (10%). The remaining three patients (14%) met criteria for generalized anxiety disorder. Of the 21 patients with TH, 2 (10%) met diagnostic criteria for an adjustment disorder with depressed mood, and 1 (5%) met criteria for an adjustment disorder with mixed anxiety and depressed mood. HARS scores were higher among patients with ECH (Kruskal-Wallis, 2 = 4.3, df = 1, p = 0.03). ECH patients also showed significantly lower Auditory Verbal Learning Test scores (Kruskal-Wallis, 2 = 6.5, df = 1, p = 0.01).

CONCLUSIONS: When compared with a group of patients with TH, ECH patients showed a higher frequency of anxiety disorders during the year before the onset of headaches and significantly greater HARS scores during the episode. In addition, patients with ECH were selectively impaired in verbal memory.

Annette · Posted: Mon Feb 11, 2008 10:03 am Post subject:

Interesting article from the New York Time ( today ) about Clusterheadaches

Effects on Mental and Emotional Functioning

People with episodic cluster headaches tend to have low sexual appetites and impaired verbal memory and are more likely to suffer from anxiety. According to one study, nearly a quarter of patients with cluster headaches met the criteria for having anxiety disorders. Furthermore, the anxiety disorders occurred more frequently within the year before the onset of their cluster headaches. (None of these patients had depression or abused alcohol or drugs.) Some studies suggest that the biologic abnormalities in the hypothalamus of the brain that are associated with episodic cluster headaches may also contribute to these emotional and mental difficulties.

Auras and Stroke Risk

In rare cases, patients with cluster headaches have migraine-like aura. Headaches that are accompanied by aura may increase the risk of stroke or transient ischemic attack (TIA). A 2005 study found that patients who had headaches with auras were about four times more likely to have a stroke or TIA than patients who had headaches without aura. TIA symptoms are similar to those of stroke, but last only briefly. A TIA is often a warning sign that a person is at risk for a more severe stroke.

Headaches with auras may also increase the risk for eye retinal damage (retinopathy), which can lead to severe vision problems or blindness. The risks for stroke and retinopathy are associated with the effects of aura-related headaches on small blood vessels in the brain and the eyes.

This is the link to the whole article

http://health.nytimes.com/health/...cluster-headaches/background.html

Sherri · Posted: Mon Feb 11, 2008 11:34 am Post subject:

Thanks for the info Annette.

Admin edit
_________________
"Great spirits have always encountered VIOLENT opposition from the MEDIOCRITIES." -Einstein.

Annette · Posted: Mon Feb 11, 2008 11:56 am Post subject:

post deleted by Admin

Sherri · Posted: Mon Feb 11, 2008 6:55 pm Post subject:

Annette,

I've got to be honest, I've asked to die during hits...more times than Im able to count. And I MEANT IT.

I've actually been furious that I lived. When it gets really painful, and Im just so tired, confused....lost...I want out. :smt022

I've thought about crawling to the drawer I keep my box cutter in...and slicing my arteries...so the blood will pump out and it will be over as quickly as possible. I dont want to slowly bleed to death on top of being in inhuman, otherwordly pain.

I've moved the box cutter down three floors in the basement in my storage unit...so that won't ever happen. There's no way in hell I would go down three floors during a hit....I can't even if I want to.

I considered jumping off of my terrace...but it's not high enough. I'd end up breaking my leg...drawing attention to myself...and then when the ambulance arrived, I'd be asking for oxygen for a broken leg??

I seriously wouldn't care much about the broken leg during hit. I would AFTERWARDS though.

I DON'T think these kinds of thoughts when I'm not in pain. ONLY DURING HITS...AND ON REALLY BAD DAYS I'm not suicidal...don't worry about that.

It just gets bad sometimes...too much for me to take at times. :smt022 That's where my CCH family comes in. You have to KNOW how vital you supporters really are... you keep us alive...and you don't know it.

Yes, this is a graphic admission. Yes, it's frightening to hear. Yes, it concerns you...makes you wonder. However, alot of CH's really do feel this way...some rarely...some more often. We are only human. Yes, it hurts THAT badly. And if you have no support, or dr's or family or friends telling you to get over it...it's even worse.

Honesty is important. If others want to know what CH is truly like...they have to know all of it. They're not nicknamed "suicide headaches" for nothing.

So...Im letting you know just how important you are....and why I love supporters so very much and a HUGE part of my heart belongs to each one of you.

_________________
"Great spirits have always encountered VIOLENT opposition from the MEDIOCRITIES." -Einstein.

Annette · Posted: Mon Feb 11, 2008 8:15 pm Post subject:

Sherri, I do understand it from a supporter's point of view.

Daniel had done the same thing, many times. He had begged me to kill him during those kip 10 hits. No one fully understand how horrible these things are until they have one or live with someone who has it. You are even stronger than Daniel. When he thought he was going to go chronic, he became suicidal even outside the hits, because he couldnt bear the thoughts of getting these hits every single day, for years. Thank God we finally found the right combo which really helped reducing the number of hits as well and the intensity. Then the cycle ended.

Interestingly, I chatted to Ike yesterday and found that Ikes CH is almost identical to Daniels, from triggers to characteristics.

Daniels last cycle went on for 8 months and for the 1st 6 months nothing worked for him. The neurologist was getting worried that he was " med resistant ". Yet because we continued searching, trying, we finally found the meds that did work.

Never give up hope, real relief may just be around the next corner.

Sherri · Posted: Mon Feb 11, 2008 8:36 pm Post subject:

Annette,

Im glad I didn't freak you out, and you didn't panic.

I can imagine Daniel's terror at the prospect of becoming chronic. Im sooooooo thankful you found something that helped.

Im also so sorry you have to see someone you love so much suffer.

...and to ask you to please kill them. I know. I've begged...I wanted it to just stop so badly...so so badly.

I really just wanted you to know you are precious.

_________________
"Great spirits have always encountered VIOLENT opposition from the MEDIOCRITIES." -Einstein.

Annette · Posted: Mon Feb 11, 2008 9:28 pm Post subject:

Oh Sherri, I freaked and panic big time ! The only saving grace is my training. I am trained to switch off and just concentrate on the presence and see what I could do.

Then again the frustration was huge, because I was also trained to be DOING something, like CPR or something ! Here I couldnt do a thing. So to focus, I often just kept myself busy changing freshly washed face towels and add more ice to the bucket for him.

Not to be able to do anything to help, to sit there and endure the hit with your loved one is the hardest of all.

Thanks for your kind words, you are very precious to me too