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An Electroencephalographic Investigation of Patients with Cluster Headache

Cluster headache (Horton's headache, histaminic cephalgia) is a headache entity with attack characteristics 1 differing from those of migraine. Thus, there are clear differences between the 2 entities as far as the following parameters are concerned: sex (male preponderance in cluster headache), so-called irritative, ischemic or 1.phase symptoms (lacking in cluster headache), nausea and vomiting (generally absent in cluster headache), duration and severity of attacks (short-lasting and severe attacks in cluster headache), persistent same-sided unilaterality of pain attacks (typical only for cluster headache), autonomic eye-symptoms (cluster headache). Furthermore, the cluster phenomenon itself (periods with accumulation of attacks, with intervening attack free periods of varying duration) is typical of cluster headache. Recently, we have shown that the corneal indentation pulse (CIP) pattern differs in the 2 disorders, increased attack-induced amplitudes on the symptomatic side being typical of cluster headachea. The marked difference between these 2 disorders with regard to these and other parameters, strongly suggests, but does not prove, that there not only is a different localization of the pathological process in the 2 types of headache, but that the nature of the process underlying the pain production may be different. Our working hypothesis is that migraine is a disorder affecting the brain, whereas cluster headache largely is an extracerebral disorder. On this basis it may seem advantageous to study all available clinical parameters for cerebral function in cluster