Synonyms
Cluster headache, erythroprosopalgia English: cluster headache
Definition
Bing-Horton syndrome is a headache disorder. The headache is intermittent, always one-sided and may be accompanied by lacrimation or other symptoms. The syndrome occurs 1 time in about 100 people and the age peak is between 25 and 30 years.
There are usually up to 3 headache episodes per year. A distinction is made between different forms of headache. The most frequent is the episodic form, less frequent is the permanent, chronic form.
Causes
It is believed that this disease is an inflammation in the area of a brain structure called sinus cavernosus. This venous plexus is located at the frontal base of the skull. Like a sponge, it collects oxygen-poor blood from various areas of the brain and drains the collected blood into larger veins that carry the blood further to the heart.
Various structures, such as the ophthalmic artery and nerves, run through the venous plexus from the brain to the facial skin or eye muscles. Once the plexus is inflamed, all structures that pass through it are in danger of being affected. Bing-Horton syndrome is characterized by a sharp, piercing pain in and around the eye socket.
The pain can radiate into the temple and is usually constant on the sides. The attacks can add up to 8 per day, one of which has a variable duration of about 30 minutes. The term cluster headache is derived from its episodic, even cluster-like, occurrence.
The headache attacks described above occur regularly, for example within 2 weeks. This is followed by a period without symptoms. In addition to the pain, there are irritation symptoms such as tears or reddening of the eye, runny nose, sweating in the forehead area, unintentional closing of the eyelid or narrowing of the pupil.
These are all signs of involvement of structures that run through the irritated venous plexus. Typically, the affected person is always in motion in order to obtain relief. In order to rule out other more serious diseases of the brain or eye, the eye is examined for the presence of glaucoma.
It may be necessary to examine the neural fluid for signs of inflammation, and if necessary an image of the skull and brain is also taken (computer tomography or magnetic resonance imaging). As with migraine, drugs called “triptans” can be given. In order to counteract the inflammatory pain, these cause, among other things, a narrowing of the affected vessels, which relieves the pain.
A special feature is the administration of 8 to 10 litres of 100% oxygen via a nasal probe for 15 minutes. Alternatively, the administration of anaesthetic spray (lidocaine) can help to stop the pain. Verapamil, a so-called calcium antagonist, can be used to prevent further attacks.
This is originally a drug used to treat cardiac arrhythmia. Cortisone or medication from the treatment of epilepsy (valproate) may also be necessary. If, despite the attempts at prevention with medication, further seizures do not fail to occur and the patient is severely impaired, an attempt is even made to eliminate the nerve node from which the nerve responsible for the pain is running, using high-frequency therapy or injection of narcotics. An overview of all topics in the field of neurology can be found under Neurology A-Z
- Cluster headache
- Headaches
- Migraine
- Stress