CLUSTER HEADACHE

Cluster headache is a rare condition that predominately affects older men. The diagnosis is based on the history and clinical characteristic s, which are distinctive. The headache is always unilateral, excruciat ing and, most uniquely, occurs in timed attacks, called ''clusters.'' The etiology is unknown, but disturbances in the hippocampal areas con trolling circadian rhythm may contribute to cluster headache. Various treatments to relieve individual attacks and to shorten active cluster periods have been used, including systemic corticosteroids, lithium, ergotamines and calcium channel blockers. Patient education and indivi dualized treatment are important elements of the management plan.