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Richard is a 40-year-old man with a history of 4 weeks of cluster headache once each year.

Case Study:

Richard is a 40-year-old man with a history of 4 weeks of cluster headache once each year. These began when he was 35 years old. His cluster periods occur in the fall. The cluster period begins slowly, increasing over 1 week, reaching a peak where Richard has two or three severe cluster attacks each day. They occur from 10 p.m. to 3 a.m. Each cluster headache lasts from 40 to 90 minutes, and the headaches are severe. The pain is always on the right side, with eye tearing and nasal congestion. 

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Richard comes into our office 1 week into this fall’s cluster series. The headaches are increasing in intensity, and he is miserable with the pain.

Please complete the following questions: 

  • Describe Cluster Headache and its epidemiology.
  • What would be your goals for therapy for Richard? Give rationale with evidence from articles. 

Please limit your posts to the above 2 questions.

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