Difference Between Cluster Headache and Trigeminal Neuralgia

Differences Symptoms Diseases

Excruciating pain on one side of the head is a hallmark symptom of cluster headache and trigeminal neuralgia, both of which can last for weeks or even months in some patients. If you're experiencing a cluster headache, chances are you've had pain in your temple or behind your eye. Trigeminal neuralgia, on the other hand, causes sudden, electric-like spasms on one side of the face. The next paragraphs will go even further into the differences between them.

What is Cluster Headache?

Cluster headaches are characterised by extreme pain in the back of or around one eye, which occurs in cycles of one week to one month.

Severe discomfort behind or around the eye is one of the symptoms. It can cause tearing or swelling in the afflicted eye and a reddening of the cheek on the affected side of the face. Furthermore, ptosis on the afflicted side is possible. Moreover, people may get a stuffy or runny nose, and they may feel agitated. Cluster headaches can be extremely painful, to the point that the sufferer has to seek medical attention in an urgent care or emergency room.

Diagnosis − A diagnosis is generally made based on the patient's symptoms, especially the level of pain and its proximity to an eye, however imaging can rule out other potential causes. Furthermore, men are disproportionately affected by this sort of headache compared to women.

Causes The causes of cluster headaches, including why they are more prevalent in males, remain a mystery to medical experts. Scientists are speculating that issues with the hypothalamus in the brain are to blame for the disease.

Treatment − The treatment often involves the use of powerful pain medications such ergotamine- based drugs and triptans. In certain cases, verapamil and prednisone may also be utilised to alleviate symptoms.

What is Trigeminal Neuralgia?

Sharp, electric-like spasms on one side of the face are a hallmark of Trigeminal Neuralgia (TN). The lower face and jaw are the usual targets, but the nose and eyelids can also be impacted. The pain from this chronic disease is sometimes compared to that of childbirth. The two trigeminal nerves in the face are involved, as they are responsible for carrying pain and other feelings from the face to the brain. The chin, the middle of the face, and the forehead are all served by separate branches of the trigeminal nerve.

Pain that comes on suddenly and might be triggered by noise or touch is a common symptom. Face contact, eating, drinking, chatting, a wind on the face, shaving, smiling, talking, and brushing are all potential causes. In some cases, the spasms persist for just minutes, while in others, the episodes last for weeks or months. There is a possibility that Type I or Type II pain is present.

Throbbing and shock-like describe type I pain, also known as classic pain, which has distinct remission phases. Several common everyday actions, like as stroking one's face, might set it off. Atypical pain, of which type II is a subtype, is characterised by a persistent, aching pain that may not subside at all and may be more generalised in its distribution. That's why it's so challenging to find an effective treatment for Type II (American Association of Neurological Surgeons, 2020).

Although many times the reason is unknown, certain cases have been linked to a tumour, enlarged blood vessels, or multiple sclerosis. Women and those over the age of 50 are overrepresented in this group. TN is not only difficult to diagnose but also difficult to cure; options include anti-seizure drugs, microvascular decompression, glycerol injections, and gamma-knife radiosurgery (Pietrangelo, 2016).

Differences: Cluster Headache and Trigeminal Neuralgia

The following table highlights the major differences between Cluster Headache and Trigeminal Neuralgia −

Characteristics	Cluster Headache	Trigeminal Neuralgia
Description of Pain	The pain of a cluster headache has been likened to "sticking a hot poker in your eye" and "suicide headache" by some sufferers.	Trigeminal neuralgia causes painful, electric shock-like spasms in the face
Typical Location	Cluster headache pain is localised behind one eye or at the temple.	Trigeminal neuralgia most often manifests in the lower cheek and jaw, but can also manifest in other locations, such as the region around the nose and above the eye.
Classification	Cluster headaches can be either episodic or persistent. Periodic bouts of pain followed by periods of relief define episodic cluster headache, which often lasts for at least a month. Cluster headaches are considered chronic if they continue for more than a year with no pain-free periods or with pain-free periods that last for less than a month.	There are two types of pain associated with trigeminal neuralgia, Type I and Type II. Throbbing and shock-like describe type I pain, also known as classic pain, which has distinct remission phases. Several common everyday actions, like as stroking one's face, might set it off. Atypical pain, of which type II is a subtype, is characterised by a persistent, aching pain that may not subside at all and may be more generalised in its distribution.

Characteristics

Cluster Headache

Trigeminal Neuralgia

Description of Pain

The pain of a cluster headache has been likened to "sticking a hot poker in your eye" and "suicide headache" by some sufferers.

Trigeminal neuralgia causes painful, electric shock-like spasms in the face

Typical Location

Cluster headache pain is localised behind one eye or at the temple.

Trigeminal neuralgia most often manifests in the lower cheek and jaw, but can also manifest in other locations, such as the region around the nose and above the eye.

Classification

Cluster headaches can be either episodic or persistent. Periodic bouts of pain followed by periods of relief define episodic cluster headache, which often lasts for at least a month.

Cluster headaches are considered chronic if they continue for more than a year with no pain-free periods or with pain-free periods that last for less than a month.

There are two types of pain associated with trigeminal neuralgia, Type I and Type II. Throbbing and shock-like describe type I pain, also known as classic pain, which has distinct remission phases.

Several common everyday actions, like as stroking one's face, might set it off. Atypical pain, of which type II is a subtype, is characterised by a persistent, aching pain that may not subside at all and may be more generalised in its distribution.

Conclusion

In summary, Cluster headaches and trigeminal neuralgia are both types of headaches that can cause severe pain, but they have some key differences. Cluster headaches are characterized by intense pain on one side of the head, tend to occur in "clusters" and are relatively rare.

Trigeminal neuralgia is a type of facial pain caused by irritation or damage to the trigeminal nerve and is usually felt in one or more specific areas of the face and is less frequent but with shorter duration. Both types of headaches are treated with medication, but the specific medications used can be different.

Vineet Nanda

Updated on: 04-Apr-2023

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