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Elevated Body Heat Can Cause Cluster Headaches

From the WebMD Archives

Sept. 16, 1999 (Minneapolis) -- An increase in body temperature can cause cluster headache attacks, according to a British study in this week's issue of TheLancet. Patients who get this type of headache can protect themselves by keeping their bedrooms cool at night and avoiding steaming hot baths during times when they are prone to headaches, the authors write.

Cluster headaches are relatively rare, affecting one in 10,000 patients, lead author Joseph N. Blau, MD, tells WebMD. These types of headaches typically affect one side of the face and are characterized by severe pain around the eye, according to Blau. He says that during an attack, the patient typically will have a bloodshot eye on the affected side, as well as a swollen and sometimes drooping eyelid. The nostril will also be congested. Blau is a consultant for the Hospital for Neurology and Neurosurgery in London, where he also directs the City of London Migraine Clinic.

Although most of the symptoms do occur on the same side of the head as the headache, Blau says he undertook the study because several patients had also reported sweating on both sides of the head, as well as on the neck and trunk of the body.

"A new [trigger] of cluster headache attacks [has] emerged: increased body heat, either from the environment, a hot bath, or central heating, generally within an hour, or from exertion," Blau writes. He also found that sexual intercourse can cause a temperature spike.

Cluster headaches occur much more frequently in men than in women. Ernestina H. Saxton, MD, PhD. Saxton, who was not involved in the study, tells WebMD that the attacks usually come in a series, or cluster, that may last weeks to months and then may not return for a year or more. During a cluster series, or season, headaches can be triggered by some aspects of the patient's diet or factors in the environment. But when the series is ended, those factors will not cause headaches. For example, Saxton says, alcohol is a known cluster headache trigger but may only trigger the headache during certain times of the year.

The biggest part of taking care of headache is ... avoiding triggers," says Saxton. Patients can discover their own triggers by keeping a headache diary, she says. Making a list of factors or situations that trigger the headaches will enable cluster patients to manage their condition and their headache seasons more effectively, she tells WebMD. Saxton is an associate professor of neurology at UCLA, where she directs the migraine clinic.

Working with a pool of 200 patients who had been diagnosed with cluster headaches, Brau and his co-author took patient histories either during or shortly after a cluster period. The patients were asked about body temperature and perspiration during the attacks. Of these patients, 70 reported sweating on both sides of the face, neck, and body, and six felt hot but did not recall sweating. Another 66 recalled neither perspiring nor feeling hot.

The findings don't mean that cluster patients should avoid heat and become celibate, say Saxton. "In some patients, [avoiding] heat may be important during the [cluster] season but not at other times."

Cluster headache attacks are often treated with medications used for migraines. Drugs such as Imitrex (sumatriptan) and Maxalt (rizatriptan) often can stop an individual attack. During a headache season, a physician will often prescribe a drug to help prevent recurrent headaches, Saxton says. She adds that some medications used to treat high blood pressure are effective at preventing the series of headaches. Although they are usually taken daily, patients may be able to take them only during the time of the year associated with a cluster period.