q & a
By Gary Cohen
Seeing Red
Dr. Frederick G. Freitag
The pain of cluster headache can bring sufferers to their knees, but Dr. Frederick G. Freitag says the condition is manageable— with the right treatment.
When it comes to pain, there are many varieties— and headache sufferers are intimately familiar with all of them. There is the persistent, dull ache. The sharp, stabbing sting. The relentless, steady drum. But few headache varieties are more painful than cluster headache, a rare neurological disease defined by cyclical,“ clustered” attacks.
Frederick G. Freitag, MD, osteopathic physician and vice president of the National Headache Foundation, has treated thousands of cluster headache patients during his career. After 27 years at the Diamond Headache Clinic in Chicago, Dr. Freitag recently became the medical director and director of headache medicine research for the Comprehensive Headache Center at Baylor Health Care System in Dallas.
In the past, he has been involved in drug research for cluster headache and has worked with organizations, such as ClusterBusters, to help spread the word about this excruciating headache disorder. He recently sat down with Head Wise to discuss cluster headache and what can be done to treat it.
HEAD WISE( HW): Tell us a little about cluster headache. DR. FREITAG: Cluster headache is considered one of the primary headache disorders. It has been thought to be akin to migraine. In fact, for years, it was called“ red migraine.” Cluster attacks are very different, though. They are a disorder that we believe to be related to a dysfunction in a small gland called the hypothalamus. This is, in essence, the Pentium chip for your brain because of how it controls a variety of things, including pain modulation and the autonomic nervous system.
HW: Who does cluster headache most commonly affect? DR. FREITAG: From the newer epidemiologic studies, it is still a male predominant disorder. It’ s about the reverse ratio from migraines. So 70 percent of all migraine sufferers are women— about 70 percent of all cluster headache sufferers are men.
HW: How can people learn to recognize cluster headache? DR. FREITAG: It’ s a much more severe pain than we typically associate with migraine. It’ s usually located primarily in the eye and temple region. Many people will describe it as feeling like a hot, burning poker is being run through their eye. Thankfully, the pain is relatively brief in comparison to migraine. For patients with cluster headache, the attacks usually last 15 minutes to several hours, and they occur in groups, or bunches. They occur all together and then, as fast as they came on, they’ re gone until the next cycle of
If you want to hear more from Dr. Freitag, you can download the full podcast or read the transcript online at www. headwisemag. org. www
24 HEAD WISE | Volume 1, Issue 2 • 2011