Peculiar symptom cracks a case of Cluster Headache

Cluster headaches come in groups – called cluster periods – that can last for several weeks or months. Between the clusters of headaches are pain-free times that can last months or even years. Cluster headaches affect men more frequently than women.
Pain from cluster headache is typically on one side of the head and in the worst attacks the pain can be excruciating. Pain may also be bilateral and non-throbbing.
There are two types of cluster headaches, episodic and chronic.
Episodic Cluster Headache
This type of cluster headaches have clearly defined groups of headache attacks. The periods of pain can last seven days to one year, but are usually between two weeks and three months. Between the headache attacks, there are periods with no pain that are at least a month long. To have episodic cluster headaches there must have been at least two cluster periods.
Chronic Cluster Headache
To have chronic cluster headache, attacks occur for more than one year without the pain free period or the pain free time lasts less than one month. Some sufferers’ cluster headaches begin as chronic and become episodic, or vice versa.
Facts about Cluster Headaches
·         Cluster headaches last a short period of time, but cause severe pain
·         Men suffer from cluster headaches three to six times more often than women
·         Less than one adult in 1,000 suffers from cluster headaches
·         The disorder surfaces when people are in their 20s or older
·         With each episode, the pain almost always occurs on the same side of the head
·         About 5% of cluster headaches appear to be inherited according to the International Headache Society
·         About 10% to 15% of cluster headache sufferers never have pain-free periods, according to the IHS
A Case
A young man of 26 years, student, came with a complaint of headache since childhood coming off and on. He was treated a year ago with Belladonna, Spigelia, Nux vom, Sangunaria with no significant effect. The headache remained.
Chief complaints :
Pain in forehead
Location – between the eyebrows
Sensation – deep boring electric shooting type
Modality – < Morning, reading
Ø  Sleep
Concomittant –  heaviness in head and  body, lethary, disinclination to study.
Diagnosis – ? Cluster headache ( Ciliary Neuralgia or Migranous Neuralgia )
Past History – Operated two years back for some tumour ? in the back.
–       Headache since childhood
Family History – Mother – Nothing significant
Father – Alcoholic
Personal History
Occupation – student
Socio-economic status – lower middle class
Marital Status – Unmarried
Addiction – nothing specific
Physical Generals
Appetite – decreased
Desires – spicy and salty food
Aversion – nothing specific
Thirst – decreased
Urine – nothing significant
Stool – once, satisfactory
Mental Generals
Wants to stay alone, talks less, sad as to how I will prepare for the upcoming examination of Company Secretary. I am not able to study and concentrate. I have passed foundation and have to sit for Executive level.
First prescription – Avena sativa Q and Hypericum 30 was given to ease the patient.
The patient felt better. Heaviness gone, but still pain between eyebrow remained with decrease in intensity of the pain.
Second prescription ( a week later ) – Actea racemosa 30 was given 2drops on alternate days to be taken in the morning along with Avena sativa Q. Advised EEG  if the symptoms returned.
The patient felt much at ease. Headache gone and now could study properly.
Discussion
The patient’s picture was depictive of cluster headache with a peculiar symptom of pain in forehead between the eyebrows which was electric-like deep pain. The symptoms corresponds to Actea racemosa. The patient was relieved. Here, the peculiar symptom pointed to the correct remedy.
Theme – There is no short cut in Homoeopathy. Exactness in prescription i.e. the simillimum  is the only answer.