Behavior during cluster headache

Abstract

Cluster headache (CH), also known as "suicide headache," is characterized by a distinctive behavior during attacks. In 80% to 90% of cases, patients are restless and constantly moving in a vain attempt to relieve pain. They often perform complex, stereotyped actions. During attacks, CH sufferers do not want to be touched, stroked, or comforted and frequently moan a great deal, cry, or even scream. They sometimes indulge in violent, self-hurting behavior. Restlessness is a highly sensitive and highly specific parameter for CH and has been included among the signs and symptoms accompanying pain of the disorder in the Second Edition of the International Classification of Headache Disorders. A few hypotheses on pathophysiology of restlessness are addressed in this paper.

Circular saw suicide

“…These may include restlessness, moaning, screaming and in some cases violent and self-harming behaviour. 12 Head-banging may occur in an apparently vain attempt to relieve the severe pain. It is possible that the patient in our report inflicted a head injury upon himself as a result of and directed towards the site of his severe headache.…”

The Primary Headaches as a Reflection of Genetic Darwinian Adaptive Behavioral Responses

“…Patients were often embarrassed and felt surprised by their own behavior, expressing doubts about their own sanity. There was no difference in behavior between men and women with CH: suicide and self‐hurting behaviors have been described, and violent behavior during the attack may have legal consequences 31 . Psychiatrically quite normal patients with CH may warn their spouses ahead of the attack to be left alone because of a feeling of losing control and aggressive and homicidal impulses during the attack.…”

Illicit drug use in cluster headache patients and in the general population: A comparative cross-sectional survey

“…High-quality studies in this field (that is, studies including adequate CH patient and control groups and using specific psychometric instruments or indicators) are lacking (1). Most of the hypotheses on personality traits, psychological features and coping style in CH patients, such as those which suggest that these individuals are characterised by impulsiveness, aggressive behaviour, emotional ability, anxiety and poor social contacts, have not been validated by solid observational data (1)(2)(3)(4)(5)(6).…”