"I feel an irresistible urge to bang my head against the wall": a case series highlighting agitation and severe pain in cluster headache
DOI:
https://doi.org/10.48208/HeadacheMed.2025.29Keywords:
Cluster headache, Psychomotor agitation, Head-banging, Self-injurious behavior, Trigeminal autonomic cephalalgiaAbstract
Abstract
Introduction
Cluster headache is a primary headache disorder characterized by severe, unilateral pain, typically associated with cranial autonomic symptoms, including conjunstival injection, lacrimation, nasal congestion, rhinorrhea, eyelid oedema, forehead and facial sweating, miosis and ptosis. Beyond these hallmark features, patients often exhibit marked psychomotor agitation, sometimes expressing the wish to engage in head-banging behaviors as an instinctive response to unbearable pain. This case series highlights three such patients.
Cases report
In all cases, appropriate preventive therapies reduced both the frequency of attacks and the desire for self-injurious behavior.
Conclusion
These reports highlight the extreme suffering associated with cluster headache and emphasize the importance of timely recognition and effective management strategies.
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Copyright (c) 2025 Marcelo Moraes Valença, Rita Santana dos Reis, Juliana Ramos de Andrade (Author)
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