Regular headaches can have a big impact on your life. That is certainly the case with severe types such as cluster headache, migraine or rare, genetic types such as hemiplegic migraine. That is why we at the LUMC carry out in-depth research into better methods to diagnose and treat these severe types of headache. And because we carry out our research in the treatment room, you can immediately benefit from it. This way we ensure you get the best possible care.
Why you are in good hands at the LUMC
At the LUMC you are treated by doctors who have years of experience with treating severe types of headache. This experience is important, because cluster headache and migraine are not always properly diagnosed and treated. Also people around you may not understand it. This is because a lot is still not known about these disorders. Establishing the right diagnosis may therefore sometimes take years. With the knowledge and experience we have built up at the LUMC we try to establish a correct diagnosis as fast as we can in order to give you the best possible treatment.
The team that helps you includes neurologists who are known both nationally and internationally for their expertise on headaches. They work together with trainee neurologists, physician researchers and nurse practitioners. At the same time there is close cooperation with other LUMC specialities. So if necessary we can quickly involve a different department in the treatment or research. Because of that intensive cooperation between various disciplines we can offer you high-quality care.
Unique position in the Netherlands
The LUMC is the only university medical centre in the Netherlands specializing in headaches. As a result we have gained a lot of valuable expertise and knowledge in the past decades. For instance about the identification and treatment of symptoms when your headache is not understood anywhere else. Or about additional problems often accompanying headaches, such as depression as a result of migraine. Thanks to our medical research into headaches we have a unique position in the Netherlands.
Medical research into headaches
As a result of our medical research we have learned a lot in recent years about cluster headache and migraine, especially about what goes wrong during a headache attack. However, many question are still unanswered. What for instance causes these disorders? And why does someone get an attack at a certain moment? Although we can quite often properly treat many types of headache nowadays, we cannot yet cure them. That's why we continue our intensive medical research unabatedly. And often you can help out with this research. We gain more and more knowledge this way and you have access to the latest treatment methods.
What is migraine?
Migraine is a very stressful and socially debilitating disorder, with headaches occurring as attacks. It is one of the most prevalent types of headache. More than 10% of the Dutch population suffers from migraine attacks each year, with an average of two attacks per month. In principle every person may get one or two migraine attacks in his/her life. But someone is only considered a migraine patient when the attacks occur regularly.
Symptoms of migraine
Migraine can manifest itself in various ways. The most prevalent type is characterized by:
- headache attacks lasting between 4 and 72 hours;
- a throbbing pain on one side of the head, getting worse with physical strain;
- side effects such as nausea, vomiting and/or hypersensitivity to light and sound.
The headache attacks are often so severe that patients have to take to their bed. Before the headache about 1 in 3 patients suffers from auras. These usually consist of brief visual problems (visual aura). A visual aura can consist of coloured shimmering, pulsating patches or light flashes. Vision may also (partly) disappear. Other possible neurological symptoms include sensory symptoms or difficulty speaking. A migraine aura usually lasts between 5 minutes and 1 hour.
What causes migraine?
What exactly causes a migraine attack is as yet unknown. We do know however that migraine patients are hypersensitive to certain stimuli. This is probably partly due to genetic factors. The sensitivity of the brain to stimuli can also temporarily change due to circumstances. For instance fatigue or menstruation.
What is a cluster headache?
A cluster headache is a relatively rare, but extremely serious type of headache characterized by attacks. It owes its name to the fact that the attacks usually occur in clusters (episodes). This means that patients suffer from alternating periods of a few weeks to months with many attacks and periods of a few months to years without attacks. In some cases it may happen that these attacks do not occur in episodes, but all year round.
Although women can also suffer from cluster headaches it is more common in men. In the Netherlands there are about 17,000 cluster headache patients. Simply because cluster headache occurs relatively rarely, it may be years before it is diagnosed. Most general practitioners rarely see someone in their practice suffering from cluster headaches.
Symptoms of cluster headaches
A cluster headache can manifest itself in various ways. The most prevalent type is characterized by:
- headache attacks lasting between fifteen minutes and three hours;
- a very severe, headache on one side near the eye or temple;
- attacks which occur every second day up to eight times per day.
Usually a cluster headache also coincides with one or more symptoms on the same side of the headache:
- A red and/or watering eye
- A blocked or runny nose
- A swelling of an eye lid
- A sweaty face
- The feeling that your ear is blocked
- Redness of the face or forehead
An attack may also cause restlessness and agitation.
What causes cluster headaches?
The exact cause of cluster headaches is still unknown. It is also not clear whether genetic factors play a role. It is known however that in some families it occurs more often. Because the attacks often reoccur in the same period, it is assumed that certain brain structures are involved which influence daily rhythm. This is also called the 'biological clock'. As yet there is no scientific proof.
What is hemiplegic migraine?
Hemiplegic migraine is a rare and severe type of migraine; the headache attack coincides with weakness (of half of the body). The symptoms vary from weakness in one hand, to paralysis on one side of the body. Hemiplegic migraine is usually strongly genetic. If more than one family member suffer from this disorder, we call this familial hemiplegic migraine (FHM). However, you may also only be the only one in your family suffering from it. In that case it is referred to as sporadic hemiplegic migraine (SHM).
Symptoms of hemiplegic migraine
The symptoms of hemiplegic migraine are identical to those of 'normal' migraine, with the exception of the paralysis symptoms. These usually occur during the aura stage and may last between a few minutes and several days. The headache occurs after or during this period of weakness.
The main problem of hemiplegic migraine is usually not the headache, but the severe aura symptoms, because they can last for so long. At the same time, in some cases there is an increased risk of epileptic attacks or coordination disorder (ataxia).
What causes hemiplegic migraine?
Hemiplegic migraine is almost always due to genetic factors. This is because of an error in the genetic material. However, to date not much is known about the exact cause of hemiplegic migraine and its symptoms.