Experiential phenomenology of cluster headache ; Phénoménologie expérientielle de l’algie vasculaire de la face (AVF)

International audience ; Objectives: Cluster headache (CH) is a rare disease (1 to 3 / 1000), predominant in men (sex ratio: 4 men / 1 woman) and characterized by frequent very painful paroxystic attacks occurring sometimes 8 times by day. CH is a disease without lesion and impairs the quality of life of patients. Attacks occur only on the same hemiface and can last from 15 minutes to 3 hours. The pain is particularly severe and a frequent and extreme psychiatric symptomatology is observed during the attacks. Treatments are rare and not always efficient: sumatriptan, oxygen, LSD, psilocybin. In this paper we try to answer to the question: "What does that make you to have a cluster headache attack ? ", using elicitation interview developed by Vermersch. Patients and methods: Ten patients have been interviewed using elicitation interview (EI) (40-50 mn for one interview). All these patients (7 men and 3 women) T suffer from chronic or episodic CH, with a mean age of 43 years. The patients come from the Lariboisiere hospital (Paris), and more precisely from the center of headache urgency. EI allows describing the pre-reflexive consciousness contents. The method is described in Balzani and coll., and in Petitmengin and coll (see bibliography). Data analysis were performed using Interpretative phenomenological analysis (IPA). Results: From the EI, we have distinguished three phenomenological axes, following Heidegger’s philosophy: 1) An alteration of being-to-the-world with a strong unbearable feeling of imprisonment, and physical restriction. At the same time the patients present a stereotypical and automatic behavior with few motor schemes and escaping strategies. When pain arises, they want to leave and to go very far. Aggressive behavior frequenly occur. Sometimes, the patients are not able to perform the sumatripan injection, due to a motor inhibition. Some patients try to do autohypnosis or other methods to resist to the pain. 2) An alteration of being-to-the self, going from the corporal distortion to the body ...