Cluster Headache: Symptoms, Causes & Treatment

Cluster headache is a relatively rare type but one of the most painful headaches of all, even described as suicide headache because of its severity. It is characterized by attacks of very severe pain centered around one eye or the temple on one side of the head, with a single attack lasting from 15 minutes to three hours.

It is called cluster because the attacks come in time clusters: periods during which attacks recur daily or several times a day for weeks or months, followed by remission periods that may be long. Attacks often come at regular times and sometimes wake the patient from sleep. The pain on the same side is accompanied by distinctive signs such as eye redness and tearing, nasal congestion or runny nose, facial sweating, and a drooping eyelid, and during an attack the patient is restless and unable to sit calmly, unlike a migraine patient.

Despite its severity, cluster headache is treatable, but it needs correct diagnosis and specialized treatment, as ordinary painkillers do not help because of the attack's brevity and intensity. Treatment includes two types: rapid acute-attack treatment (such as high-flow oxygen inhalation and certain medications) and preventive treatment taken during the cluster period to reduce the number and severity of attacks. Seeing a neurologist is therefore very important for anyone suffering from this headache pattern.

• Very severe pain around one eye or the temple on one side.
• Short attacks (15 minutes to 3 hours) recurring in clusters.
• Eye redness and tearing and nasal congestion on the same side.
• Drooping eyelid, facial sweating, and restlessness with inability to stay calm.

• A disturbance in the hypothalamus region of the brain that regulates the biological clock.
• The exact cause is not fully certain.
• Triggers: alcohol and smoking during the cluster period.

• Clinical diagnosis from the characteristic attack pattern and accompanying symptoms.
• Brain imaging (MRI) to rule out other causes when needed.

Acute-attack treatment

• High-flow oxygen inhalation and fast-acting medications prescribed by the doctor.

Preventive treatment

• Medications taken during the cluster period to reduce the number and severity of attacks.
• Avoiding triggers such as alcohol during the cluster.

Ordinary painkillers do not help because of the attack's brevity. This content is educational and does not replace consulting a neurologist.

• Severe suffering and impact on sleep and daily life.
• Anxiety and depression from the pain's severity and recurrence.

• Avoiding triggers such as alcohol and smoking during the cluster period.
• Adhering to the prescribed preventive treatment.
• Keeping a regular sleep pattern.