Cluster headaches

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Cluster headaches occur as attacks of severe, one-sided headaches. Typically, a number of attacks occur over several weeks (a cluster of attacks). They then usually go for weeks, months or years until a next cluster develops. An injection with a medicine called sumatriptan will usually relieve each headache. Some medicines are also used which aim to prevent the headaches.

What are cluster headaches and what are the symptoms?

Cluster headaches consist of attacks of severe one-sided pain in the head. It is sometimes called migranous neuralgia. Each attack develops suddenly, usually without any warning. Typically, you feel the pain mainly in or around one eye or temple. The pain may spread to other areas on the same side of the head. The pain may be 'burning' or 'boring'. Each attack lasts 15-180 minutes, but most commonly 45-90 minutes. Attacks may occur from once every two days, to eight times a day.

The pain during an attack can be so severe that you are likely to become restless, agitated, and unable to lie down. Some people even bang their head against the wall in frustration with the pain. Attacks often occur at night and wake you from sleep.

During each attack, one or more of the following symptoms also usually occurs: redness and watering of the eye; a runny and bunged up nose; sweating of the face; swelling of the eyelids; drooping of the eyelid; constriction of the pupil in the eye.

Attacks occur in clusters (bouts). That is, a number of attacks of pain occur over a period of time and then stop. During a cluster, each attack of pain usually occurs on the same side of the head. Each cluster of attacks usually lasts for several weeks or months. Each cluster is usually separated by months or years of remission (where no attacks occur). However, how often clusters occur can vary greatly from case to case. For example:

A fairly typical case is for a cluster to last 6-12 weeks once a year, or every two years, and at about the same time of year.
Some people have more frequent clusters, some less, than the above typical situation.
In a small number of cases only one cluster of attacks ever occurs.
In about 1 in 10 cases, attacks continue without any remission periods. (This is called chronic cluster headache.)