Headaches – Cluster


Cluster Headaches, considered some of the most pain-intensive kind of headaches, are a series of short headaches that occur daily for weeks or months at a time.

They occur in cyclical patterns (cluster periods) and often keep happening during the same time of the year, so people often mistake them for allergies. It commonly occurs during sleep with intense pain centered around one eye. Cluster headaches are known to suddenly stop and go into remission for months or years. Even though there is not a cure for cluster headaches, there are treatments to help alleviate the pain, decrease the duration of the headache, and possibly prevent the attacks. Cluster headaches are often difficult to evaluate and some acute medications can provide some relief. Contact our doctor to talk about your symptoms and treatment options.

Treatment Options

Treatment options may include:

  • Treatments include:
  • Inhaling pure oxygen
  • Injections or nasal spray medications
  • Local anesthetics
  • Oral medications (often too slow)
  • Surgery

There are some preventable treatments available including Verapamil (a calcium channel blocker), corticosteroids (e.g. prednisone), lithium carbonate, and anesthetic injections (occipital nerve block).


Symptoms include:

  • Pain and/or symptoms on one side of the head
  • Drooping eyelid
  • Excruciating pain centered around one eye
  • Facial sweating
  • Pale skin on face
  • Restlessness
  • Red eyes on the affected side
  • Runny nose on the affected side
  • Swollen eye on the affected side
  • Unusual amount of tears

Symptoms of Cluster Headaches can also include sudden and severe headaches accompanied by:

  • Fever
  • Confusion
  • Nausea
  • Numbness
  • Seizures
  • Speaking difficulties
  • Stiff neck
  • Vomiting

Diagnosis / Tests

  • Your doctor will have questions about your symptoms accompanied by a physical and neurological exam. This might include imaging tests (MRI, CT scan) to eliminate other causes of your headaches.
  • It would be helpful for you to have details of your attacks including pain level, specific location of headaches, related symptoms, frequency, duration, and attack times of the day. You should also try to document any potential triggers, medications you are on, and anything that has provided you with relief.


Cluster headaches have two categories, chronic and episodic, and it is not unusual for someone with chronic cluster headaches to develop episodic cluster headaches and vice versa.


Cluster headaches regularly occur for more than one year, followed by no headaches for less than a month.


Cluster headaches regularly occur for more than one year, followed by no headaches for less than a month.


Specific causes for cluster headaches are unknown. While some types of headaches are triggered by foods, stress, or hormonal changes, cluster headaches aren’t usually triggered by anything. Once an attack begins, alcohol can quickly increase the severity of the pain, which is why many people who suffer cluster headaches completely avoid alcohol during a cluster period.


  • Attacks occur at night, usually shortly after going to bed.
  • Attacks often happen at the same time of day.
  • Cluster headaches most commonly occur between adolescence and middle age.
  • One attack can last from 15 minutes to three hours.
  • There is no cure for cluster headaches.
  • Specific causes for cluster headaches are unknown.

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