Doctor's Notes on Cluster Headache FAQs
Cluster headache is an uncommon condition characterized by short-lived attacks of sudden, severe pain that is usually one-sided and occurs in clusters, usually at the same time of day or night for several weeks. Episodic cluster headaches occur in periods (clusters) lasting from one week to one year, separated by headache-free intervals lasting at least two weeks. Chronic cluster headaches occur for more than one year without remission or with remissions lasting less than 2 weeks.
Symptoms of cluster headaches include intense pain that comes on without warning and peaks around 5 to 10 minutes from when the headache first begins, and then the pain continues at peak intensity for up to three hours. The pain is generally described as excruciating, explosive, deep, and/or piercing (but usually not throbbing), like an ice pick is being driven into the eye. The stabbing eye pain can feel like an electrical shock. Cluster headache pain often begins in the eye and always on one side of the face. Other symptoms of cluster headaches include stuffy and runny nose on the same side as the pain around the eye, watery eyes, increased blood flow to the membranes lining the eyeball and the inside of the lids, facial sweating, eyelid swelling, complete or partial Horner syndrome (a condition causing ptosis [eyelid closure], change in pupil size on one side of the face, and lack of sweating) that may persist between attacks, and fast heartbeat.
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Cluster HeadachesCluster headaches are different that typical headaches or migraines in that they begin intensely and last from 5 minutes to an hour. They may come several times during the day, punctuated by painless periods. The cause is unclear, but competing theories trace this type of headache to either a malfunctioning vascular system in the brain, or a malfunctioning neurological symptom in the brain. A variety of drugs is used to treat cluster headaches.
Migraine and Cluster Headache MedicationsMigraines and cluster headaches are severe recurrent headaches. Medications to treat them fall under a number of different categories. These include triptans and ergot alkaloids for abortive therapy. For preventative therapy, a number of different drug classes are available, including beta blockers, predisone, antidepressants, lithium, antiseizure medications and others.
Migraine and Related HeadachesTwo general types of headaches exist: primary (like migraines and cluster headaches) and secondary (headaches caused by a structural problem, trauma, or infection) Triggers include stress, lack of sleep, not enough food or fluids, and many other causes. A variety of medications all working through a variety of different mechanisms are used to treat migraines.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.