Cluster Headache

A cluster headache is a rare type of headache that is more common in men. Cluster headaches start suddenly. The pain is usually behind or around one eye and is very severe. The eye and nose on the same side as the pain may become red, swollen and runny. Cluster headaches also cause restlessness. These headaches can be frightening to the sufferer and his or her family.

A cluster headache can last a few minutes or several hours, but it usually lasts for 30 to 45 minutes. Cluster headaches typically occur at the same time each day for several weeks, until the “cluster period” is over. Cluster periods usually last 4 to 8 weeks and may occur every few months. At other times, no cluster headaches will occur.

Causes

The cause of cluster headaches is not known. Cluster headaches do not appear to be related to other illnesses or to diseases of the brain. They do not seem to run in families.

Diagnosis

Are you having a cluster headache or another kind of headache? Your description of your headaches will help your doctor make the diagnosis. The time and pattern of attacks are very important, so keep a diary of your pain. Family members or others who see you during a headache can also help by telling the doctor how you look and act. Don’t be embarrassed to tell your doctor about your attempts to relieve the pain (such as banging your head against furniture). These attempts are common, and talking about them will help your doctor judge how severe the headaches are.

Your doctor will also give you a physical exam. Tests will probably not be needed to diagnose cluster headaches, but your doctor may order tests to rule out other illnesses.

Prevention

During a cluster period, it is important to keep to your usual routine, remain calm and avoid changing your sleep pattern. Once a cluster period has started, a change in sleep pattern, particularly taking an afternoon nap, seems to bring on the headaches.

Drinking alcohol will also bring on headaches during cluster periods. This happens very quickly — before you finish the first drink. Alcohol should be completely avoided until the cluster period is over. Stress may bring on attacks, and the headaches may start when you are relaxing after a stressful time.

Treatment

Several treatments are available for cluster headaches. It is important to work with your doctor to talk about side effects of different medicines, pick the right treatment for you and set up a schedule for taking the medicines your doctor prescribes.

Your doctor will most likely prescribe two medicines:

  • The first medicine is taken regularly during a cluster period to reduce the number of headaches. For the medicine to work, the level of the drug in your blood must be high at the time your attacks usually start.
  • The second medicine is taken to relieve the pain when a cluster headache occurs. Attacks begin too quickly for you to reach medical help. You must be ready to take this medicine as soon as an attack begins. You may want to teach family members about your headaches and medicines so that they will be able to help you when you have an attack.

Medicines taken by mouth work too slowly to give relief for cluster headaches. For this reason, your doctor may prescribe a medicine that is taken by inhaler, as an injection (a “shot”) or as a rectal suppository. Other treatments that work for some people are rapidly breathing pure oxygen through a mask or using a local anesthetic (numbing medicine) in their nose.

Coping

Although cluster headaches are very painful, with the right treatment most people cope very well. Preventive medicines work well to reduce the number of headaches during cluster periods. When a cluster headache does occur, medicines can greatly shorten the headache and reduce its severity. It is important that you work with your doctor to find the right treatment for you.