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Cluster Headaches

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What Are the Symptoms of a Cluster Headache?

Cluster headaches generally reach their full force within five or ten minutes after onset. The attacks are usually very similar, varying only slightly from one attack to another.

  • Type of pain: The pain of cluster headache is almost always one-sided, and during a headache period, the pain remains on the same side. When a new headache period starts, it rarely occurs on the opposite side.
  • Severity/intensity of pain: The pain of a cluster headache is generally very intense and severe and is often described as having a burning or piercing quality. It may be throbbing or constant. The pain is so intense that most cluster headache sufferers cannot sit still and will often pace during an attack.
  • Location of pain: The pain is located behind one eye or in the eye region, without changing sides. It may radiate to the forehead, temple, nose, cheek, or upper gum on the affected side. The scalp may be tender, and the pulsing in the arteries often can be felt.
  • Duration of pain: The pain of a cluster headache lasts a short time, generally 30 to 90 minutes. It may, however, last from 15 minutes to three hours. The headache will disappear only to recur later that day. Typically, in between attacks, people with cluster headaches are headache-free.
  • Frequency of headaches: Most sufferers get one to three headaches per day during a cluster period (the time when the headache sufferer is experiencing daily attacks). They occur very regularly, generally at the same time each day, and have been called "alarm clock headaches," because they often awaken the person at the same time during the night.

Most cluster sufferers (80%-90%) have episodic cluster headaches that occur in periods lasting seven days to one year, separated by pain-free episodes lasting 14 days or more.

In about 20% of people with cluster headaches, the attacks may be chronic, meaning there are less than 14 headache-free days per year. 

Cluster headaches are not typically associated with nausea or vomiting. It is possible for someone with cluster headaches to also suffer from migraines.

Can the Onset of a Cluster Headache Be Predicted?

Although the pain of a cluster headache starts suddenly, there may be a few subtle signs of the oncoming headache. They include:

  • Feeling of discomfort or a mild, one-sided burning sensation
  • The eye on the side of the headache may become swollen or droop. The pupil of the eye may get smaller and the conjunctiva (the pink tissue that lines the inside of the eyelid) will redden.
  • Nasal discharge; there may be nasal discharge or congestion and tearing of the eye during an attack, which occur on the same side as the pain.
  • Excessive sweating
  • Flushing of the face on the affected side
  • Light sensitivity
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