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    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

    What Is the Treatment for Cluster Headaches?

    • Abortive medications. The most successful treatments are Imitrex (sumatriptan) or other triptans, and breathing oxygen through a face mask for twenty minutes. Other options include: ergotamine drugs and intranasal lidocaine.
    • Preventive medications. Your doctor can prescribe preventive medications to shorten the length of the cluster headache period as well as decrease the severity of the headaches. All cluster headache sufferers should take preventive medication unless their cluster periods last less than two weeks. Some drugs used in the prevention of cluster headaches include verapamil, lithium, divalproex sodium, prednisone (only short courses), and ergotamine tartrate.
    • Surgery. This may be an option for people with chronic cluster headaches who have not been helped with standard therapy. Most of the procedures involve blocking the trigeminal nerve.

    All of these treatments should be used under the direction of a doctor familiar with treating cluster headaches. As with any medication, it is important to carefully follow the label instructions and your doctor's advice.

    WebMD Medical Reference

    Reviewed by Richard Senelick, MD on September 23, 2014
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