An in-depth report on the causes, diagnosis, treatment, and prevention of cluster headaches.
What Are Cluster Headaches?
Cluster headaches are one of the most painful types of headache. They are marked by excruciating, stabbing, and penetrating pain, which is usually centered around the eye. Cluster headache attacks occur very suddenly and without warning, with the pain peaking within 15 minutes.
Symptoms of Cluster Headache Attacks
In addition to pain, symptoms of cluster headaches may include:
- Swollen or droopy eyelid
- Watery, tearing eye
- Stuffy or runny nose
- Contracted eye pupil
- Forehead and facial sweating
- Intolerance to light and sound
Who Gets Cluster Headaches?
- Cluster headaches are rare, affecting less than 1% of the population.
- Men are much more likely to suffer from cluster headaches than women.
- Many people who have cluster headaches have a personal or family history of migraine headaches.
Treatment of cluster headaches focuses on relieving pain when attacks occur, and on preventive strategies to reduce attack duration and frequency. Oxygen therapy and injections of sumatriptan (Imitrex, generic) are the most effective treatments for acute attacks. Verapamil (Calan, generic), a drug for high blood pressure, is typically the first choice of medication used for long-term prevention.
Behavioral treatments can be a helpful supplement to drug therapy. These treatments include relaxation therapy, biofeedback, cognitive-behavioral therapy, and stress management. People should also identify and avoid any triggers, such as alcohol use and cigarette smoking, which may provoke cluster headache attacks.
Cluster Headache Survey
Results from the U.S. Cluster Headache Survey, the largest study of Americans with cluster headache, reveal:
- Diagnostic delays. Many people with cluster headache experience at least a 5-year delay in having their symptoms correctly diagnosed as cluster headache. Only 21% of survey respondents reported a correct initial diagnosis. Sinusitis and migraine were common misdiagnoses.
- Suicidal thoughts. More than half (55%) of respondents reported experiencing suicidal thoughts.
- Time of attacks. Most cluster headache attacks occur between early evening and early morning hours, with a peak time of midnight to 3 a.m.
- Triggers. Alcohol, especially beer, is the most common trigger of attacks, followed by weather changes and smells.