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What Is a Cluster Headache? Symptoms, Causes and Treatment
A cluster headache is a rare but extremely painful headache disorder. The pain typically develops rapidly on one side of the head, especially around or behind one eye. Attacks commonly last 15 minutes to 3 hours and can occur multiple times per day during a period lasting weeks or months.
Written and medically reviewed by Amarish Dave, DO, board-certified neurologist. This page is educational and does not replace an individual medical evaluation.
Understanding cluster headache
Unlike many people experiencing migraine, who may prefer to lie still in a dark room, people experiencing a cluster headache are often restless and may pace during an attack. This striking restlessness, together with the one-sided location, is one of the features that helps a neurologist distinguish cluster headache from other headache disorders.
Common symptoms
Symptoms can include the following, and the accompanying eye and nasal symptoms commonly occur on the same side as the headache:
- Severe stabbing or burning pain around or behind one eye
- Red or watery eye on the painful side
- Runny or congested nose on the same side
- Eyelid swelling or drooping
- Facial or forehead sweating
- Restlessness or pacing
Why are they called “cluster” headaches?
The headaches tend to occur in clusters. Someone may experience attacks every day—sometimes several times per day—for weeks or months, followed by a period without headaches. Attacks can occur at remarkably similar times of day and frequently occur at night.
How are cluster headaches treated?
Treatment differs from typical headache treatment because attacks develop rapidly. Acute treatments can include high-flow oxygen and fast-acting triptans. Preventive treatments may include medications such as verapamil, with other therapies selected according to the individual patient. Specific medication recommendations are made during a headache and migraine evaluation, not through this website.
Important safety information
A new severe headache should be medically evaluated. Sudden “thunderclap” headache, headache associated with weakness, numbness, difficulty speaking, confusion, seizure, fever or stiff neck, or a dramatically different headache pattern can require urgent or emergency evaluation.
Key takeaways
- Cluster headache causes rapid-onset, extremely severe pain around or behind one eye.
- Attacks last 15 minutes to 3 hours and can occur multiple times per day for weeks or months.
- Eye and nasal symptoms typically appear on the same side as the pain.
- Restlessness and pacing during attacks help distinguish cluster headache from migraine.
- Acute treatment may include high-flow oxygen and fast-acting triptans; prevention is individualized.
- A new severe headache, or a dramatic change in pattern, should be medically evaluated.
Continue learning about headache care
Learn more about headache and migraine evaluation, migraine, and our neurology services. Browse more answers in the Neurology Video Library.
Frequently asked questions
- What is a cluster headache?
- Cluster headache is a rare but extremely painful headache disorder. Pain develops rapidly on one side of the head, especially around or behind one eye, and attacks typically last 15 minutes to 3 hours.
- How is cluster headache different from migraine?
- Cluster headache attacks are shorter, strictly one-sided, and often occur at similar times of day in clusters lasting weeks or months. Unlike many people with migraine who prefer to lie still in a dark room, people with cluster headache are often restless and may pace during an attack.
- How are cluster headaches treated?
- Because attacks develop rapidly, treatment differs from typical headache care. Acute treatments can include high-flow oxygen and fast-acting triptans, and preventive treatment may include medications such as verapamil, selected for the individual patient.
- When is a severe headache an emergency?
- A sudden 'thunderclap' headache, a headache with weakness, numbness, difficulty speaking, confusion, seizure, fever or stiff neck, or a dramatically different headache pattern can require urgent or emergency evaluation.
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