Consider Cluster Headache

Cluster Headache

Cluster headache (CH) always involves pain that is one sided (although it can switch sides) and the main defining feature is the association with one or more of the ‘cranial autonomic’ features normally described as follows:

• Reddening and tearing of the eye
• A runny or blocked nostril
• Droopy eyelid
• Constriction of the pupil
• Flushing and facial sweating

Although possible, it is very unusual to have an attack with none of these features. These features tend to come and go with each attack. However, some sufferers may continue to experience the constricted pupil and/or a droopy eyelid, especially after frequent attacks.

The pain is excruciatingly severe. It is located mainly behind or around the eye, around the top side of the head and within the temple and forehead, although any part of the head or neck can be affected. The headache normally lasts from between 45 minutes and 1½ hours, but can range from between 15 minutes and 3 hours (or more). The pain often reaches its peak very quickly and maintains its intensity over a period of time before ending equally quickly.

There have also been several descriptions by CH sufferers of symptoms similar to those of migraine. Just before an attack starts many sufferers have symptoms such as tiredness and yawning. Features during an attack can also include feeling sick, actually being sick, and having an over sensitivity to smells, light and sound. However, unlike most migraine sufferers, nine out of ten CH sufferers are usually restless and irritable during an attack, preferring to move around in the hope that this will relieve the pain.

The cluster attack frequency varies from between one every other day to three times a day, however, some sufferers can have up to eight attacks (or more) each day. Regardless of frequency, attacks can often occur rather uncannily at the same time each day.

Alcohol, exercise and increases in environmental temperature can actually trigger an attack. Drinking alcohol can cause an attack within one hour amongst most CH sufferers, unlike migraine sufferers who generally have a headache some hours after a drink. Alcohol does not usually trigger an attack during a period of pain-free remission. The drug nitroglycerine, sometimes used in the acute treatment of angina, can also trigger an attack. Allergies, sensitivity to food, hormonal changes, and stress do not appear to be triggers of an attack, although this does vary between sufferers.

If this brief description does not match your headache type, consider Paroxysmal Hemicrania.

If your headaches only ever wake you during sleep, consider Hypnic Headache.