They’re called “cluster headaches” because these headaches come in clusters lasting for weeks or even months. You can have a series of cluster headaches, and they then can go into remission for months or years before returning.
Symptoms of Cluster Headaches
Cluster headaches have a characteristic timing, severity, type, and location of symptoms.
When you have a cluster headache you’ll feel severe pain that’s often described as sharp or burning. The pain occurs on one side of the face, above the eye, and around the temple on the same side of your face. The pain will usually peak in the first five to 10 minutes and can last up to two hours before subsiding. It can wake you up in the middle of the night. You may also experience other symptoms associated with cluster headaches, including swelling around one or both eyes, tearing or reddening of eyes, nasal congestion, pale skin, and restlessness.
Your healthcare provider may detect Horner syndrome, a condition in which the pupil of the affected eye is smaller than normal, and the eyelid is drooping. Along with the symptoms, this sign will resolve as soon as the headache dissipates.
How Are Cluster Headaches Treated?
Pain medications—even narcotics—usually don’t work well with cluster headaches.
Cluster headache treatment involves methods for treating a headache while it’s happening, as well as preventative methods.
Acute Treatment
Inhaled oxygen is the first line therapy for cluster headache treatment, meaning it’s the treatment of choice. Research has shown that inhaling oxygen can slow or stop a cluster headache attack.
Your healthcare provider also may recommend medications called triptans to stop a cluster headache. Imitrex is a common triptan. You can inject triptan medications, take them by mouth, or take them nasally.
Injectable dihydroergotamine is also sometimes used. Be aware that dihydroergotamine is dangerous if used combined with triptans.
Sometimes triptans or injectable dihydroergotamine are prescribed with inhaled oxygen.
Preventatives
If your cluster attacks are not frequent, you might not be prescribed a preventative medication to take all the time. Preventives are usually started at the time that a cluster attack starts. Learn about triggers of cluster headaches so you may help prevent them.
These include verapamil, nerve blocks, Topamax, or Emgality, a cGRP inhibitor, A short course of steroids may help shorten the cluster episode.
