Cluster Headache vs. Migraine
Cluster headaches are headaches that come in groups (clusters) separated by pain-free periods of months or years.
- During the period in which the cluster headaches occur, pain typically occurs once or twice daily, but some patients may experience pain more than twice daily.
- Each episode of pain lasts from 30 to 90 minutes.
- Attacks tend to occur at about the same time every day and often awaken the patient at night from a sound sleep.
- The pain typically is excruciating and located around or behind one eye.
- Some patients describe the pain as feeling like a hot poker in the eye. The affected eye may become red, inflamed, and watery.
- The nose on the affected side may become congested and runny.
Unlike patients with migraine headaches, patients with cluster headaches tend to be restless. They often pace the floor, bang their heads against a wall, and patients can be driven to desperate measures including contemplating suicide.
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What are cluster headaches?
Cluster headache is pain that occurs along one side of the head. It's frequently described as pain that occurs around, behind, or above the eye and along the temple in cyclic patterns or clusters. The pain of a cluster headache is very severe. Many patients describe a “drilling” type of sensation. For classification as a true cluster headache, associated autonomic features such as tearing/watering of the eye, redness of the conjunctiva, rhinorrhea or nasal stuffiness, eyelid drooping, sweating on one side of the face, or changes in pupil size (with the pupil on the affected side becoming notably smaller) are usually present. The headache lasts from 15 minutes to a maximum duration of about 3 hours. However, the headache can recur up to eight times daily. Cluster headache was originally described in the 17th century, but it wasn't until the mid- 20th century that it became known by this name.
Who gets cluster headaches?
Males are two to four times more likely to develop cluster headache than females; however, the overall frequency is quite low, with a prevalence rate of about 1 per 1,000. Because of the rarity of the condition, limited information is available.
Although the vast majority of patients are adults, cluster headache has been reported in children as young as 6 years of age.
What are the symptoms and signs of cluster headaches?
Cluster headache is always unilateral, or one-sided. However, some patients may experience some variability of the side on which their headache occurs. Most patients describe their pain as occurring around or behind the eye. Pain is also described as radiating along the forehead, into the jaw or along the gum line and into the teeth, or across the cheek of the affected side. Infrequently, pain may extend into the ear, neck, or shoulder. Although watering (tearing) of the eye is frequently identified, some patients may only experience some redness of the conjunctiva. Eyelid drooping or swelling and a runny nose (rhinorrhea) are often associated with the pain of a cluster headache. Symptoms more commonly identified with migraine headaches, including sensitivity to light, sounds, or odors may occur. However, unlike migraine headache, movement does not worsen the pain of a cluster headache. In fact, many patients describe a sense of restlessness during their pain.
The headaches associated with cluster occur in groups. While the headaches themselves may be brief (as short as 15 minutes), the headaches can recur up to eight times in 24 hours. Headaches may last as long as 3 hours. Cluster cycles may last for only a single day, or may linger for many weeks.
Medically Reviewed by a Doctor on 2/2/2015