Do You Suffer From Cluster Headaches?

An estimated 200,000 to 1 million US residents currently suffer from cluster headaches. These painful, recurring attacks are often confused for migraines or other headache disorders, and as a result, may even delay appropriate treatment. Proper identification can help sufferers find relief faster when a headache hits. Anyone with headaches should learn how to tell the difference.

Symptoms of Cluster Headaches

Cluster headaches present as severe pain on one side of the head; similar to migraines, this pain usually centers behind one eye or near the temple. According to Mayo Clinic, some sufferers also experience pre-headache auras and migraine-like nausea, which may further lead them to misidentify the source of their distress. However, there are additional features to watch for that are more specific to cluster headaches.

Most cluster headache sufferers usually experience redness or tearing of the eye on the same side as the pain. The pupil on the affected side may also be smaller than the other, and the eyelid might even droop. Some people have stuffiness or congestion in one nostril, or the affected side of the face might flush or sweat.

Cluster Headaches vs. Migraines

Sufferers have described their headaches as even more intense than migraines, with pain so severe that they can’t even lie down. Instead, they may find themselves pacing or rocking; some patients have reported banging their heads in their agony. Most cases resolve within 30 minutes of onset, although they can persist for 2 hours or longer. Attacks can be either episodic or chronic; episodic cluster headaches often occur daily for weeks or months, with remission periods that can last for years, whereas chronic sufferers may never see relief for more than a month at a time.

Unlike migraines, cluster headaches recur regularly during the cluster cycle, usually hitting at the same time every day. In most cases, they strike in the middle of the night, just when the sufferer has fallen deep asleep. Some people may resolve one headache and fall back asleep, only to wake with additional pain shortly after. Cluster headaches can strike anyone, but they occur about twice as often in men as in women. Migraines, on the other hand, are nearly three times more common in women.

Distinguishing Cluster Headaches From Other Headaches

Cluster headaches can mimic other similar headache disorders as well, and a thorough comparison of symptoms may help narrow down the specific issue. Other types that are easy to mistake for cluster headaches include:

• Tolosa-Hunt syndrome causes similar pain, but it also features weakness and paralysis of the affected eye muscles. Sufferers may also experience paralysis of certain facial muscles, double vision, fevers, fatigue, vertigo and joint pain. Protrusion of the eyeball(s) may also occur.
• Trigeminal neuralgia causes severe pain that radiates along the mouth, nose or cheek. Attacks can seem to hit randomly, although sufferers can sometimes trigger them via actions like chewing or brushing their teeth.
• Giant cell arteritis causes inflammation in the arteries, leading to muscle pain, fever, stiffness, and headaches. Some patients develop double-vision and other visual disturbances, and up to 30% experience irreversible blindness in at least one eye. 
• Paroxysmal hemicrania can cause between 2-40 headaches a day, each lasting 2-45 minutes. Onset is random and unpredictable. This type of headache is more common in women.
• SUNCT syndrome stands for Short-lasting, Unilateral, Neuralgiform headache attack with Conjunctival injection and Tearing. It causes multiple, short events that usually only last a few seconds, although some can extend for minutes. SUNCT hardly ever strikes at night.

Treatment Options for Cluster Headaches

High-flow oxygen therapy is the gold standard for immediate relief from cluster headaches. Some nasal sprays or injections that work for migraines can also help, as can short-course steroid treatments. However, sufferers usually don’t experience any relief from opioids, which also diverges from severe migraine treatments. Because cluster headaches tend to peak quickly, most oral medications are also a waste of time.

The use of neuromodulation devices, which use electrical currents or magnets to dampen brain activity, holds promise. This option is ideal for people at risk for medication-overuse headaches or who have had other types of treatments fail. Neuromodulation can be expensive, however, and insurance companies often don’t cover treatments.

Cluster headaches can be disruptive and difficult to live with, but help is available once the correct diagnosis can be made. People who suffer from headache symptoms or known cluster headaches may want to talk to their doctors about the different treatment options rather than suffering in silence as too many do. Why continue to suffer when a solution could be available?

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