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Cluster Headaches

Cluster headaches come in groups – called cluster periods – that can last for several weeks or months. Between the clusters of headaches are pain-free times that can last months or even years. Cluster headaches affect men more frequently than women.

Pain from cluster headache is typically on one side of the head and in the worst attacks the pain can be excruciating. Pain may also be bilateral and non-throbbing.

There are two types of cluster headaches, episodic and chronic.

Episodic Cluster Headache

This type of cluster headaches have clearly defined groups of headache attacks. The periods of pain can last seven days to one year, but are usually between two weeks and three months. Between the headache attacks, there are periods with no pain that are at least a month long. To have episodic cluster headaches there must have been at least two cluster periods.

Chronic Cluster Headache

To have chronic cluster headache, attacks occur for more than one year without the pain free period or the pain free time lasts less than one month. Some sufferers’ cluster headaches begin as chronic and become episodic, or vice versa.

Facts about Cluster Headaches

  • Cluster headaches last a short period of time, but cause severe pain
  • Men suffer from cluster headaches three to six times more often than women
  • Less than one adult in 1,000 suffers from cluster headaches
  • The disorder surfaces when people are in their 20s or older
  • With each episode, the pain almost always occurs on the same side of the head
  • About 5% of cluster headaches appear to be inherited according to the International Headache Society
  • About 10% to 15% of cluster headache sufferers never have pain-free periods, according to the IHS

Other names for Cluster Headaches

  • Horton’s headache
  • Harris-Horton’s disease
  • Ciliary neuralgia
  • Erythro-melalgia of the head
  • Erythroprosopalgia of Bing
  • Migrainous neuralgia

Difference between cluster headache and migraines

Migraines are typically made worse by physical activity, cause throbbing pain and occurs with at least one of the following migraine symptoms: nausea, vomiting, sensitivity to light and sensitivity to sound. Cluster headaches are identified by groups of intense head pain, but don’t usually cause the other bodily symptoms.

Cluster headache diagnosis

The International Headache Society defines Cluster Headache as having the following characteristics:

  1. At least five attacks that have the criteria, B through D
  2. Severe or very severe head pain in the area around the eyes and below the forehead that last from 15 minutes to three hours if not treated
  3. Headache has at least one of the following:
    1. Ipsilateral conjunctival injection and/or lacrimation—which is pink eye, swollen eyelid and/or tearing
    2. Nasal congestion and/or runny nose
    3. Eyelid swelling
    4. Forehead and facial sweating
    5. Drooping eyelid or constriction of the pupil
    6. Restlessness or agitation
  4. Headache attacks occur every other day up to eight each day
  5. Not caused by another disorder


Written by: Otesa Miles | Last review date: November 2010