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“Cluster Migraine”

Readers often ask about something they call “cluster migraine”. It’s not an official diagnosis in the International Classification of Headache Disorders, so delving into the topic took some sleuthing. I found the following five questions raised in relation to the phrase “cluster migraine”:

1. Can a person have both cluster headache and migraine?

2. Can a person with migraine have cluster headache symptoms without also having cluster headache?1

3. Can a person with cluster headache have migraine symptoms without also having migraine?2

4. Do migraine attacks cluster together in time?

5. Is it possible to have migraine attacks that are as painful as cluster headaches?

Migraine and cluster headache can overlap

“Yes” is the answer to the first three questions. Both migraine and cluster headache involve the same nerves. This doesn’t mean they are necessarily intertwined, but some symptoms overlap. Key differences are:

  • Cluster attacks tend to last 15 minutes to three hours and can come many times in a day
  • During a cluster attack, a person becomes restless and agitated (many pace during an attack)
  • Cluster headaches usually come on suddenly and disappear rapidly

To learn more, check out this excellent article from Tammy Rome explaining what cluster headache is and how it is treated. Tammy has both migraine and cluster headache, so she’s well-versed in both.

The only way to know if you have migraine, cluster headache, or both is to seea health care provider, ideally one who specializes in headache medicine. An accurate diagnosis is critical to getting the best treatment, no matter which headache disorder(s) you may have.

Migraine attacks can cluster together

Yes, migraine attacks can group together in time. In fact, research is increasingly showing that migraine frequency tends to be cyclical for many patients. Someone can go six months without a migraine attack, then have five in one month, then have a break before another spate of attacks. This is different from cluster headache. It doesn’t mean a person has “cluster migraine”—they simply have migraine attacks that tend to group together in time.

Migraine pain compared to cluster headache pain

Pain is a subjective experience, so it’s impossible to say definitively whether a migraine attack can cause as much pain as a cluster headache. Everyone I’ve met who has both cluster headache and migraine say that the pain of a migraine attack is a breeze compared to that of cluster headache. Headache specialists also say that the pain their cluster headache patients experience seems more severe than that of migraine. I cannot speak for anyone else, but I believe cluster headache is more painful than migraine based on what I’ve been told and read. And I’ve had some vicious migraine attacks.

If you’ve been diagnosed with “cluster migraine”…

“Cluster migraine” is not a recognized diagnosis in the International Classification of Headache Disorders. If a doctor gives you this diagnosis, consider that their migraine knowledge may not be current. You might find more effective treatment with a different doctor.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Applebee, A. M., & Shapiro, R. E. (2007). Cluster-migraine: Does it exist?.Current pain and headache reports11(2), 154-157.
  2. Zidverc‐Trajkovic, J., Podgorac, A., Radojicic, A., & Sternic, N. (2013). Migraine‐Like Accompanying Features in Patients With Cluster Headache. How Important Are They?. Headache: The Journal of Head and Face Pain,53(9), 1464-1469.

Comments

  • Cristina
    1 week ago

    My 14 yr old daughter has been suffering from severe quick onset headaches possible migraine never thought it was possible to get a cluster headache too. Has been seen by Dr and neurologist with no success so far. She gets them first thing in the morning and then it subsides after 2 hours..

  • mgraine43
    3 months ago

    I understand, believe me! That migraine pain is bad. I have wondered sometimes if I was having a stroke during some of mine. Or if I’d die from the pain, but I know you don’t do that, since at age 12 I had spinal cord surgery, and they gave me all of the pain medication they could w/o killing me, but I begged them to anyway. I couldn’t speak at a normal level—I screamed until my voice gave out. I was still screaming, but no one could hear me. Thing is, I had gone through pain before, but that was just ridiculous. Everyone has a limit. But it’s also subjective & each person is different. I have a lot of the symptoms of cluster headaches but mine last for ? (I have intractable migraines). So it’s weird to see how much they have in common. But what I don’t think is helpful is focusing on the competition of the pain. We all suffer. And by all means, tell how you experience it! But if you don’t experience everyone else’s pain, it really is hard to say what’s worse or better. The American Migraine Foundation had a group on FB, and if someone posted that wow, they wished their pain was like THAT or they wished they only had 3 days of a migraine, they removed the comment(s). We never saw rules about this, so people were confused when their comments disappeared! 🙂 But this is just a concern I had, as a migraineur & as a psychologist. 🙂 No arguing intended, if it somehow came across that way. ☺️

  • Theresa
    4 months ago

    I have both cluster/migraine headaches. The cluster usually hit hard and fast and are going within a few hours. The migraine type can last days, weeks, forever.
    I have thrown up with both.
    Life is fun.

  • debbieleq
    1 year ago

    Never considered that I may have cluster headaches, but when I watched the interview on the Migraine World Summit about them I was shocked on how much I could relate to the symptoms. Especially with having to stop yourself from hurting yourself to stop the feeling of pain. Last night I was crying and begging for sleep because the pain was so bad. I had the urge to knock myself out physically. This happens at least 3 times a week. I wonder if I need to bring this up to my neurologist.

  • Holly Baddour moderator
    1 year ago

    @debbieleq– Most definitely this sounds like something worth raising to your neurologist. That is wonderful that you watched the Migraine World Summit on this topic. If you related to the information that was provided and even more so after reading this article, it seems like it would make sense to at least ask your migraine specialist about at your next visit. Migraine attacks can definitely bring us to our knees and leave us begging for mercy, but my understanding of cluster migraines is that the pain is especially intense. Also, I’d encourage you to raise this with your doctor especially because there is a fairly new treatment that is available that was originally specifically designed for people with cluster migraine- so, if that’s what you have, it might be worth pursuing this treatment:https://migraine.com/news/new-vagus-nerve-stimulator-approved-treat-cluster-headaches/ We have a number of articles on the device here:https://migraine.com/?s=gammacore&submit=Go – and on the topic of cluster, in general, here: https://migraine.com/?s=cluster&submit=Go. Hope this helps and stay in touch as to what you find!

  • Exhausted
    2 years ago

    Recent research at Mayo Clinic now lists Cluster as a diagnosis and the treatments suggested. When I last visited my doctor and suggested clusters were the problem (after many visits that found no help) and described my symptoms, he immediately stated that he knew about clusters and offered a treatment for me that has stopped them. Unlike migraine, the pain is intensely worse. I’ve had both and thought migraine was the winner in the pain category. When clusters started, I experienced pain — although shorter in endurance– beyond pain I thought I could live through. I feel such compassion for anyone suffering migraine or cluster. There are just not enough words to describe them.

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