ArticlesKids' Headaches: The Diagnosis Is Difficult
Pulling Ahead of Headaches
Drug ReferencesBelladonna Alkaloids; Ergotamine; Phenobarbital
Relative to other types of primary headache, cluster headaches are rare. The pain they produce is severe and tends to recur in the same way each time for individuals who experience cluster headaches.
Cluster headaches occur in groups, or clusters, and individual attacks last about one to three hours on average. The frequency of occurrence may range from every other day to multiple times a day. Cluster periods are followed by remissions that may last months or years.
While symptoms may differ from person to person, the following are common symptoms of a cluster headache:
Sudden onset of pain, generally around or behind the eye (retro-orbital)
Pain builds to a peak in about 10 to 15 minutes
Restlessness or agitation
Red or watering eyes
Sweating on the forehead
Eyelid drooping or swelling
The symptoms of a cluster headache may resemble other conditions or medical problems. Always see your doctor for a diagnosis.
Males are affected more than females
Headaches typically begin around age 30
Heredity may influence cluster headaches
The exact cause of cluster headaches is unknown
According to the American Academy of Family Physicians (AAFP), cluster headaches are diagnosed by a reported history of a pattern of recurrent bouts of near-daily headache attacks lasting for days, weeks, or months. While not used routinely for diagnosis, positron emission tomographic (PET) scanning and functional magnetic resonance imaging (MRI) are being used by researchers to help understand how cluster headaches are caused and how they affect the human body.
A two-pronged approach is necessary for treatment of cluster headaches: acute treatment and prevention. The first step is to stop or at least subdue an attack in progress. The AAFP recommends oxygen therapy through a face mask to help stop an acute attack.
A nasal spray called sumatriptan (Imitrex) is also used to relieve the severe pain of a cluster headache. Sumatriptan is a selective serotonin receptor agonist--a medication that causes blood vessels in the brain to constrict, thereby relieving pain.
The second part of cluster headache treatment is to prevent recurrent attacks by using daily medication. There are numerous medications that are used to prevent cluster headache attacks, but only a few have been tested through randomized controlled clinical trials.
Medications that may be used to prevent cluster headaches include:
Verapamil. A medication that relaxes blood vessels.
Prednisone. A steroid medication that reduces inflammation and swelling.
Ergotamine. A medication that works together with caffeine to prevent blood vessels in the head from expanding.