What Are Cluster Headaches?

A headache is a headache, right? Absolutely not. In fact, over 150 different kinds of headaches are recognized. Some are mild, some severe, some relatively innocuous, and some can pose a serious health threat. The World Health Organization indicates headaches and migraines are two of the most common conditions worldwide: up to one in 20 adults have a headache every — or almost every — day, and one in seven experience migraines. That adds up to a lot of pain, missed workdays, and health care costs.

At Memphis Neurology, conveniently located in Germantown, Tennessee, and Southaven, Mississippi, our expert team of neurologists understands the burden of headache pain, which is why they offer advanced diagnostic tools and cutting-edge treatments. They also realize that, unlike tension headaches and migraines, most of their patients are unfamiliar with the cluster headache, which can be severely debilitating. That’s why they’ve put together this guide, so if you experience cluster headache symptoms, you’ll recognize them and seek out medical help.

The difference between primary and secondary headaches

Primary headaches are standalone headaches, meaning they’re not a symptom of underlying disease. Instead, they’re caused by a number of issues, including problems in the pain-sensitive structures in your head, chemical activity in the brain or the nerves and blood vessels around the skull, or muscle triggers in your head and neck. In addition, some people are genetically predisposed toward headaches — other family members with headaches pass on a faulty gene.

Primary headaches fall into four categories:

1. Tension-type (most common)
2. Migraine (a neurological condition)
3. Cluster
4. New daily persistent

In contrast, secondary headaches are triggered by an underlying medical condition (e.g., cancer, heart disease) and are a symptom of that condition.

Cluster headaches 101

Cluster headaches occur in, well, clusters. They’re a series of relatively brief but extremely painful headaches that happen every day for weeks or months at a time, and almost at the same time each day and the same season each year. That leads many people to mistake cluster headaches for allergy symptoms or work stress.

Cluster headaches are the least common type of headaches, affecting fewer than one in every 1,000 people. Men are more likely than women to develop them, and it usually happens before age 30. They may completely go away for months or even years (remission), but they can return without warning.

A cluster headache starts when a nerve pathway in the base of your brain is triggered. The signal appears to come from a deep-brain structure, the hypothalamus, which houses the "internal biological clock" that controls your sleep and wake cycles — hence the regularity.

The nerve affected is the trigeminal nerve. It's located near the eye, and it branches up to the forehead, across the cheek, down the jaw, and above the ear, all on the same side.

People who experience cluster headaches find the pain so bad, they often pace back-and-forth during an attack. The pain can be more intense than a migraine attack, but it usually doesn’t last as long.

Symptoms and characteristics of cluster headaches

Perhaps the most notable symptom of a cluster headache is the pain usually starts suddenly. Other symptoms include:

• General facial discomfort or a mild burning
• Swollen or drooping eye
• Constricted pupil
• Red or watery eyes
• Runny or congested nose
• Sweating
• Light sensitivity

Interestingly, cluster headaches are more prevalent in heavy drinkers. But while, during a cluster period, just a bit of alcohol can trigger a headache, during headache-free periods, no amount of alcohol does.

The main characteristics of cluster headaches are what really set them apart:

• Speed: reach full force within five to 10 minutes
• Pain: almost always on one side of your head, and it remains there when you have daily attacks; follows the path of the trigeminal nerve
• Short duration: usually last 30-90 minutes, though can be as little as 15 minutes or as long as three hours
• Predictable: attacks linked to the circadian rhythm and happen so regularly they've been called "alarm clock headaches”
• Frequent: usually daily headaches (up to eight a day) for two weeks to three months; in between these periods, they'll be pain-free for at least two weeks

Treating cluster headaches

Cluster headaches can be treated in a number of ways, through lifestyle changes (stress reduction, trigger avoidance), preventive and abortive medications, Botox® injections, nerve blocks, and trigger point injections. Your doctor will tailor your treatment to your individual needs.

If you’re dealing with cluster headaches and don’t know where to turn for relief, get in contact with Memphis Neurology to set up a consultation. Call us at either location or book online with us today.