Symptoms of cluster headache typically set in at a particular time of the day, usually at the same time each night or in the early morning. They also occur at the same time of the year (usually during spring or autumn.).

Cluster headache has a cyclical pattern in which the headaches occur periodically alternating with periods of remission during which you feel no headache. Along with head pain, there are other associated symptoms.

An episode of recurrent cluster attacks is known as a cluster period that usually from weeks to months. This is followed by remission periods when the headaches stop.

You should know that a cluster headache differs from a migraine in symptoms. A migraine headache is accompanied by nausea, sensitivity to light, and vomiting, whereas a person with a cluster headache will experience symptoms of watery eyes and a running nose.

The causes of cluster headaches still remain elusive though some trigger factors have been identified

The pain of cluster headache

Fortunately, cluster headache is the least common type of headache. Its pain is probably the worst pain you can experience – much worse than a migraine headache or tension headache. It usually reaches its peak within the first five to ten minutes of its onset.

The headache is one-sided and stays on the same side during future attacks too, switching to the other side during subsequent attacks in only 15% of the cases.

Within 5 to 10 minutes of onset, the headache pain reaches its peak. The cluster headache pain is of a piercing type (often referred to as ice-pick pain) and may be constant or throbbing.

The patient is unable to sit still and usually paces around during the cluster attack. Once the headache starts to subside, the other accompanying symptoms described below disappear within minutes.

During a cluster period, smoking tobacco and drinking alcohol can trigger a cluster headache attack. However, during the period of remission, both these acts will not give you a headache.

The cluster headache pain is located in the eye region either in the eye or behind the eye and may radiate to the cheeks, temple, forehead, nose, and gums on the same side.

Duration and frequency of cluster headache pain

During the “cluster period”, the headache may appear two to three times a day and this period can last for a period of two weeks to three months. Some individuals have been known to experience cluster headaches even six times a day.

The headache may last for as short as 15 minutes to three hours or more – the average being about 45 minutes.

The period of remissions may last for months or even years, which may again be followed by the cluster period. This reappearance of the cluster period can come without any warning signs.

Other symptoms

Other symptoms include

  • Migraine-like nausea and aura
  • Extreme lacrimation (teary eye)
  • Nasal congestion or a running nose on the same side of the head
  • The pupil of the eye on the side of the pain may constrict (shrink)
  • The eye on the side of the pain may become red and swollen.
  • Drooping of the eyelid on the same side of the headache
  • There may be sweating on the face and the facial skin becomes pale.
  • Bulging and pulsating temporal artery on the side of the pain
  • Restlessness
  • Swelling in the forehead or facial side affected

People affected with cluster headaches are likely to pace and rock back and forth, unlike those with migraine. Sensitivity to light and sound can also occur with a cluster headache but on one side.

What Is A Cluster Period?

A cluster period usually lasts for several weeks to months. The beginning and duration of each cluster period usually remain the same, developing seasonally mostly during every spring or autumn.

Most individuals experience episodic cluster headaches that can last for one week to a year. This is followed by a painless remission period that can last for a year before the next period begins.

There are variations to this occurrence. For example, chronic cluster periods may last for more than a year, or the remission painless periods might last less than a month.

During a cluster period, a person may have:

  • Headaches every day or several times in a day.
  • A single episode can last from 15 minutes to 3 hours
  • The headache often comes at the same time each day
  • Most attacks develop at night before the person goes to bed.
  • The pain usually ends abruptly with quickly decreasing intensity. After attacks, most individuals feel fatigued.

A person with cluster headache invariably consults his doctor because of the severity of the symptoms. The doctor sends him through the diagnostic drill, prescribes treatment, and usually offers advice on how to prevent future attacks.