What should you know about cluster headache?

Attacks often centre around an eye and may come with tearing, eye redness, a blocked or runny nostril, eyelid swelling, facial sweating, or restlessness. They tend to recur in recognisable bouts, but a clinician should assess a new pattern before it is labelled cluster headache.

Cluster headache is a primary headache disorder rather than pain caused by sinus congestion or eye strain. Clinicians consider where the pain starts, how quickly it builds, the length and timing of attacks, symptoms on the painful side, and whether the person feels driven to move around.

Migraine and several eye, nerve or blood-vessel conditions can overlap with parts of this picture. Examination and, in selected situations, imaging help rule out another cause rather than simply confirming the diagnosis from pain intensity.

Arrange a medical assessment and keep a diary of attack time, duration, pain side, eye or nose changes, medicines used and possible triggers. Alcohol can trigger attacks during an active bout for some people, so avoiding it during that period may help.

Treatment plans often separate fast-acting therapy for an attack from preventive medicine used during a bout. Ordinary pain tablets may act too slowly for the rapid pain pattern. Use prescribed treatments exactly as directed and discuss side effects or inadequate relief rather than increasing doses yourself.

Seek emergency care for a sudden explosive headache, headache after significant injury, or headache with weakness, confusion, fainting, seizure, fever and neck stiffness, new vision loss, or persistent vomiting. A painful red eye with reduced vision also needs urgent assessment. These warnings matter even if earlier attacks were diagnosed as cluster headache.

Prompt review is also appropriate when the pattern changes, treatment stops working, attacks begin during pregnancy, or headache is accompanied by new neurological symptoms.

Ask what features support the diagnosis, whether an eye examination or imaging is needed, which medicine should be used at attack onset, and whether preventive treatment is suitable. Clarify safe dosing, medication interactions and what change should trigger reassessment.