Cluster headache causes: what to know

Cluster headache involves activity in pain-processing pathways and areas that help regulate the body clock. The exact reason these systems become active is not fully understood. Attacks can occur in periods of frequent symptoms, followed by quieter intervals. During an active period, alcohol is a recognised trigger for some people, and disrupted sleep or strong smells may also be relevant for an individual. A trigger can bring on an attack without being the underlying cause of the disorder.

Keep a diary covering sleep, alcohol, smoking or smoke exposure, strong smells, meal timing, stress, attack timing, and associated eye or nasal symptoms. Do not deliberately test a suspected trigger while you are unwell. Take the record to a GP Consultation, where the clinician can review the pattern, examine you, and discuss treatment or referral. Mention recent head injury, new medicines, or a family history of severe headaches.

Emergency assessment is needed for a first sudden explosive headache, weakness, confusion, loss of consciousness, seizure, fever with a stiff neck, or new loss of vision. Seek prompt review if the pain is steadily changing, follows a head injury, or occurs with a painful red eye. Recurring attacks without these signs still deserve a GP Consultation because several conditions can resemble cluster headache.

Ask which features support cluster headache, whether any medicines or conditions could mimic it, which triggers are worth avoiding, whether prevention is appropriate, and what emergency symptoms to watch for.