Cluster headache in a teenager: what to know

Cluster headache can cause intense pain around one eye, tearing, a red eye, a blocked nostril, facial sweating, or marked restlessness. Attacks may recur at a similar time of day. In teenagers, migraine, sinus or eye problems, infection, medication effects, and other neurological causes can look similar. A clinician will ask about the pattern, sleep, recent illness, injury, medicines, and family history. Do not assume that a teenager’s severe headache is simply dehydration or stress.

Tell a parent, guardian, school nurse, or trusted adult and arrange a medical appointment. Keep the teenager in a calm, safe place and write down when attacks start, how long they last, which side hurts, and any eye or nasal changes. Follow only medicines and doses recommended for that young person. A GP consultation can guide examination and referral if needed; the clinician may also create an action plan for future attacks.

Get emergency help for a sudden severe headache, confusion, fainting, seizure, weakness, trouble speaking, new vision loss, repeated vomiting, fever with a stiff neck, or headache after a significant head injury. Seek urgent review when the pain is new and escalating, wakes the teenager repeatedly, or comes with a painful red eye. Read more about [Headache](/symptoms/headache/) and [Facial Pain and Pressure](/symptoms/facial-pain-and-pressure/).

What diagnoses should be considered at this age? Does the eye need checking? What can safely be used during an attack? Which changes require emergency help? Should school receive an action plan?