What should you know about cluster headaches?

An attack often centres around one eye or the temple and may bring tearing, a red eye, a blocked or runny nostril, facial sweating, or drooping of the eyelid on the same side. Attacks tend to be short compared with some other headaches, but may recur in a pattern over days or weeks, sometimes at similar times. A person may feel restless rather than wanting to lie still. Facial pain and pressure or a more general headache can have other causes, so the pattern matters.

Keep a diary of start time, duration, side, eye or nose symptoms, possible triggers, sleep, alcohol exposure, and medicines taken. Arrange a GP consultation for a new repeated pattern or pain that disrupts daily life. Diagnosis is based on the history and examination; additional tests may be considered when the pattern is unusual. Do not repeatedly self-treat severe attacks without medical guidance, because the appropriate treatment depends on the diagnosis.

Get emergency help for a sudden explosive headache, new weakness or numbness, trouble speaking, fainting, confusion, seizure, fever with a stiff neck, a new visual loss, or severe headache after a head injury. Urgent assessment is also sensible when a new headache is accompanied by a painful red eye or when the usual pattern changes sharply.

Ask whether your pattern fits cluster headache, which acute treatment is suitable, whether preventive treatment is needed, and which symptoms should prompt emergency care.