Cluster headache: what you should know

Attacks usually cause intense pain around or behind one eye or at the temple. The painful side may have a watery or red eye, a blocked or runny nostril, eyelid swelling, or facial sweating. A person may feel restless and unable to lie still. Attacks can arrive in a repeated pattern over a period, sometimes at similar times of day or night, followed by a quieter interval.

The pattern matters more than the label alone. Migraine, other headache disorders, eye problems, sinus disease, and rare urgent conditions can overlap with part of this presentation. A clinician will ask about attack timing, side, associated eye and nose changes, alcohol or other triggers, and any symptoms between attacks.

Arrange prompt medical assessment for suspected cluster headache, especially if this is the first bout or the pain is severe. Treatment is usually planned for both the attack and prevention of further attacks; ordinary household painkillers may not act quickly enough. Keep a record of timing, duration, side, eye or nose symptoms, sleep, and possible triggers to support the consultation.

Use prescribed treatment exactly as directed and do not borrow another person's oxygen or headache medicine. A GP can assess you and arrange specialist care when the pattern is uncertain, recurrent, or difficult to control.

Seek emergency help for a first or sudden extreme headache, pain with weakness, confusion, fainting, seizure, trouble speaking, persistent vomiting, fever with a stiff neck, or new vision loss. Urgent assessment is also needed for severe eye pain with a red eye, or a headache after head injury. Call for help if an attack feels different from previous episodes or is escalating quickly.

Does my one-sided pain and eye or nose pattern fit cluster headache? What should I use during an attack? Is prevention needed during a bout? Could another condition explain the symptoms, and when should I attend emergency care?