Seasonal cluster headaches: what to know

Seasonal cluster headaches are severe attacks of one-sided head or facial pain that may recur in bouts around the same time of year. Pain is often centred around one eye or the temple, and the same-side eye may water or become red. A blocked or runny nostril, eyelid drooping or marked restlessness can accompany an attack.

Cluster headache attacks tend to follow a striking pattern: pain is one-sided, starts quickly, and repeats at similar times during an active bout. Unlike many migraine attacks, people often feel unable to lie still. Alcohol, heat, strong smells or changes in sleep may trigger attacks for some people during a bout, although triggers differ.

A new severe headache should not be self-diagnosed. Migraine, sinus disease, eye problems and other conditions can cause head or facial pain. A detailed history helps a clinician choose the right assessment.

Keep an attack diary with the start time, duration, side, eye or nose symptoms, possible triggers and medicines used. Arrange a [GP Consultation](/treatments/consultations-and-assessment/gp-consultation/) promptly if attacks are new, recurring or disrupting sleep. Do not rely on repeated over-the-counter painkillers without advice, because they may not work for this pattern and can create additional headache problems.

Seek emergency help for a sudden explosive headache, new weakness or numbness, trouble speaking, confusion, fainting, fever with a stiff neck, persistent vomiting, a painful red eye with vision change, or a headache after a significant injury. Urgent assessment is also needed when a familiar pattern changes sharply or the pain is unlike anything you have experienced before.

Ask whether the timing and one-sided symptoms fit cluster headache, which warning signs require emergency care, what acute treatment is suitable, and whether preventive treatment is needed during a bout.