What to expect from a GP consultation for cluster headache

Tell the GP where the pain starts, how quickly it builds, how long an attack lasts and whether attacks occur at a similar time or in bouts. Mention a red or watery eye, blocked or runny nostril, eyelid drooping, restlessness, nausea or light sensitivity on the painful side. The GP may ask about alcohol, sleep, medicines and previous headache types, then check vision, pupils, strength, sensation, coordination and neck movement. A new or unusual pattern may need further assessment rather than being labelled cluster headache immediately.

Keep a headache record with start time, side, duration, associated eye or nose changes, possible triggers and medicines taken. If safe, bring the packaging of treatments you use and note whether they helped. Ask what to do at the first sign of an attack, whether oxygen or a fast-acting prescribed treatment is appropriate, and whether preventive treatment or neurology review should be considered. Do not rely on ordinary painkillers without discussing the pattern, because repeated self-treatment can complicate headache care.

Get emergency help for a sudden explosive headache, new weakness or numbness, trouble speaking, collapse, confusion, seizure, fever with a stiff neck, or new vision loss. Seek prompt review for a first severe headache, a major change in your usual pattern, headache after a significant injury, or headache during pregnancy. These warning features require assessment regardless of whether the pain resembles a previous attack.

Does my attack pattern fit cluster headache or another headache disorder? What should I use during an attack? Is preventive treatment suitable? Do I need a neurology referral? Which symptoms mean emergency care?