When to worry about facial pain and pressure with cluster headache

Cluster headache commonly causes intense one-sided pain around the eye, temple, cheek, or forehead. Facial pressure may occur with a watery or red eye, blocked or runny nostril, eyelid drooping, or restlessness on the same side. A familiar pattern is useful information, but pain unlike previous attacks should not be automatically attributed to cluster headache.

Use the acute treatment prescribed for your attacks as instructed and record timing, duration, side, eye or nose symptoms, and response. Do not drive if vision is affected or medicine makes you drowsy. Arrange review if attacks become more frequent, last longer, or respond differently to your usual plan.

Seek emergency care for a sudden explosive headache, fainting, confusion, weakness, numbness, trouble speaking, seizure, or new vision loss. Get urgent assessment for fever with neck stiffness, a painful red eye with reduced vision, or facial swelling. Contact your clinician promptly when pain changes side or follows a head injury.

Ask whether the pattern fits cluster headache, which treatment to use first, whether prevention is appropriate, and how to distinguish usual facial symptoms from warning signs.