Symptoms of cluster headaches

Cluster headaches are the most severe headaches. They can be many times more intense than a migraine attack.

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Cluster headaches occur one to three times per day. They occur very regularly, generally at the same time each day, and generally reach their full force within five or 10 minutes. The pain of a cluster headache can last anywhere from 15 minutes to three hours, then completely disappears only to recur later in the day. In some people, an "alarm clock headache" occurs at the same time each night. These nocturnal attacks can be more severe than the daytime attacks, awakening a person after an hour or two of sleep.

In any individual, attacks usually vary only slightly from one to the next. The pain is almost always one-sided and doesn't switch sides during a headache period. (It may rarely switch sides for a new headache period.) The pain is located behind one eye or in the eye region. It may radiate to the forehead, temple, nose, cheek, or upper gum on the affected side. The scalp may be tender, and the pulsing in the arteries often can be felt.

The pain of cluster headaches is generally very intense and severe and is often described as having a burning or piercing quality. It may be throbbing or constant, and most people cannot sit still but must pace during an attack. Although the pain of a cluster headache starts suddenly, a minimal warning of the oncoming headache may occur, such as a feeling of discomfort or a mild one-sided burning sensation.

During an attack, the affected eye may become swollen or droop. The pupil of the eye may get smaller and the conjunctiva (the tissue that lines the inside of the eyelid) may redden. There may be nasal discharge or congestion and tearing of the eye, all on the same side as the pain. The person may have excessive sweating, and the face may become flushed on the affected side. Cluster headaches are not typically associated with nausea or vomiting. But as is true for people with migraines, people with cluster headaches may develop severe sensitivity to light and sound.

Most people experience cluster periods at the same time each year, during a specific season. In about 20 percent of people with cluster headaches, the attacks are chronic: The series of headaches are not separated by periods of remission.

People who suffer from cluster headaches--especially people who feel pain in the teeth or cheeks during an attack--have an increased risk of developing a stomach ulcer.

It is possible for someone with cluster headaches to also suffer from migraines.