HealthyCanada.com

A cluster headache is a relatively rare type (0.1% of the population) of headache that starts suddenly and is characterized by excruciating pain in or around one eye. The condition is more common in men than in women, although prevalence among women is rising. Unlike migraines, which first occur much earlier, cluster headaches usually do not develop until someone is in their late-twenties or early-thirties.

Cluster headache has been described as a "red hot poker" pushed through the eyeball, so excruciating is the stabbing pain. Tearing of the eye and a blocked or runny nose are other common symptoms. You may also notice that your cheek is swollen or that your face is flushed.

There are two forms of cluster headache: episodic and chronic:

• Episodic is characterized by cluster periods of seven days to one year, periods of remission of more than 14 days up to months or years, and occasional shorter bouts.
  
  
• Chronic is characterized by absence of remission for one year or short remissions of less than 14 days, increased frequency of attacks, and relative resistance to drugs.

A cluster headache usually lasts about 45 minutes and occurs at the same time each day for several weeks, until the "cluster period" ends. Once a cluster period has started, a change in sleeping pattern, particularly taking an afternoon nap, seems to bring on the headaches even more. Drinking alcohol also can spur headaches during cluster periods.

Your description of your headaches will help your doctor make a diagnosis. The time and pattern of attacks are important, so keep a pain diary. During a cluster period, it is important to keep to your usual routine, stay calm, and stick to your sleep pattern.

Your doctor may first send you for tests to rule out other possible conditions such as sinusitis that may produce similar symptoms as chronic headaches. If he determines that you are suffering from chronic headaches, several treatments are available. Your doctor may prescribe a preventative medicine to be taken regularly during a cluster period to reduce the number of headaches and a second medicine to relieve the pain when a cluster headache occurs. There is some evidence that the "triptans", drugs that work for migraine headaches, may also help some people with cluster headaches.

Oral medicines work too slowly to give relief. For this reason, your doctor may prescribe a medicine that is taken by inhaler, as an injection or as a rectal suppository. Other possible treatments include rapidly breathing pure oxygen through a mask or using a local anesthetic in the nose.

If you keep a pain diary, you may be able to identify certain things which trigger your headaches, whether a particular activity or something that you have had to eat or to drink. Once you are familiar with these triggers, you can avoid them and, hopefully, reduce the frequency or severity of your pain.