Cluster Headache

What is Cluster Headache?

Cluster headache is one of the most severe pain conditions we treat. The pain is sharp, burning, or piercing, centred behind or around one eye, and it can spread to the forehead, temple, and nose on the same side. Attacks are short, often 30 to 45 minutes, but they can strike several times a day.

What gives the condition its name is the pattern. Attacks come in clusters that last for weeks or months, then ease into a remission period before returning, sometimes at the same time of year. It is more common in men and usually begins before the age of 30.

A defining feature is the set of symptoms on the painful side: a watering or red eye, a drooping eyelid, a blocked or runny nostril, and sweating. During an attack many people feel restless and need to move or pace, which is the opposite of migraine where people prefer to lie still.

Symptoms

• Severe, sharp, or burning pain around or behind one eye
• Pain on one side that may spread to the forehead, temple, or nose
• A watering, red eye on the painful side
• A drooping eyelid or a blocked, runny nostril on the same side
• Restlessness and an urge to pace during an attack
• Attacks that recur daily in cycles, often waking you from sleep

How We Treat It

Cluster headache responds to targeted nerve procedures, and getting the diagnosis right is the first step because the treatment differs from other headaches. A sphenopalatine ganglion block, a small injection that reaches a nerve cluster behind the nose, can reduce the frequency and severity of attacks and help break an active cycle. We use this nerve block as a central part of management during a bad spell.

For patients whose attacks are frequent and resistant, we consider Botox injections around the head and neck as a longer-acting option to reduce the burden between cycles. We coordinate these procedures with preventive medication where it is appropriate, so that the active cluster period is as short and as manageable as possible.