Chapter 2, Episode 4: What is Cluster Headache?


This content has been medically reviewed by Dr. Christopher Rhyne.

Cluster headaches are attacks of severe, stabbing pain centered around one eye and temple. Along with extreme head pain, people with cluster may also experience autonomic symptoms which can include tearing of the eyes, runny nose, eyelid swelling or drooping, forehead sweating, and nasal congestion. The symptoms usually last 30 minutes to 3 hours and can occur up to eight times a day, typically in cycles lasting weeks to months. 

The pain is so severe it can cause restlessness, agitation and sweating. While people with migraine may find relief with rest, people with cluster are typically unable to stay still and are often found pacing or rocking due to the severity of pain.

Cluster headache can be episodic or chronic. About 90% of people with the disease have an episodic form which means a person experiences at least two cycles that last for 1 week to 1 year with remission periods longer than three months. People with chronic cluster headache have cycles that last for at least one year but do not have a headache-free period or their remission period will last less than three months.

Episodic patients typically go into a cycle of attacks when the seasons change, most commonly in January and July. Why cluster headaches are linked to seasonal changes is likely due to the amount of daylight. Seasonal shifts make nights shorter and days longer or vice versa which can disrupt sleep cycles leading to attacks. 

It is unclear why people get cluster headache but studies have found connections with the trigemino-vascular pain system, the hypothalamus and the autonomic nervous system.

The disease occurs in approximately 1 per 1,000 people in the US or 326,500 Americans.1  While the disease is more common in men, it is important to still consider this diagnosis in women.

Sumatriptan is FDA approved for the acute treatment of cluster headache. Non-invasive vagus nerve stimulation is FDA cleared for the acute treatment of cluster headache and adjunctive, or supplemental, use for the prevention of cluster headache. Galcanezumab is FDA approved for prevention of cluster headache.

Another effective treatment is 100% high-flow oxygen via a non-rebreather mask for 15-20 minutes but unfortunately it is often not covered by insurance for this use.

While they aren’t FDA approved for cluster, other common treatments that may be helpful include verapamil, lithium, prednisone, topiramate, divalproex sodium, methylergonovine, sphenopalatine ganglion stimulation and nerve blocks. 

Psychedelics are currently being investigated as a treatment for cluster.

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This video is sponsored in part by Amgen.



*The contents of this video are intended for general informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of a physician or other qualified health provider with any questions you may have regarding a medical condition. AMD does not recommend or endorse any treatment, products, or procedures mentioned. Reliance on any information provided by this content is solely at your own risk.