Symptoms of Cluster Headaches

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The pain from cluster headaches is so severe that patients have called them “suicide headaches” and likened them to the worst suffering imaginable. Characterized by groups of recurring attacks of 15 minutes to several hours each, these headaches tend to localize on one side of the face, usually centering on the temple around one eye. Alongside this pain, the condition can cause droopiness and tearing in the affected eye, facial swelling, runny nose, and restlessness.

Woman with tremendous headache

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Cluster periods, characterized by multiple attacks in a day, can last for weeks or even months at a time and are usually followed by periods of remission that last for a month or more. In chronic cases, however, these headache-free times are shorter or completely absent.    

Frequent Symptoms

Extreme headache isn’t the only symptom of this condition, though it’s, of course, the most prominent. During cluster attack periods, symptoms occur one to four or more times a day, lasting from 15 minutes to several hours, though they can last longer. What are the symptoms of cluster headache? Here’s a breakdown:

  • Unilateral headache: Headache with this condition is very severe; localizing on one side of the head, it tends to begin behind one eye before moving to the brow and often radiating to other parts of the face and neck.

Typically, attacks will recur on only one side of the head, though occasionally they can migrate from one to the other.

  • Drooping eye: The flesh around the eye on the affected side will sag and start to droop.
  • Facial swelling: Swelling in the face can occur on the affected side, often localizing around the affected eye.
  • Facial sweating: Oftentimes, you may experience perspiration on the side of the face experiencing an attack.
  • Restlessness:  Unlike migraine, which often makes people tired, cluster headache actually leads to restlessness and increased jittery activity. This means you may be more likely to pace or rock back and forth while sitting.

Rare Symptoms & Long-Term Effects

In most cases, cluster headaches don’t have specific symptoms that arise prior to onset, and there are not too many long-term effects. That said, chronic and more intense cases are liable to have an impact:

  • Prodromes: These are symptoms that occur prior to the onset of an attack. While they most often occur in cases of migraine, occasionally patients of cluster headache will experience a similar sensitivity to light and sound.
  • Memory effects: Largely, long-term effects of this condition are uncommon; however, research has pointed to impact on working memory in some episodic and many chronic cases.
  • Quality-of-life: Studies have also shown that both acute and chronic cases can have a significant effect on quality-of-life. Obviously, the severity and difficulty of this condition can seriously affect your day to day living, work performance, and ability to spend quality time with family.
  • Depression and anxiety: Both chronic and episodic cluster headache sufferers are more likely to report feeling depressed or have higher levels of anxiety.  

When to See a Doctor

If you suspect you’re experiencing cluster headaches, your best bet is to seek out medical help as soon as possible. This way, you’ll be able to rule out other factors or conditions and begin the work of taking on and preventing attacks. Some symptoms and sign warrant immediate emergency treatment, including:

  • Abrupt, severe headache
  • Headache alongside other symptoms, including fever, nausea, and vomiting
  • Mental confusion during and following attacks
  • Issues like seizures, numbness, inability to form speech, and numbness (these are signs of very dangerous brain conditions)
  • Symptoms that refuse to go away

A Word From Verywell

Headache issues are especially difficult because they can be unpredictable and lead to severe symptoms. Far too often, you may be tempted to underestimate signs of cluster headache (or other primary headache disorders), attributing them to stress or other factors. Remember: sometimes a headache isn’t just a headache.

Given how severe and impactful this condition can be, you owe it to yourself—as well as your loved ones and coworkers—to ensure you get the medical care you need. The fact of the matter is that therapies and treatments do exist for this condition, so there’s no need to suffer in silence. With the help of the right doctor, as well as the support of those around you, you can get a handle on this challenging disorder.

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3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Wei DY, Yuan ong JJ, Goadsby PJ. Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. Ann Indian Acad Neurol. 2018;21(Suppl 1):S3-S8. doi:10.4103/aian.AIAN_349_17

  2. Edvardsson B. Symptomatic cluster headache: a review of 63 cases. Springerplus. 2014;3:64. doi:10.1186/2193-1801-3-64

  3. UpToDate. Cluster headache: Treatment and Prognosis.

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