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 always localize on one side of the face, usually centering on the temple around one eye. Alongside this pain, the condition can cause watery tears 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 some chronic cases, however, these headache-free times are shorter or completely absent.    

Frequent Symptoms

Cluster headaches are often described as a red, hot, poker eye. 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.
  • Eye tearing: Your eye can become watery, and you can experience tears during an episode.
  • Runny nose: You can have watery mucus from the nostril on the affected side.
  • Drooping eye: The skin around the eye on the affected side might 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 painful side of the face,
  • 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 prior to onset, and there are not too many long-term effects.

That said, chronic and more intense cases can involve the following:

  • Prodromes: These are symptoms that occur prior to the onset of an attack. While they most often occur in cases of migraine, occasionally cluster headache is preceded by similar sensitivity to light and sound. Another prodrome is a "shadow headache," or a feeling that the cluster is coming on.
  • Cognitive effects: Largely, long-term effects of this condition are uncommon; however, memory or concentration can be affected in some episodic and many chronic cases.
  • Quality-of-life: Acute and chronic cluster headaches can have a significant effect on your quality of life. 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: Chronic and episodic cluster headaches are associated with feeling depressed or having high 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 therapies for treatment and prevention for your cluster attacks.

Some symptoms and signs 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 won't go away

A Word From Verywell

Headaches can be difficult to live with because they can be unpredictable and can cause severe symptoms. You may be tempted to attribute cluster headaches (or other primary headache disorders) 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 get the medical care you need. Learn about potential triggers or associations of cluster headaches, even though scientific research is very limited. The fact of the matter is that therapies and treatments can be effective 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.

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.

Additional Reading

By Mark Gurarie
Mark Gurarie is a freelance writer, editor, and adjunct lecturer of writing composition at George Washington University.