Cluster headaches are a series of relatively short but extremely painful headaches every day for weeks or months at a time. You tend to get them at the same time each year, such as the spring or fall. Because of their seasonal nature, people often mistake cluster headaches for symptoms of allergies or business stress.
We don't know what causes them, but we do know that a nerve in your face is involved, creating intense pain around one of your eyes. It's so bad that most people can't sit still and will often pace during an attack. Cluster headaches can be more severe than a migraine, but they usually don't last as long.
The pain usually starts suddenly. When that happens, you may notice:
Cluster headaches are more common in people who smoke or are heavy drinkers. During a cluster period, you'll be more sensitive to alcohol and nicotine -- just a bit of alcohol can trigger a headache. But drinking won't trigger one during headache-free periods.
Treatment OptionsWhile cluster headache experiences can vary, in most cases it can be successfully treated by individualizing acute and preventive drug treatment. A full treatment plan might include a temporary medication bridge to provide initial relief with steroids, as well as daily preventive medication to help avoid attacks during these weeks-long cycles.
It’s important to note that only sumatriptan and dihydroergotamine injections (DHE) are FDA-approved for acute treatment of CH, while galcanezumab (Emgality) is approved for prevention of Episodic Cluster. The FDA has approved a portable device without significant side effects--the non-invasive vagal nerve stimulator (gammaCore)—for the acute headache attacks and preventative treatment of episodic cluster headache attacks. This device is now commercially available with a prescription.