Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Cluster headaches, although uncommon, are one of the more severe forms of head pain. They occur more commonly in men and are characterized by severe and constant pain deep in and around the eye on the affected side. The pain is generally intense and nonthrobbing, and often radiates into the forehead, temple, and cheek. The pain may leave as rapidly as it began or fade away gradually. Almost always the same eye is affected. The exact cause of cluster headaches is unknown.

Living With Your Diagnosis
These headaches occur in “clusters.” The cluster usually begins in the spring or fall, and each cluster lasts approximately 2–3 months. The headaches usually occur nightly after 1–2 hours of sleep or several times during the day and night. Each attack lasts nearly an hour. Often a distinct pattern is detectable, with headaches recurring with remarkable accuracy at the same time each day for a period of 6–12 weeks, followed by complete freedom from headaches for many months or years. In addition to the headache, some individuals have watering eyes, drooping eyelids, or visual problems on the side of the headache.

There are many treatment options for cluster headaches. Once the disorder is diagnosed, patients may be started on medication to prevent further headache attacks. Calcium channel blocking medications and ergotamine tartrate are often the firstline medications for prevention. Intranasal lidocaine or subcutaneous sumatriptan can be used to abort an attack. Methysergide or predisone may also be effective for cluster headaches. For breakthrough headaches, headaches that occur despite being on a preventive medication, the most effective treatment is inhaling pure oxygen. If breakthrough headaches are frequent, your doctor may prescribe oxygen therapy for use at home. If attacks are less frequent, there are oral medications that are also effective and more convenient than pure oxygen.

The DOs
• Maintain an adequate and regular sleep schedule.
• Take your medications as prescribed.
• If you are taking a prescription drug, check with your doctor before using over-the-counter pain relief medications.
• Keep your follow-up appointments for reassessment.

The DON’Ts
• Don’t use alcohol and tobacco.
• Avoid exposure to oil-based solvents, high altitude, and strenuous exercise because they may precipitate an attack.

When to Call Your Doctor
• If you have a fever with your headache.
• If you have a headache that is more severe than your usual headache and is resistant to the medication that is normally effective for you.
• If you have any weakness, numbness, or tingling in your arms or legs.
• If you have difficulty walking or talking.
• If you have severe vomiting that cannot be controlled with your medication.
• If you have any problems associated with your medication.