Cluster Headache –What Is It?

The cluster headache is a malady that affects just 69 out of 100,000 people in the population-much fewer than those who suffer from migraines, sinus headaches, or one of the many other types of headaches. This is probably why it was not really recognized by the medical community until the last 150 years or so and is still largely misunderstood. One of the earliest known mentions of the cluster headache was by von Mollendorff in 1867. In 1956, Sir Charles Symonds gave a more complete account which helped to educate the general public about this little known malady. Over the course of time there have been many different names attributed to these headaches including erythroprosopalgia, spenopalatine neuralgia, ciliary neuralgia, Rader's syndrome, vidian neuralgia, and histamine cephalalgia. It is no wonder that a clear diagnosis was not available-and also no wonder that they started calling the condition a "cluster headache."


Classified as a treatable, it is usually episodic-which means that you will have 1-3 episodes within a few weeks and then go for months or even up to a year without an episode. They involve pain in the periorbital area (around the eyes.) However some people suffer from a cluster headache as a chronic condition-this means that they have no pain-free episodes. People who suffer from episodic headaches can alternately suffer from chronic headaches and then go back to episodic.


Although this type of headache is often classified together with the migraine headache, the cluster headache is not the same at all-even responding to different types of medication. Migraines typically respond to drugs containing propanolol, but clusters do not show the same relief from this type of drug. On the other hand, migraines do not really respond to drugs that contain Lithium, while a cluster headache generally will respond to this type of drug. The link that these two types of headaches sometimes share is that people who get clusters often suffer from migraines simultaneously-suggesting some sort of common cause.

Who Gets This Type Of Headache?

Unlike the migraine which affects far more women than men, the cluster affects men more than women at a ratio of 6: 1. The onset of the first episode with a cluster headache usually occurs sometime between the ages of 20 to 50, but there have been recorded occurrences in patients younger than 10 and older than 80. For women the onset is not related to their monthly menstrual cycle and women who are pregnant often experience a cessation in symptoms for the duration of their pregnancy. Taking birth control pills can also aggravate the condition for a person who suffers from the cluster headache.


There are many suggested causes, or "triggers" for this type of headache. They include: food, hay fever, stress, alcohol, relaxation, and exposure to heat, cold, or glare. Every individual has different trigger mechanisms so it is important that any person suffering from the cluster headache malady try to figure out what their individual triggers are. One way to do this is to keep a headache journal. When an episode starts record everything that happened in the day or so leading up to the episode. Write down everything you eat, drink, where you went, your state of mind, any other physical symptoms or problems that are or are not headache related (such as a head cold) and so on. Once you have done this before each episode, you may begin to see a pattern. With the pattern noted you and your doctor can more successfully diagnose and treat your condition. Although it is rare, treatments are getting better and it is becoming more understood.