Cluster headache
Among the most severe pain a person can experience: strictly one-sided attacks around the eye, with tearing, a running or blocked nostril and restlessness, arriving in clusters over weeks.
~1 in 1,000 · more common in men · often misdiagnosed for years
Why it's so often missed
Cluster headache is frequently mislabelled as migraine, sinusitis or a dental problem, and the average person waits years for a correct diagnosis. The pattern is the diagnosis: short, devastating, strictly one-sided attacks with autonomic features on the same side.
The autonomic signature
Attacks come with same-side autonomic signs; this cluster of features is what distinguishes a TAC from migraine.
- A red or watering eye on the painful side
- A blocked or running nostril on the same side
- A drooping eyelid or constricted pupil
- Restlessness or agitation: pacing rather than lying still
Episodic and chronic patterns
In episodic cluster headache, attacks come in bouts lasting weeks to months, separated by remission. In chronic cluster headache, remissions are short or absent. Both are treatable, and access to the right acute and preventive options changes lives, which is exactly why getting the diagnosis right matters.
From your story to a working plan
- 01Intake specifically screens for the autonomic features and timing that distinguish cluster from migraine
- 02Your assessment flags any red flags and the need for urgent or specialist referral where appropriate
- 03Your clinician receives a structured history that shortens the path to effective treatment
- 04Education explains acute options and the importance of avoiding common triggers during a bout
