CLUSTER HEADACHES

Cluster headaches occur in "clusters", in that, they have a tendency to occur periodically, with regular bouts (clusters), and separated by spontaneous remissions.

They are relatively rare, and tend to occur mainly in men.  It is thought that Thomas Jefferson, author of the US Declaration of Independence, suffered from cluster headaches.  He wrote, "An attack of the 'periodical' headache came upon me ... rendering me unable to write or read without great pain."

Symptoms:

The pain of cluster headaches is often excruciating, developing in one eye and then spreading to the same side of the face, forehead or temple.  The pain is constant, piercing and tearing in nature, causing its victims to clutch their heads, pacing up and down the rooms (unlike migraine sufferers who want to lie in a darkened, quiet room).

Associated with the headache may be drooping, swelling or redness and tearing of the eye.  The nose may be runny as well.  Nausea and vomiting are rare in cluster headaches.

The headaches are sometimes referred to as "alarm clock headaches" because of their ability to wake a person from sleep, and their seemingly precise regularity, both in terms of the individual attacks, and the clusters themselves.

Triggers:

Smoking is known to trigger cluster headaches.

Management:

The management of cluster headaches involves treating the acute attacks and preventing future attacks by taking of prophylactic medication.

Simple pain-killers such as paracetamol and NSAIDs typically are unfortunately ineffective as abortive treatment.

Treatment of acute attacks:
1. Sumatriptan.
2. Ergot derivatives eg. Ergotamine are also useful as abortive rescue medication for acute attacks.
3. Others methods such as inhalation of 100% oxygen, lignocaine spray up the nostrils, vigorous exercise, ice applied over the face etc. 

Prophylactic treatment:
Prophylaxis (preventive) treatment should be considered with your doctor if your headaches are very frequent. A whole range of medication can be used for prophylaxis and they may include beta blockers, calcium channel blockers, antidepressants, anticonvulsants, NSAIDS, angiotensin blockers etc.

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The article above is meant to provide general information and does not replace a doctor's consultation. 
Please see your doctor for professional advice.