Medical Health Encyclopedia

Symptoms Signaling the Onset of an Attack. Over three-quarters of patients report tingling sensations and irritability minutes to hours preceding an attack. A minority of patients experience migraine-like auras (which are odd sensory experiences, such as seeing shimmering light or blind spots).

Symptoms of a Cluster Headache Attack. When the actual attack occurs, symptoms typically escalate rapidly (within about 15 minutes) to intense levels. People often awaken with them a few hours after they go to bed.

The pain usually develops as follows:

• The pain is typically described as severe, stabbing or boring.
• It is virtually always on one side, although it may occur on the opposite side in other attacks or even within the same attack. In most cases the pain is centered behind one eye or near the temple.

The symptoms of a cluster headache include stabbing severe pain behind or above one eye or in the temple. Tearing of the eye, congestion in the associated nostril, and pupil changes and eyelid drooping may also occur.

• The pain often radiates to other parts of the head, such as the forehead, cheek, jaw, or upper or lower teeth. Less commonly it radiates to the ear, nose, neck, or shoulder. (This occurs more often in chronic cluster headache sufferers than those with the episodic form.)
• Pain does not worsen with movement (as it often does with migraine headaches).

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Other symptoms include the following:

• Excessive tearing, a drooping eyelid, and one stuffy or runny nostril. All of these symptoms appear on the same side as the pain.
• Feelings of intense restlessness and agitation. People in the throes of a cluster headache may pace the floor or may even bang their heads against the wall in an attempt to cope with the pain. These are common events and help differentiate a cluster from a migraine attack (in which people have a tendency to sleep).
• Facial sweating.
• Nausea. (According to one study this occurs in about half of people.)
• Intolerance to light (in one eye), sounds, or smells can occur.
• Migraine-like auras marked by visual, motor, or speech disturbances. Such events occur in between 6% and 14% patients and may be associated with a personal or family history of migraine headaches.
• Rarely, partial and temporary paralysis.