Complaints & connections · borters.ch
Extremely severe one-sided attacks in series — treatable, but often mistaken for migraine.
Also known as: cluster headache · Horton’s headache
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Extremely severe, strictly one-sided attacks around the eye and temple, in bouts (“clusters”) — often with a tearing eye, blocked nose and marked restlessness, frequently at night at the same time. Very treatable: acute relief usually from high-flow oxygen or a sumatriptan injection; prevention often with verapamil. Have it assessed by a neurologist.
High-flow oxygen through a non-rebreather mask ends many attacks within minutes. The device belongs at home, not in the emergency room — the attack is over before one gets there.
An attack peaks within minutes. A tablet takes too long; the form injected under the skin or sprayed into the nose works fast enough.
Time of day, duration, side, what came before. The series often have a fixed time of day and a fixed season — that is the basis of any preventive treatment.
Within a series even one glass often triggers an attack within an hour. Between series that is usually not so — for many this difference is the clearest pointer to the diagnosis.
The most common preventive drug is increased slowly with an ECG alongside, because it can slow conduction in the heart. That is part of the plan, not of caution.
With migraine one wants quiet and darkness; here one cannot keep still. The distinction decides the treatment — and it is often missed for years.
Oxygen through a mask and injected sumatriptan stop the attack within minutes. Verapamil prevents and needs weeks. Ordinary painkiller tablets come too late — the attack is over before they are in the blood.
The attack lasts fifteen minutes to three hours and comes in episodes: up to eight times a day over weeks to months, often at the same time of day and with a seasonal clustering. About one in a thousand people is affected, men more often. The pain sits on one side around the eye, with tearing, a running nose and a drooping lid on the same side. Oxygen at twelve to fifteen litres a minute through a mask ends the attack in about seven out of ten within fifteen minutes.
A boring, burning pain behind or around one eye and at the temple that never changes side within a series. The intensity is often described as the worst someone knows.
On the same side: a watering and reddened eye, a drooping lid, a narrow pupil, a blocked or running nose, sweating on the face. These accompanying signs are decisive for the diagnosis.
Unlike migraine it keeps no one still: pacing up and down, rocking, pressing the head against the wall. This difference alone often separates the two pictures.
Attacks of fifteen minutes to three hours, one to eight times a day, often one to two hours after falling asleep, over weeks to months — and then months to years of quiet. Series cluster in spring and autumn.
Serves the distinction: one-sided pain around the eye in someone over fifty can also come from an inflammation of the arteries, which is treated at once.
No value explains the pain itself. This one looks for the rare but important exception: an inflammation or infection behind the complaints.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
Circadian control via the hypothalamus; levels often reduced — used preventively.
Oxygen through a mask ends the attack within 15 minutes for most and is the recognised acute treatment. Ordinary breathing exercises do not achieve this — the difference matters.
Cluster attacks typically come at the same hour at night and follow the inner rhythm. Fixed sleep times and no alcohol during the cluster period are the two practical points.