Dr Lucio D’Anna is a Consultant Neurologist at the Department of Stroke & Neurosciences at Imperial College London NHS Trust. He is also Honorary Senior Lecturer at the Division of Brain Sciences, Imperial College London.
The pain is on one side of the head, usually centred over one eye, one temple or the forehead. However, for some people, the side can vary from time to time and it can spread to a larger area making diagnosis harder. Cluster headache often starts at night waking people one to two hours after they have gone to sleep. The pain usually reaches its full intensity within 5 to 10 minutes and lasts at this agonising level for between 30 and 60 minutes. It then stops, usually fairly abruptly.
Other symptoms which are characteristic of cluster headache are a blocked or runny nose, and on the same side of the head as the pain, a drooping eyelid and watering and redness of one eye. Many people also experience a flushed or sweating face. Alcohol can trigger cluster headache, often bringing on the pain within an hour of drinking.
At Dementech Neuroscience Clinic, we offer a comprehensive approach to headaches including multiaxial assessments of symptoms and investigation of other neuropsychiatric issues associated with headaches, blood and imaging assessments. We will use blood tests and imaging scans to precisely make the diagnosis and differentiate from other disorders.
Painkillers are not usually effective but oxygen and Sumatriptan injections can reduce the pain within 10 minutes during an attack. Some people may need to take the preventative treatment when the cluster period starts and continue for about two weeks after the bout has ended.