Cluster Headache vs Migraine

Cluster headaches are rare, extremely painful and debilitating headaches that occur in groups or clusters. They often appear during seasonal changes. They are also described as suicide headaches, a reference to the excruciating pain and resulting desperation that has culminated in actual suicide.

A migraine is a form of vascular headache. Migraine headache is caused by a combination of vasodilatation (enlargement of blood vessels) and the release of chemicals from nerve fibers that coil around the blood vessels. During a migraine attack, the temporal artery enlarges. (The temporal artery is an artery that lies on the outside of the skull just under the skin of the temple.) Enlargement of the temporal artery stretches the nerves that coil around the artery and cause the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the artery magnifies the pain.

Comparison chart

Improve this chart Cluster Headache Migraine
Characteristics of pain: Stabbing Deep throbbing and pulsating
Gender predominance: More common in males More common in females
Sensitivity to light or sound: Rare typical
Runny nose and red, watery eye: Present rare
Location of pain: Pain located near the eye on affected side Deep stabbing pain around the temple or the eye
Severity of pain: Very severe Ranging from moderate to quite severe
Time of onset: Short; headaches peak within 45 minutes long, headache gradually peaks in around 4-24 hrs
Triggers: Nitroglycerin (glyceryl trinitrate), hydrocarbons (petroleum solvents, perfume), Alcohol, napping, etc. Bright lights, loud noises, Changes in sleep patterns, exposure to smoke, Skipping meals etc.
Prodromal aura before headache: Absent present
Nausea or vomiting: Rare common

Contents

edit Signs and symptoms:

edit Cluster Headaches

  • Deep stabbing pain around the temple or the eye which is usually unilateral.
  • Stuffy or runny nose
  • Tearing or redness in eyes, droopy eyelids

edit Migraine

  • Moderate to severe, throbbing head pain.
  • Most commonly one sided pain; less frequently both sides of the head are affected
  • Pain located near the eye on affected side
  • Pain that worsens with physical activity
  • Sensitivity to light and/or sound
  • Nausea or vomiting
  • Debilitating pain that hinders daily activities

edit Pain and Other symptoms

  • Pain during cluster headaches is far worse, significantly more severe than a migraine.
  • Cluster headaches are frequently associated with Horner's syndrome, ptosis (drooping eyelids), conjunctival injection (which results in red, watery eyes), lacrimation (tearing), miosis (constricted pupil), eyelid edema, nasal congestion, rhinorrhea (runny nose), and sweating on the affected side of the face. The neck is often stiff or tender in association with cluster headaches afterwards, and jaw and teeth pain are sometimes reported.
  • Sensitivity to light is more typical of a migraine, as is vomiting, but both can be present in some sufferers of cluster headache, although rare.
  • It has been known to strike at the same time each night or morning, often at precisely the same time during the day a week later.

edit Prevalence

While migraines are diagnosed more often in women, cluster headaches are diagnosed more often in men. The male-to-female ratio in cluster headache ranges from 4:1 to 7:1. It primarily occurs between the ages of 20 to 50 years.

edit Genetics

First-degree relatives of sufferers are more likely to have the condition than the population at large.

edit Triggers

edit Cluster Headaches

  • Nitroglycerin (glyceryl trinitrate)
  • Alcohol
  • Hydrocarbons (petroleum solvents, perfume)
  • Heat and napping may also act as a trigger.
  • Significant change in sleep or work schedules, with resulting decrease in sleep and REM

edit Migraine

According to the National Library of Medicine's Medical Encyclopedia, Migraine attacks may be triggered by:

  • Allergic reactions
  • Bright lights, loud noises, and certain odors or perfumes
  • Changes in sleep patterns
  • Smoking or exposure to smoke
  • Skipping meals
  • Alcohol
  • Menstrual cycle fluctuations, birth control
  • Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
  • Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

edit Diagnosis

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

  • 5 or more attacks
  • 4 hours to 3 days in duration
  • 2 or more of - unilateral location, pulsating quality, moderate to severe pain, aggravation by or avoidance of routine physical activity
  • 1 or more accompanying symptoms - nausea and/or vomiting, photophobia, phonophobia

edit See Also

edit References

Comments: Cluster Headache vs Migraine

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Anonymous comments

I used to get Cluster Headachs all the time. I started taking melatonin every night 1/2 before bedtime and I've never had one since. Not sure if it would work for anybody else but you could try.

204.✗.✗.11 on 2013-05-06 21:20:32

I have read many comments on here about the types of headaches you all get. There are definitely differences between a regular migraine and a cluster. A "regular" migraine is like a twinge to cluster sufferers...what is a twinge? It's when the side of your face that you get the cluster on twitches and shoots pain down your face constantly throughout the day into your cheeks and teeth...the pain so severe you get a root canal thinking something is wrong with your tooth....when there was nothing wrong at all (in some cases many have yanked their own...and no i am not exagerrating im being real) It's the fear of going to sleep at night knowing that "the reaper" is here to pay a visit..and when he knocks on your door waking you from your blissful sleep pain excriating...you choose your weapon of choose (ie: phone, hardwood floor, end of lamp; etc) to pound your face in because THAT feels better than anything. It's a trip to the er after you had 5 that day and exhausted what you can take at home screaming and pacing over and over and begging the nurse for help....it's worse than natural child birth....how do I know? Because I went to the university of penn in Philadelphia and was diagnosed with cluster migraines.....I have given NATURAL birth and I would do it 20 times over to get rid of my "reaper". The doctor said he has only seen 5 women in his 35 years of practice with clusters....then he brought the students in with my permission to learn as I was starting to get my twinges in front of them....they learned what it looked like. Your body heat rises so high without a temperature showing on a thermometer....my ritual take my med take a LUKE warm shower and gradually go cold so cold you shiver....take a bowl of ice cubes and water have someone wipe down your pulse points while breathing your o2.....then all you can do is wait...and fear that in about an hour your sleep (IF you're not afraid to sleep that is) WILL be interrupted by another one....and then when the third one stops and your so tired you fall exhausted to the cold tiled floor because that feels better than your bed....you get up and you go to work and have everyone in your business asking if your ok....face swelled, red and your eyes with dark circles....and you have to be polite and say yes thank you.....that my friends are what a cluster migraine is.....anything else is just a twinge in a cluster sufferers eyes.

173.✗.✗.14 on 2013-05-06 17:08:03

Honestly, I have both of these headaches and all the other types too. Recently, I have been having issues with both clusters and headaches. Also, I am playing with the triptan class of drugs (i.e. sumatripatan or Imitrex) and have been through most of the drugs in this class. My neuro want give me topamax because I get my headaches in clusters that occur sporadically (like a cycle) every 6 months and last 1-1.5 months and go away. So far Imitrex seem to help some when I catch it early enough but it's not that great either. I tried the needless one and it seemed more potent but then switched to the needle Imitrex. I think my body got use to it rather quickly. I hate having these left-sided, pulsating, headaches. Anyone who says OTCs help haven't had a real migraine/cluster headache before. I wish there was an easier way to treat these headaches. Like the other commenter, I believe the preservatives in the food may cause these issues + headaches run on my dad side. It's amazing that my younger brother and I both suffer from these types of headaches and we're both right-handed. LOL. All seriousness, I could drill a hole in my head and it would feel better. I am currently having headaches now since last week.

97.✗.✗.66 on 2013-01-15 22:57:07

I've been getting both migraines and cluster headaches for years...It's so hard to explain to someone who hasnt had one because they just dont understand. I feel like they are thinking that I'm making it up. I'm afraid to drink alcohol anymore and I'm always having to cancel out on plans and "I feel" that my friends and family are disappointed in me and are thinking "Here we go again" or "How convenient that she's sick again"...It makes me sad. I've tried Topamax and had terrible side affects. The only way I manage to get thru them is by taking Exederin Migraine (with a little food) and my imitrex injections which are needless. It's called Sumavel DosePro and it usually works quickly if I catch them in time. They are pressurized so you hold it against your abdomen or thigh and within a second it dispenses the imitrex and most of the time I can feel it move throughout my body...then I lay down for a bit propped up. These injections are also available in needle form. I hope this helps some of you...I honestly think all this processed foods and preservatives that we eat have a lot to do with these headaches and it's tough in this day and age to stay away from it all.

174.✗.✗.225 on 2013-01-11 13:17:17

I have been experiencing cluster head ache last seven years. It's terrible and the pain just kill me. I wish if I had a cure from this pain. Every year the pain is getting worse. I feel like someone stabbed in my eye and head..... I fee like dying,,,,,,,,or I wish during the attack. Suggest me if you know something better....thanks

58.✗.✗.111 on 2012-12-18 14:37:26

I take topiramate for my clusters which is primarily for epilepsy and I have been cluster free now for 2 years. I know the pain is unbearable. Every night 45 min of hell but the shots were amazing and fast. Just bloody expensive. At least the spells only lasted 2 months and they were gone as fast as they came. I wish you all well. Stay cool and push hard on your inner foot even ice them it really does help. Try not to knock youse of out. Good luck to all. Booze does not help either. Stay hydrated.

207.✗.✗.178 on 2012-02-14 04:57:12

My fiance also suffers from cluster headaches believed to have come from epilepsy,but oxygen DOES NOT work for him.He's been on hundreds of medications that didn't work,and the only thing that works for him is methadone from his pain doctor.

173.✗.✗.133 on 2012-01-26 18:59:55

Can migraine also cause a watery eye and runny nose?

134.✗.✗.160 on 2011-11-21 02:51:46

To: 173.8.252.75: There have been some studies about the health impacts of daylight savings time switching. Our bodies sometimes have difficulty in adjusting, which manifests itself in the form of headaches or migraines. Here is an interesting study about the correlation (not causation) between daylight savings and suicide rates: http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8425.2007.00331.x/abstract http://news.ycombinator.com/item?id=1226230

67.✗.✗.66 on 2011-11-15 17:34:18

I have cluster headaches and my insurance will not pay for the oxygen so I use the shot, it works rather quickly. This is the first year I have had a cluster episode with the time change, why?

173.✗.✗.75 on 2011-11-15 14:58:36

I get Cluster Headaches, but have been able to get real relief from oxygen. Breathing in oxygen from a tank at 8 liters ---just as soon as I feel a headache coming on can stop it within 5-10 minutes. And anyone who gets Clusters will tell you, that's about all the time you've got, before the pain is unbearable. But OXYGEN WORKS.

75.✗.✗.20 on 2011-09-20 23:53:41

My ex-husband suffers, usuallly daily from "cluster headaches" that are debilitating. He was diagnosed with cluster headaches. I was curious as to what affect that having high blood pressure might have in relation to this type of headache. I feel so bad for him.hem

68.✗.✗.42 on 2010-07-11 23:15:44

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