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Exploding Eye: Cluster Headaches

What Are Cluster Headaches?

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Updated: November 21, 2003

The pain has been described as feeling "like the eye is going to explode." They've caused their victims to pace the floor in agony, unable to lie down; literally bang their heads against a wall; even, on rare occasions, to commit suicide to escape the pain. They're cluster headaches, and those who suffer from them are often called ClusterHeads.

To be able to discuss cluster headaches, there are some terms we need to define:

  • cluster headache or cluster attack: defined by the International Headache Society as "one episode of continuous pain that lasts 15 to 180 minutes."
  • cluster or cluster period: defined by the International Headache Society as "the period of time during which attacks occur regularly, and at least every other day." The cluster period is weeks for most people, but can be as long as weeks or even years.
  • remission: defined by the International Headache Society as "the time during which no attacks occur either spontaneously or by induction with alcohol or nitroglycerin. To count as remission the attack free period must exceed 14 days"
  • episodic cluster headache: defined by the International Headache Society as occurring "in periods lasting seven days to one year separated by pain-free periods lasting 14 days or more."
  • chronic cluster headache: defined by the International Headache Society as attacks occurring "for more than one year without remission or with remissions lasting less than 14 days."

Symptoms of Cluster Headaches

  • excruciating pain, usually on one side of the head, often around the eye, often described as "piercing" or "stabbing"

  • excessive tearing, swelling and redness of the eye on the affected side

  • miosis on the affected side

  • inability to lie down or remain still

  • drooping of the eye eyelid on the affected side

  • sweaty forehead or face

  • runny or stuffy nose on the affected side

  • anxiety, depression, dejection, irritability

Cluster Attacks
Cluster headaches are six times more common among men than women. The average cluster headache or cluster attack averages 45 to 90 minutes in length. They nearly always occur on the same side throughout a cluster period. Cluster attacks are usually without warning, but a very small number of ClusterHeads have been known to have migraine-like aura symptoms. They often begin during the REM (dreaming) phase of sleep. What causes these attacks is still unknown though the symptoms are vascular in nature, caused by the swelling of blood vessels in the head. 

The pain of cluster attacks most often centers around the eye of the affected side. It can extend outward to the temple, forehead, jaw, and even the neck on the affected side. Cluster attacks produce pain nearly unimaginable in its intensity. Because it usually centers around the eye, the eye often feels a great deal of pressure, and some sufferers have described the pain as feeling "like the eye is going to explode" or "like someone plunged a hot fireplace poker into the eye."

Cluster and Genetics
It was long held that cluster headaches were not inherited as migraines are. Studies, however have indicated heredity to be a factor in 7% of cluster sufferers. A significant indicator was shown when studies of monozygotic twins found that in all five of the sets of twins studied, both twins experienced cluster headaches.1



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  3. Headaches & Migraines
  4. Headaches 101
  5. Cluster Headaches
  6. Exploding Eye: Cluster Headaches. The pain has been described as feeling "like the eye is going to explode." About Headaches and Migraine

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