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id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> 3 Diagnosis </div> </a> <button aria-controls="toc-Diagnosis-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Diagnosis subsection </button> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> <li id="toc-Differential" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Differential"> <div class="vector-toc-text"> 3.1 Differential </div> </a> <ul id="toc-Differential-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prevention" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Prevention"> <div class="vector-toc-text"> 4 Prevention </div> </a> <button aria-controls="toc-Prevention-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Prevention subsection </button> <ul id="toc-Prevention-sublist" class="vector-toc-list"> <li id="toc-Verapamil" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Verapamil"> <div class="vector-toc-text"> 4.1 Verapamil </div> </a> <ul id="toc-Verapamil-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Glucocorticoids" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Glucocorticoids"> <div class="vector-toc-text"> 4.2 Glucocorticoids </div> </a> <ul id="toc-Glucocorticoids-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgery" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Surgery"> <div class="vector-toc-text"> 4.3 Surgery </div> </a> <ul id="toc-Surgery-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other"> <div class="vector-toc-text"> 4.4 Other </div> </a> <ul id="toc-Other-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> 5 Management </div> </a> <button aria-controls="toc-Management-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> Toggle Management subsection </button> <ul id="toc-Management-sublist" class="vector-toc-list"> <li id="toc-Oxygen" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Oxygen"> <div class="vector-toc-text"> 5.1 Oxygen </div> </a> <ul id="toc-Oxygen-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Triptans" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Triptans"> <div class="vector-toc-text"> 5.2 Triptans </div> </a> <ul id="toc-Triptans-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Opioids" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Opioids"> <div class="vector-toc-text"> 5.3 Opioids </div> </a> <ul id="toc-Opioids-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Other_2" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Other_2"> <div class="vector-toc-text"> 5.4 Other </div> </a> <ul id="toc-Other_2-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Epidemiology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Epidemiology"> <div class="vector-toc-text"> 6 Epidemiology </div> </a> <ul id="toc-Epidemiology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> 7 History </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> 8 Society and culture </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research_directions" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research_directions"> <div class="vector-toc-text"> 9 Research directions </div> </a> <ul id="toc-Research_directions-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> 10 References </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> 11 External links </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" > Toggle the table of contents </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading">Cluster headache</h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 35 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-35" aria-hidden="true" > 35 languages </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B5%D8%AF%D8%A7%D8%B9_%D8%B9%D9%86%D9%82%D9%88%D8%AF%D9%8A" title="صداع عنقودي – Arabic" lang="ar" hreflang="ar" data-title="صداع عنقودي" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target">العربية</a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Klaster_ba%C5%9F_a%C4%9Fr%C4%B1s%C4%B1" title="Klaster baş ağrısı – Azerbaijani" lang="az" hreflang="az" data-title="Klaster baş ağrısı" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target">Azərbaycanca</a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Cefal%C3%A0lgia_de_Horton" title="Cefalàlgia de Horton – Catalan" lang="ca" hreflang="ca" data-title="Cefalàlgia de Horton" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target">Català</a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Syndrom_nakupen%C3%BDch_bolest%C3%AD_hlavy" title="Syndrom nakupených bolestí hlavy – Czech" lang="cs" hreflang="cs" data-title="Syndrom nakupených bolestí hlavy" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target">Čeština</a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Hortons_hovedpine" title="Hortons hovedpine – Danish" lang="da" hreflang="da" data-title="Hortons hovedpine" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target">Dansk</a></li><li class="interlanguage-link interwiki-de badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://de.wikipedia.org/wiki/Cluster-Kopfschmerz" title="Cluster-Kopfschmerz – German" lang="de" hreflang="de" data-title="Cluster-Kopfschmerz" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target">Deutsch</a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Cefalea_en_racimos" title="Cefalea en racimos – Spanish" lang="es" hreflang="es" data-title="Cefalea en racimos" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target">Español</a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Seria_kapdoloro" title="Seria kapdoloro – Esperanto" lang="eo" hreflang="eo" data-title="Seria kapdoloro" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target">Esperanto</a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%B3%D8%B1%D8%AF%D8%B1%D8%AF_%D8%AE%D9%88%D8%B4%D9%87%E2%80%8C%D8%A7%DB%8C" title="سردرد خوشه‌ای – Persian" lang="fa" hreflang="fa" data-title="سردرد خوشه‌ای" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target">فارسی</a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Algie_vasculaire_de_la_face" title="Algie vasculaire de la face – French" lang="fr" hreflang="fr" data-title="Algie vasculaire de la face" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target">Français</a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Cefalea_en_acios" title="Cefalea en acios – Galician" lang="gl" hreflang="gl" data-title="Cefalea en acios" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target">Galego</a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B5%B0%EB%B0%9C_%EB%91%90%ED%86%B5" title="군발 두통 – Korean" lang="ko" hreflang="ko" data-title="군발 두통" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target">한국어</a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%93%D5%B6%D5%BB%D5%A1%D5%B5%D5%AB%D5%B6_%D5%A3%D5%AC%D5%AD%D5%A1%D6%81%D5%A1%D5%BE" title="Փնջային գլխացավ – Armenian" lang="hy" hreflang="hy" data-title="Փնջային գլխացավ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target">Հայերեն</a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Sakit_kepala_cluster" title="Sakit kepala cluster – Indonesian" lang="id" hreflang="id" data-title="Sakit kepala cluster" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target">Bahasa Indonesia</a></li><li class="interlanguage-link interwiki-it badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://it.wikipedia.org/wiki/Cefalea_a_grappolo" title="Cefalea a grappolo – Italian" lang="it" hreflang="it" data-title="Cefalea a grappolo" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target">Italiano</a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%9B%D7%90%D7%91_%D7%A8%D7%90%D7%A9_%D7%9E%D7%A7%D7%91%D7%A6%D7%99" title="כאב ראש מקבצי – Hebrew" lang="he" hreflang="he" data-title="כאב ראש מקבצי" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target">עברית</a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/Cluster-fejf%C3%A1j%C3%A1s" title="Cluster-fejfájás – Hungarian" lang="hu" hreflang="hu" data-title="Cluster-fejfájás" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target">Magyar</a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Clusterhoofdpijn" title="Clusterhoofdpijn – Dutch" lang="nl" hreflang="nl" data-title="Clusterhoofdpijn" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target">Nederlands</a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E7%BE%A4%E7%99%BA%E9%A0%AD%E7%97%9B" title="群発頭痛 – Japanese" lang="ja" hreflang="ja" data-title="群発頭痛" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target">日本語</a></li><li class="interlanguage-link interwiki-no badge-Q17437796 badge-featuredarticle mw-list-item" title="featured article badge"><a href="https://no.wikipedia.org/wiki/Klasehodepine" title="Klasehodepine – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Klasehodepine" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target">Norsk bokmål</a></li><li class="interlanguage-link interwiki-or mw-list-item"><a href="https://or.wikipedia.org/wiki/%E0%AC%95%E0%AD%8D%E0%AC%B2%E0%AC%B8%E0%AD%8D%E0%AC%9F%E0%AC%B0_%E0%AC%AE%E0%AD%81%E0%AC%A3%E0%AD%8D%E0%AC%A1_%E0%AC%AC%E0%AC%BF%E0%AC%A8%E0%AD%8D%E0%AC%A7%E0%AC%BE" title="କ୍ଲସ୍ଟର ମୁଣ୍ଡ ବିନ୍ଧା – Odia" lang="or" hreflang="or" data-title="କ୍ଲସ୍ଟର ମୁଣ୍ଡ ବିନ୍ଧା" data-language-autonym="ଓଡ଼ିଆ" data-language-local-name="Odia" class="interlanguage-link-target">ଓଡ଼ିଆ</a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Klasterowy_b%C3%B3l_g%C5%82owy" title="Klasterowy ból głowy – Polish" lang="pl" hreflang="pl" data-title="Klasterowy ból głowy" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target">Polski</a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Cefaleia_em_salvas" title="Cefaleia em salvas – Portuguese" lang="pt" hreflang="pt" data-title="Cefaleia em salvas" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target">Português</a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9A%D0%BB%D0%B0%D1%81%D1%82%D0%B5%D1%80%D0%BD%D1%8B%D0%B5_%D0%B3%D0%BE%D0%BB%D0%BE%D0%B2%D0%BD%D1%8B%D0%B5_%D0%B1%D0%BE%D0%BB%D0%B8" title="Кластерные головные боли – Russian" lang="ru" hreflang="ru" data-title="Кластерные головные боли" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target">Русский</a></li><li class="interlanguage-link interwiki-sq mw-list-item"><a href="https://sq.wikipedia.org/wiki/Dhimbja_grupore_e_kok%C3%ABs" title="Dhimbja grupore e kokës – Albanian" lang="sq" hreflang="sq" data-title="Dhimbja grupore e kokës" data-language-autonym="Shqip" data-language-local-name="Albanian" class="interlanguage-link-target">Shqip</a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Cluster_headache" title="Cluster headache – Simple English" lang="en-simple" hreflang="en-simple" data-title="Cluster headache" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target">Simple English</a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Glavobol_v_skupkih" title="Glavobol v skupkih – Slovenian" lang="sl" hreflang="sl" data-title="Glavobol v skupkih" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target">Slovenščina</a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9A%D0%BB%D0%B0%D1%81%D1%82%D0%B5%D1%80_%D0%B3%D0%BB%D0%B0%D0%B2%D0%BE%D0%B1%D0%BE%D1%99%D0%B0" title="Кластер главобоља – Serbian" lang="sr" hreflang="sr" data-title="Кластер главобоља" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target">Српски / srpski</a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Hortonin_syndrooma" title="Hortonin syndrooma – Finnish" lang="fi" hreflang="fi" data-title="Hortonin syndrooma" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target">Suomi</a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Hortons_huvudv%C3%A4rk" title="Hortons huvudvärk – Swedish" lang="sv" hreflang="sv" data-title="Hortons huvudvärk" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target">Svenska</a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/K%C3%BCme_tipi_ba%C5%9F_a%C4%9Fr%C4%B1s%C4%B1" title="Küme tipi baş ağrısı – Turkish" lang="tr" hreflang="tr" data-title="Küme tipi baş ağrısı" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target">Türkçe</a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9A%D0%BB%D0%B0%D1%81%D1%82%D0%B5%D1%80%D0%BD%D0%B8%D0%B9_%D0%B3%D0%BE%D0%BB%D0%BE%D0%B2%D0%BD%D0%B8%D0%B9_%D0%B1%D1%96%D0%BB%D1%8C" title="Кластерний головний біль – Ukrainian" lang="uk" hreflang="uk" data-title="Кластерний головний біль" data-language-autonym="Українська" data-language-local-name="Ukrainian" 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style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Cluster headache</th></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><a href="/wiki/File:Gray778.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Gray778.png/220px-Gray778.png" decoding="async" width="220" height="231" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/83/Gray778.png/330px-Gray778.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/83/Gray778.png/440px-Gray778.png 2x" data-file-width="550" data-file-height="578" /></a></td></tr><tr><td colspan="2" class="infobox-full-data"><a href="/wiki/Trigeminal_nerve" title="Trigeminal nerve">Trigeminal nerve</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Neurology" title="Neurology">Neurology</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Signs_and_symptoms" title="Signs and symptoms">Symptoms</a></th><td class="infobox-data">Recurrent, severe <a href="/wiki/Headache" title="Headache">headaches</a> on one side of the head, eye watering, stuffy nose<a href="#cite_note-Nesbitt2012-1">[1]</a></td></tr><tr><th scope="row" class="infobox-label">Usual onset</th><td class="infobox-data">20 to 40 years old<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Duration</th><td class="infobox-data">15 minutes to 3 hours<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Types</th><td class="infobox-data">Episodic, chronic<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label">Causes</th><td class="infobox-data">Unknown<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Risk_factor" title="Risk factor">Risk factors</a></th><td class="infobox-data"><a href="/wiki/Tobacco_smoke" title="Tobacco smoke">Tobacco smoke</a>, family history<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic method</a></th><td class="infobox-data">Based on symptoms<a href="#cite_note-AFP2013-2">[2]</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Differential_diagnosis" title="Differential diagnosis">Differential diagnosis</a></th><td class="infobox-data"><a href="/wiki/Migraine" title="Migraine">Migraine</a>, <a href="/wiki/Trigeminal_neuralgia" title="Trigeminal neuralgia">trigeminal neuralgia</a>,<a href="#cite_note-AFP2013-2">[2]</a> other <a href="/wiki/Trigeminal_autonomic_cephalgias" class="mw-redirect" title="Trigeminal autonomic cephalgias">trigeminal autonomic cephalgias</a><a href="#cite_note-3">[3]</a></td></tr><tr><th scope="row" class="infobox-label">Prevention</th><td class="infobox-data"><a href="/wiki/Verapamil" title="Verapamil">Verapamil</a>, <a href="/wiki/Galcanezumab" title="Galcanezumab">galcanezumab</a>, oral <a href="/wiki/Glucocorticoids" class="mw-redirect" title="Glucocorticoids">glucocorticoids</a>, <a href="/wiki/Steroid_injections" class="mw-redirect" title="Steroid injections">steroid injections</a>, <a href="/wiki/Civamide" class="mw-redirect" title="Civamide">civamide</a><a href="#cite_note-Rob2016-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Treatment</th><td class="infobox-data"><a href="/wiki/Oxygen_therapy" title="Oxygen therapy">Oxygen therapy</a>, <a href="/wiki/Triptan" title="Triptan">triptans</a><a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-Rob2016-4">[4]</a></td></tr><tr><th scope="row" class="infobox-label">Frequency</th><td class="infobox-data">~0.1% at some point in time<a href="#cite_note-Fis2008-5">[5]</a></td></tr></tbody></table> Cluster headache is a <a href="/wiki/Neurological_disorder" title="Neurological disorder">neurological disorder</a> characterized by recurrent severe <a href="/wiki/Headache" title="Headache">headaches</a> on one side of the head, typically around the <a href="/wiki/Eye" title="Eye">eye(s)</a>.<a href="#cite_note-Nesbitt2012-1">[1]</a> There is often accompanying eye watering, <a href="/wiki/Nasal_congestion" title="Nasal congestion">nasal congestion</a>, or swelling around the <a href="/wiki/Eye" title="Eye">eye</a> on the affected side.<a href="#cite_note-Nesbitt2012-1">[1]</a> These symptoms typically last 15 minutes to 3 hours.<a href="#cite_note-AFP2013-2">[2]</a> Attacks often occur in clusters which typically last for weeks or months and occasionally more than a year.<a href="#cite_note-AFP2013-2">[2]</a> The cause is unknown,<a href="#cite_note-AFP2013-2">[2]</a> but is most likely related to dysfunction of the posterior <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a>.<a href="#cite_note-:2-6">[6]</a> Risk factors include a history of exposure to <a href="/wiki/Tobacco_smoke" title="Tobacco smoke">tobacco smoke</a> and a <a href="/wiki/Family_history_(medicine)" title="Family history (medicine)">family history</a> of the condition.<a href="#cite_note-AFP2013-2">[2]</a> Exposures which may trigger attacks include <a href="/wiki/Ethanol" title="Ethanol">alcohol</a>, <a href="/wiki/Nitroglycerin_(medication)" title="Nitroglycerin (medication)">nitroglycerin</a>, and <a href="/wiki/Histamine" title="Histamine">histamine</a>.<a href="#cite_note-AFP2013-2">[2]</a> They are a <a href="/wiki/Primary_headache_disorder" class="mw-redirect" title="Primary headache disorder">primary headache disorder</a> of the <a href="/wiki/Trigeminal_autonomic_cephalalgia" class="mw-redirect" title="Trigeminal autonomic cephalalgia">trigeminal autonomic cephalalgias</a> type.<a href="#cite_note-AFP2013-2">[2]</a> Diagnosis is based on symptoms.<a href="#cite_note-AFP2013-2">[2]</a> Recommended management includes <a href="/wiki/Lifestyle_(sociology)" class="mw-redirect" title="Lifestyle (sociology)">lifestyle</a> adaptations such as avoiding potential triggers.<a href="#cite_note-AFP2013-2">[2]</a> Treatments for acute attacks include <a href="/wiki/Oxygen_therapy" title="Oxygen therapy">oxygen</a> or a fast-acting <a href="/wiki/Triptan" title="Triptan">triptan</a>.<a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-Rob2016-4">[4]</a> Measures recommended to decrease the frequency of attacks include <a href="/wiki/Steroid_injections" class="mw-redirect" title="Steroid injections">steroid injections</a>, <a href="/wiki/Galcanezumab" title="Galcanezumab">galcanezumab</a>, <a href="/wiki/Zucapsaicin" title="Zucapsaicin">civamide</a>, <a href="/wiki/Verapamil" title="Verapamil">verapamil</a>, or oral <a href="/wiki/Glucocorticoid" title="Glucocorticoid">glucocorticoids</a> such as <a href="/wiki/Prednisone" title="Prednisone">prednisone</a>.<a href="#cite_note-:2-6">[6]</a><a href="#cite_note-Rob2016-4">[4]</a><a href="#cite_note-Gaul11-7">[7]</a> <a href="/wiki/Nerve_stimulation" class="mw-redirect" title="Nerve stimulation">Nerve stimulation</a> or surgery may occasionally be used if other measures are not effective.<a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-:2-6">[6]</a> The condition affects about 0.1% of the general population at some point in their life and 0.05% in any given year.<a href="#cite_note-Fis2008-5">[5]</a> The condition usually first occurs between 20 and 40 years of age.<a href="#cite_note-AFP2013-2">[2]</a> Men are affected about four times more often than women.<a href="#cite_note-Fis2008-5">[5]</a> Cluster headaches are named for the occurrence of groups of headache attacks (clusters).<a href="#cite_note-Nesbitt2012-1">[1]</a> They have also been referred to as "suicide headaches".<a href="#cite_note-AFP2013-2">[2]</a> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=1" title="Edit section: Signs and symptoms">edit</a>]</div> Cluster headaches are recurring bouts of severe unilateral headache attacks.<a href="#cite_note-Beck-8">[8]</a><a href="#cite_note-pmid16628535-9">[9]</a> The duration of a typical cluster headache ranges from about 15 to 180 minutes.<a href="#cite_note-AFP2013-2">[2]</a> About 75% of untreated attacks last less than 60 minutes.<a href="#cite_note-EM2009-10">[10]</a> However, women may have longer and more severe cluster headaches.<a href="#cite_note-CHandM2019-11">[11]</a> The onset of an attack is rapid and typically without an <a href="/wiki/Aura_(symptom)" title="Aura (symptom)">aura</a>. Preliminary sensations of pain in the general area of attack, referred to as "shadows", may signal an imminent cluster headache, or these symptoms may linger after an attack has passed, or between attacks.<a href="#cite_note-12">[12]</a> Though cluster headaches are strictly unilateral, there are some documented cases of "side-shift" between cluster periods,<a href="#cite_note-13">[13]</a> or, rarely, simultaneous (within the same cluster period) bilateral cluster headaches.<a href="#cite_note-14">[14]</a> <div class="mw-heading mw-heading3"><h3 id="Pain">Pain</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=2" title="Edit section: Pain">edit</a>]</div> The pain occurs only on one side of the head, around the eye, particularly behind or above the eye, in the temple. The pain is typically greater than in other headache conditions, including <a href="/wiki/Migraine" title="Migraine">migraines</a>, and is usually described as burning, stabbing, drilling or squeezing.<a href="#cite_note-MehtaMaloney2011-15">[15]</a> While suicide is rare, those with cluster headaches may experience suicidal thoughts (giving the alternative name "suicide headache" or "suicidal headache").<a href="#cite_note-Rob2013-16">[16]</a><a href="#cite_note-17">[17]</a> The disease is considered among the most painful conditions known to medical science.<a href="#cite_note-birth-18">[18]</a><a href="#cite_note-19">[19]</a> <a href="/wiki/Peter_Goadsby" title="Peter Goadsby">Dr. Peter Goadsby</a>, Professor of Clinical Neurology at University College London, a leading researcher on the condition has commented: <style data-mw-deduplicate="TemplateStyles:r1244412712">.mw-parser-output .templatequote{overflow:hidden;margin:1em 0;padding:0 32px}.mw-parser-output .templatequotecite{line-height:1.5em;text-align:left;margin-top:0}@media(min-width:500px){.mw-parser-output .templatequotecite{padding-left:1.6em}}</style><blockquote class="templatequote">"Cluster headache is probably the worst pain that humans experience. I know that's quite a strong remark to make, but if you ask a cluster headache patient if they've had a worse experience, they'll universally say they haven't. Women with cluster headache will tell you that an attack is worse than giving birth. So you can imagine that these people give birth without anesthetic once or twice a day, for six, eight, or ten weeks at a time, and then have a break. It's just awful."<a href="#cite_note-20">[20]</a></blockquote> <div class="mw-heading mw-heading3"><h3 id="Other_symptoms">Other symptoms</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=3" title="Edit section: Other symptoms">edit</a>]</div> The typical symptoms of cluster headache include grouped occurrence and recurrence (cluster) of headache attack, severe unilateral orbital, supraorbital and/or temporal pain. If left untreated, attack frequency may range from one attack every two days to eight attacks per day.<a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-IHS-21">[21]</a> Cluster headache attack is accompanied by at least one of the following autonomic symptoms: <a href="/wiki/Ptosis_(eyelid)" title="Ptosis (eyelid)">drooping eyelid</a>, <a href="/wiki/Miosis" title="Miosis">pupil constriction</a>, redness of the <a href="/wiki/Conjunctiva" title="Conjunctiva">conjunctiva</a>, <a href="/wiki/Lacrimation" class="mw-redirect" title="Lacrimation">tearing</a>, <a href="/wiki/Rhinorrhea" title="Rhinorrhea">runny nose</a> and less commonly, <a href="/wiki/Facial_blushing" class="mw-redirect" title="Facial blushing">facial blushing</a>, swelling, or sweating, typically appearing on the same side of the head as the pain.<a href="#cite_note-IHS-21">[21]</a> Similar to a migraine, sensitivity to light (<a href="/wiki/Photophobia" title="Photophobia">photophobia</a>) or noise (<a href="/wiki/Phonophobia" title="Phonophobia">phonophobia</a>) may occur during a cluster headache. Nausea is a rare symptom although it has been reported.<a href="#cite_note-Beck-8">[8]</a> Restlessness (for example, pacing or rocking back and forth) may occur. Secondary effects may include the inability to organize thoughts and plans, physical exhaustion, confusion, agitation, aggressiveness, depression, and anxiety.<a href="#cite_note-Rob2013-16">[16]</a> People with cluster headaches may dread facing another headache and adjust their physical or social activities around a possible future occurrence. Likewise they may seek assistance to accomplish what would otherwise be normal tasks. They may hesitate to make plans because of the regularity, or conversely, the <a href="/wiki/Unpredictability" class="mw-redirect" title="Unpredictability">unpredictability</a> of the pain schedule. These factors can lead to generalized <a href="/wiki/Anxiety_disorder" title="Anxiety disorder">anxiety disorders</a>, <a href="/wiki/Panic_disorder" title="Panic disorder">panic disorder</a>,<a href="#cite_note-Rob2013-16">[16]</a> serious <a href="/wiki/Depressive_disorder" class="mw-redirect" title="Depressive disorder">depressive disorders</a>,<a href="#cite_note-22">[22]</a> social withdrawal and isolation.<a href="#cite_note-23">[23]</a> Cluster headaches have been recently associated with obstructive <a href="/wiki/Sleep_apnea" title="Sleep apnea">sleep apnea</a> comorbidity.<a href="#cite_note-24">[24]</a> <div class="mw-heading mw-heading3"><h3 id="Recurrence">Recurrence</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=4" title="Edit section: Recurrence">edit</a>]</div> Cluster headaches may occasionally be referred to as "alarm clock headache" because of the regularity of their recurrence. Cluster headaches often awaken individuals from sleep. Both individual attacks and the cluster grouping can have a metronomic regularity; attacks typically striking at a precise time of day each morning or night. The recurrence of headache cluster grouping may occur more often around <a href="/wiki/Solstice" title="Solstice">solstices</a>, or seasonal changes, sometimes showing circannual periodicity. Conversely, attack frequency may be highly unpredictable, showing no periodicity at all. These observations have prompted researchers to speculate an involvement or dysfunction of the hypothalamus. The hypothalamus controls the body's "biological clock" and <a href="/wiki/Circadian_rhythm" title="Circadian rhythm">circadian rhythm</a>.<a href="#cite_note-25">[25]</a><a href="#cite_note-26">[26]</a> In episodic cluster headache, attacks occur once or more daily, often at the same time each day for a period of several weeks, followed by a headache-free period lasting weeks, months, or years. Approximately 10–15% of cluster headaches are <a href="/wiki/Chronic_(medicine)" class="mw-redirect" title="Chronic (medicine)">chronic</a>, with multiple headaches occurring every day for years, sometimes without any remission.<a href="#cite_note-NHS-27">[27]</a> In accordance with the International Headache Society (IHS) diagnostic criteria, cluster headaches occurring in two or more cluster periods, lasting from 7 to 365 days with a pain-free <a href="/wiki/Remission_(medicine)" title="Remission (medicine)">remission</a> of one month or longer between the headache attacks may be classified as episodic. If headache attacks occur for more than a year without pain-free remission of at least three months, the condition is classified as chronic.<a href="#cite_note-IHS-21">[21]</a> Chronic cluster headaches both occur and recur without any remission periods between cycles; there may be variation in cycles, meaning the frequency and severity of attacks may change without predictability for a period of time. The frequency, severity, and duration of headache attacks experienced by people during these cycles varies between individuals and does not demonstrate complete remission of the episodic form. The condition may change unpredictably from chronic to episodic and from episodic to chronic.<a href="#cite_note-28">[28]</a> <div class="mw-heading mw-heading2"><h2 id="Causes">Causes</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=5" title="Edit section: Causes">edit</a>]</div> <table class="wikitable floatright"> <tbody><tr> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:PET1.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/PET1.jpg/150px-PET1.jpg" decoding="async" width="150" height="124" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/82/PET1.jpg/225px-PET1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/82/PET1.jpg/300px-PET1.jpg 2x" data-file-width="422" data-file-height="348" /></a><figcaption></figcaption></figure></td> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:PET2.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/5a/PET2.jpg/150px-PET2.jpg" decoding="async" width="150" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/5a/PET2.jpg/225px-PET2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/5a/PET2.jpg/300px-PET2.jpg 2x" data-file-width="360" data-file-height="359" /></a><figcaption></figcaption></figure></td> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:PET3.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/PET3.jpg/122px-PET3.jpg" decoding="async" width="122" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3e/PET3.jpg/183px-PET3.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3e/PET3.jpg/244px-PET3.jpg 2x" data-file-width="300" data-file-height="368" /></a><figcaption></figcaption></figure> </td></tr> <tr> <td colspan="3" style="text-align:center;"><a href="/wiki/Positron_emission_tomography" title="Positron emission tomography">Positron emission tomography</a> (PET) shows brain areas being activated during pain. </td></tr> <tr> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:VBM1.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/97/VBM1.jpg/150px-VBM1.jpg" decoding="async" width="150" height="138" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/97/VBM1.jpg/225px-VBM1.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/97/VBM1.jpg/300px-VBM1.jpg 2x" data-file-width="426" data-file-height="391" /></a><figcaption></figcaption></figure></td> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:VBM2.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/ab/VBM2.jpg/140px-VBM2.jpg" decoding="async" width="140" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/ab/VBM2.jpg/211px-VBM2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/ab/VBM2.jpg/281px-VBM2.jpg 2x" data-file-width="354" data-file-height="378" /></a><figcaption></figcaption></figure></td> <td><figure class="mw-halign-center" typeof="mw:File"><a href="/wiki/File:VBM3.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/VBM3.jpg/116px-VBM3.jpg" decoding="async" width="116" height="150" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/VBM3.jpg/173px-VBM3.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/26/VBM3.jpg/231px-VBM3.jpg 2x" data-file-width="303" data-file-height="393" /></a><figcaption></figcaption></figure> </td></tr> <tr> <td colspan="3" style="text-align:center;"><a href="/wiki/Voxel-based_morphometry" title="Voxel-based morphometry">Voxel-based morphometry</a> shows brain area structural differences. </td></tr></tbody></table> The specific causes and pathogenesis of cluster headaches are not fully understood.<a href="#cite_note-:2-6">[6]</a> The Third Edition of the International Classification of Headache disorders classifies cluster headaches as belonging to the <a href="/wiki/Trigeminal_autonomic_cephalgia" title="Trigeminal autonomic cephalgia">trigeminal autonomic cephalalgias</a>.<a href="#cite_note-29">[29]</a> Some experts consider the posterior <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a> to be important in the pathogenesis of cluster headaches. This is supported by a relatively high success ratio of <a href="/wiki/Deep_brain_stimulation" title="Deep brain stimulation">deep-brain stimulation therapy</a> on the posterior hypothalamic <a href="/wiki/Grey_matter" title="Grey matter">grey matter</a>.<a href="#cite_note-:2-6">[6]</a> <div class="mw-heading mw-heading3"><h3 id="Nerves">Nerves</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=6" title="Edit section: Nerves">edit</a>]</div> Therapies acting on the <a href="/wiki/Vagus_nerve" title="Vagus nerve">vagus nerve</a> (<a href="/wiki/Cranial_nerve" class="mw-redirect" title="Cranial nerve">cranial nerve</a> X) and the <a href="/wiki/Greater_occipital_nerve" title="Greater occipital nerve">greater occipital nerve</a> have both shown efficacy in managing cluster headache, but the specific roles of these nerves are not well-understood.<a href="#cite_note-:2-6">[6]</a> Two nerves thought to play an important role in cluster headaches include the trigeminal nerve and the <a href="/wiki/Facial_nerve" title="Facial nerve">facial nerve</a>.<a href="#cite_note-image-30">[30]</a> <div class="mw-heading mw-heading3"><h3 id="Genetics">Genetics</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=7" title="Edit section: Genetics">edit</a>]</div> Cluster headache may run in some families in an <a href="/wiki/Autosomal_dominant" class="mw-redirect" title="Autosomal dominant">autosomal dominant</a> inheritance pattern.<a href="#cite_note-updateongenetics-31">[31]</a><a href="#cite_note-Pinessi2005-32">[32]</a> People with a <a href="/wiki/Consanguinity" title="Consanguinity">first degree relative</a> with the condition are about 14–48 times more likely to develop it themselves,<a href="#cite_note-Nesbitt2012-1">[1]</a> and around 8 to 10% of persons with cluster headaches have a family history.<a href="#cite_note-updateongenetics-31">[31]</a><a href="#cite_note-:0-33">[33]</a> Several studies have found a higher number of relatives affected among females.<a href="#cite_note-:0-33">[33]</a> Others have suggested these observations may be due to lower numbers of females in these studies.<a href="#cite_note-:0-33">[33]</a> Possible genetic factors warrant further research, current evidence for genetic inheritance is limited.<a href="#cite_note-Pinessi2005-32">[32]</a> Genes that are thought to play a role in the disease are the hypocretin/orexin receptor type 2 (HCRTR2), alcohol dehydrogenase 4(ADH4), G protein beta 3 (GNB3), pituitary adenylate cyclase-activating polypeptide type I receptor (ADCYAP1R1), and membrane metalloendopeptidase (MME) genes.<a href="#cite_note-updateongenetics-31">[31]</a> <div class="mw-heading mw-heading3"><h3 id="Tobacco_smoking">Tobacco smoking</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=8" title="Edit section: Tobacco smoking">edit</a>]</div> About 65% of persons with cluster headache are, or have been, tobacco smokers.<a href="#cite_note-Nesbitt2012-1">[1]</a> Stopping smoking does not lead to improvement of the condition, and cluster headaches also occur in those who have never smoked (e.g., children);<a href="#cite_note-Nesbitt2012-1">[1]</a> it is thought unlikely that smoking is a cause.<a href="#cite_note-Nesbitt2012-1">[1]</a> People with cluster headaches may be predisposed to certain traits, including smoking or other lifestyle habits.<a href="#cite_note-pmid18474191-34">[34]</a> <div class="mw-heading mw-heading3"><h3 id="Hypothalamus">Hypothalamus</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=9" title="Edit section: Hypothalamus">edit</a>]</div> A review suggests that the <a href="/wiki/Suprachiasmatic_nucleus" title="Suprachiasmatic nucleus">suprachiasmatic nucleus</a> of the <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a>, which is the major biological clock in the human body, may be involved in cluster headaches, because cluster headaches occur with diurnal and seasonal rhythmicity.<a href="#cite_note-35">[35]</a> <a href="/wiki/Positron_emission_tomography" title="Positron emission tomography">Positron emission tomography</a> (PET) scans indicate the brain areas which are activated during attack only, compared to pain free periods. These pictures show brain areas that are active during pain in yellow/orange color (called "pain matrix"). The area in the center (in all three views) is activated only during cluster headaches. The bottom row <a href="/wiki/Voxel-based_morphometry" title="Voxel-based morphometry">voxel-based morphometry</a> shows structural brain differences between individuals with and without CH; only a portion of the <a href="/wiki/Hypothalamus" title="Hypothalamus">hypothalamus</a> is different.<a href="#cite_note-36">[36]</a> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=10" title="Edit section: Diagnosis">edit</a>]</div> Cluster-like head pain may be diagnosed as secondary headache rather than cluster headache.<a href="#cite_note-IHS-21">[21]</a> A detailed oral history aids practitioners in correct differential diagnosis, as there are no confirmatory tests for cluster headache. A headache diary can be useful in tracking when and where pain occurs, how severe it is, and how long the pain lasts. A record of coping strategies used may help distinguish between headache type; data on frequency, severity and duration of headache attacks are a necessary tool for initial and correct differential diagnosis in headache conditions.<a href="#cite_note-37">[37]</a> Correct diagnosis presents a challenge as the first cluster headache attack may present where staff are not trained in the diagnosis of rare or complex chronic disease.<a href="#cite_note-EM2009-10">[10]</a> Experienced ER staff are sometimes trained to detect headache types.<a href="#cite_note-38">[38]</a> While cluster headache attacks themselves are not directly life-threatening, <a href="/wiki/Suicide_ideation" class="mw-redirect" title="Suicide ideation">suicide ideation</a> has been observed.<a href="#cite_note-Rob2013-16">[16]</a> Individuals with cluster headaches typically experience <a href="/wiki/Diagnostic_delay" title="Diagnostic delay">diagnostic delay</a> before correct diagnosis.<a href="#cite_note-39">[39]</a> People are often misdiagnosed due to reported neck, tooth, jaw, and sinus symptoms and may unnecessarily endure many years of referral to <a href="/wiki/Otolaryngologist" class="mw-redirect" title="Otolaryngologist">ear, nose and throat (ENT) specialists</a> for investigation of sinuses; dentists for tooth assessment; <a href="/wiki/Chiropractor" class="mw-redirect" title="Chiropractor">chiropractors</a> and manipulative therapists for treatment; or <a href="/wiki/Psychiatrist" title="Psychiatrist">psychiatrists</a>, <a href="/wiki/Psychologist" title="Psychologist">psychologists</a>, and other medical disciplines before their headaches are correctly diagnosed.<a href="#cite_note-Flanders-40">[40]</a> Under-recognition of cluster headaches by health care professionals is reflected in consistent findings in <a href="/wiki/Europe" title="Europe">Europe</a> and the <a href="/wiki/United_States" title="United States">United States</a> that the average time to diagnosis is around seven years.<a href="#cite_note-Tfelt-Hansen2012-41">[41]</a> <div class="mw-heading mw-heading3"><h3 id="Differential">Differential</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=11" title="Edit section: Differential">edit</a>]</div> Cluster headache may be misdiagnosed as <a href="/wiki/Migraine" title="Migraine">migraine</a> or <a href="/wiki/Sinusitis" title="Sinusitis">sinusitis</a>.<a href="#cite_note-Tfelt-Hansen2012-41">[41]</a> Other types of headache are sometimes mistaken for, or may mimic closely, cluster headaches. Incorrect terms like "cluster migraine" confuse headache types, confound differential diagnosis and are often the cause of unnecessary diagnostic delay,<a href="#cite_note-42">[42]</a> ultimately delaying appropriate specialist treatment. Other types of headaches that may be confused with cluster headache include: <ul><li><a href="/wiki/Chronic_paroxysmal_hemicrania" title="Chronic paroxysmal hemicrania">Chronic paroxysmal hemicrania</a> is a unilateral headache condition, without the male predominance usually seen in cluster headaches. Paroxysmal hemicrania may also be episodic but the episodes of pain seen in chronic paroxysmal hemicrania are usually shorter than those seen with cluster headaches. Chronic paroxysmal hemicrania typically responds "absolutely" to treatment with the <a href="/wiki/Anti-inflammatory" title="Anti-inflammatory">anti-inflammatory</a> drug <a href="/wiki/Indomethacin" class="mw-redirect" title="Indomethacin">indomethacin</a><a href="#cite_note-IHS-21">[21]</a> where in most cases cluster headaches typically show no indomethacin response, making "indomethacin response" an important diagnostic tool for specialist practitioners seeking correct differential diagnosis between the conditions.<a href="#cite_note-43">[43]</a><a href="#cite_note-44">[44]</a></li> <li><a href="/wiki/Hemicrania_continua" title="Hemicrania continua">Hemicrania continua</a><a href="#cite_note-newdifferital-45">[45]</a></li> <li><a href="/wiki/SUNCT_syndrome" title="SUNCT syndrome">Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT)</a> is a headache syndrome belonging to the group of TACs.<a href="#cite_note-IHS-21">[21]</a><a href="#cite_note-Rizzoli2017-46">[46]</a></li> <li><a href="/wiki/Trigeminal_neuralgia" title="Trigeminal neuralgia">Trigeminal neuralgia</a> is a unilateral headache syndrome,<a href="#cite_note-Flanders-40">[40]</a> or "cluster-like" headache.<a href="#cite_note-47">[47]</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Prevention">Prevention</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=12" title="Edit section: Prevention">edit</a>]</div> Management for cluster headache is divided into three primary categories: abortive, transitional, and preventive.<a href="#cite_note-Nal2012-48">[48]</a> Preventive treatments are used to reduce or eliminate cluster headache attacks; they are generally used in combination with abortive and transitional techniques.<a href="#cite_note-Beck-8">[8]</a> <div class="mw-heading mw-heading3"><h3 id="Verapamil">Verapamil</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=13" title="Edit section: Verapamil">edit</a>]</div> The recommended first-line preventive therapy is <a href="/wiki/Verapamil" title="Verapamil">verapamil</a>, a <a href="/wiki/Calcium_channel_blocker" title="Calcium channel blocker">calcium channel blocker</a>.<a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-EFNS-49">[49]</a> Verapamil was previously underused in people with cluster headache.<a href="#cite_note-Beck-8">[8]</a> Improvement can be seen in an average of 1.7 weeks for episodic cluster headache and 5 weeks for chronic cluster headache when using a dosage of ranged between 160 and 720 mg (mean 240 mg/day).<a href="#cite_note-vera-50">[50]</a> Preventive therapy with verapamil is believed to work because it has an effect on the circadian rhythm and on CGRPs. As CGRP-release is controlled by voltage-gated calcium channels.<a href="#cite_note-vera-50">[50]</a> <div class="mw-heading mw-heading3"><h3 id="Glucocorticoids">Glucocorticoids</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=14" title="Edit section: Glucocorticoids">edit</a>]</div> Since these compounds are <a href="/wiki/Steroid" title="Steroid">steroids</a>, there is little evidence to support long-term benefits from <a href="/wiki/Glucocorticoid" title="Glucocorticoid">glucocorticoids</a>,<a href="#cite_note-AFP2013-2">[2]</a> but they may be used until other medications take effect as they appear to be effective at three days.<a href="#cite_note-AFP2013-2">[2]</a> They are generally discontinued after 8–10 days of treatment.<a href="#cite_note-Beck-8">[8]</a> Prednisone is given at a starting dose of 60–80 milligrams daily; then it is reduced by 5 milligrams every day. Corticosteroids are also used to break cycles, especially in chronic patients.<a href="#cite_note-:1-51">[51]</a> <div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=15" title="Edit section: Surgery">edit</a>]</div> Nerve stimulators may be an option in the small number of people who do not improve with medications.<a href="#cite_note-52">[52]</a><a href="#cite_note-EU2013-53">[53]</a> Two procedures, <a href="/wiki/Deep_brain_stimulation" title="Deep brain stimulation">deep brain stimulation</a> or <a href="/wiki/Occipital_nerve_stimulation" title="Occipital nerve stimulation">occipital nerve stimulation</a>, may be useful;<a href="#cite_note-AFP2013-2">[2]</a> early experience shows a benefit in about 60% of cases.<a href="#cite_note-54">[54]</a> It typically takes weeks or months for this benefit to appear.<a href="#cite_note-EU2013-53">[53]</a> A non-invasive method using <a href="/wiki/Transcutaneous_electrical_nerve_stimulation" title="Transcutaneous electrical nerve stimulation">transcutaneous electrical nerve stimulation</a> (TENS) is being studied.<a href="#cite_note-EU2013-53">[53]</a> A number of surgical procedures, such as a <a href="/wiki/Rhizotomy" class="mw-redirect" title="Rhizotomy">rhizotomy</a> or <a href="/wiki/Microvascular_decompression" title="Microvascular decompression">microvascular decompression</a>, may also be considered,<a href="#cite_note-EU2013-53">[53]</a> but evidence to support them is limited and there are cases of people whose symptoms worsen after these procedures.<a href="#cite_note-EU2013-53">[53]</a> <div class="mw-heading mw-heading3"><h3 id="Other">Other</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=16" title="Edit section: Other">edit</a>]</div> <a href="/wiki/Lithium_(medication)" title="Lithium (medication)">Lithium</a>, <a href="/wiki/Methysergide" title="Methysergide">methysergide</a>, and <a href="/wiki/Topiramate" title="Topiramate">topiramate</a> are recommended alternative treatments,<a href="#cite_note-EFNS-49">[49]</a><a href="#cite_note-55">[55]</a> although there is little evidence supporting the use of topiramate or methysergide.<a href="#cite_note-AFP2013-2">[2]</a><a href="#cite_note-CE2010-56">[56]</a> This is also true for <a href="/wiki/Tianeptine" title="Tianeptine">tianeptine</a>, <a href="/wiki/Melatonin" title="Melatonin">melatonin</a>, and <a href="/wiki/Ergotamine" title="Ergotamine">ergotamine</a>.<a href="#cite_note-AFP2013-2">[2]</a> <a href="/wiki/Valproate" title="Valproate">Valproate</a>, <a href="/wiki/Sumatriptan" title="Sumatriptan">sumatriptan</a>, and <a href="/wiki/Oxygen" title="Oxygen">oxygen</a> are not recommended as preventive measures.<a href="#cite_note-AFP2013-2">[2]</a> <a href="/wiki/Botulinum_toxin" title="Botulinum toxin">Botulinum toxin</a> injections have shown limited success.<a href="#cite_note-57">[57]</a> Evidence for <a href="/wiki/Baclofen" title="Baclofen">baclofen</a>, <a href="/wiki/Botulinum_toxin" title="Botulinum toxin">botulinum toxin</a>, and <a href="/wiki/Capsaicin" title="Capsaicin">capsaicin</a> is unclear.<a href="#cite_note-CE2010-56">[56]</a> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=17" title="Edit section: Management">edit</a>]</div> There are two primary treatments for acute CH: <a href="/wiki/Oxygen" title="Oxygen">oxygen</a> and <a href="/wiki/Triptan" title="Triptan">triptans</a>,<a href="#cite_note-AFP2013-2">[2]</a> but they are underused due to misdiagnosis of the syndrome.<a href="#cite_note-Beck-8">[8]</a> During bouts of headaches, triggers such as <a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">alcohol</a>, <a href="/wiki/Nitroglycerine" class="mw-redirect" title="Nitroglycerine">nitroglycerine</a>, and naps during the day should be avoided.<a href="#cite_note-EM2009-10">[10]</a> <div class="mw-heading mw-heading3"><h3 id="Oxygen">Oxygen</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=18" title="Edit section: Oxygen">edit</a>]</div> <a href="/wiki/Oxygen_therapy" title="Oxygen therapy">Oxygen therapy</a> may help to abort attacks, though it does not prevent future episodes.<a href="#cite_note-AFP2013-2">[2]</a> Typically it is given via a <a href="/wiki/Non-rebreather_mask" title="Non-rebreather mask">non-rebreather mask</a> at 12–15 liters per minute for 15–20 minutes.<a href="#cite_note-AFP2013-2">[2]</a> One review found about 70% of patients improve within 15 minutes.<a href="#cite_note-EM2009-10">[10]</a> The evidence for effectiveness of 100% oxygen, however, is weak.<a href="#cite_note-EM2009-10">[10]</a><a href="#cite_note-pmid26709672-58">[58]</a> Hyperbaric oxygen at pressures of ~2 times greater than atmospheric pressure may relieve cluster headaches.<a href="#cite_note-pmid26709672-58">[58]</a> <div class="mw-heading mw-heading3"><h3 id="Triptans">Triptans</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=19" title="Edit section: Triptans">edit</a>]</div> The other primarily recommended treatment of acute attacks is subcutaneous or intranasal <a href="/wiki/Sumatriptan" title="Sumatriptan">sumatriptan</a>.<a href="#cite_note-EFNS-49">[49]</a><a href="#cite_note-59">[59]</a> Sumatriptan and <a href="/wiki/Zolmitriptan" title="Zolmitriptan">zolmitriptan</a> have both been shown to improve symptoms during an attack with sumatriptan being superior.<a href="#cite_note-Law2013-60">[60]</a> Because of the vasoconstrictive side-effect of triptans, they may be contraindicated in people with <a href="/wiki/Ischemic_heart_disease" class="mw-redirect" title="Ischemic heart disease">ischemic heart disease</a>.<a href="#cite_note-AFP2013-2">[2]</a> The vasoconstrictor <a href="/wiki/Ergot" title="Ergot">ergot</a> compounds may be useful,<a href="#cite_note-EM2009-10">[10]</a> but have not been well studied in acute attacks.<a href="#cite_note-Law2013-60">[60]</a> <div class="mw-heading mw-heading3"><h3 id="Opioids">Opioids</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=20" title="Edit section: Opioids">edit</a>]</div> The use of <a href="/wiki/Opioid" title="Opioid">opioid</a> medication in management of cluster headache is not recommended<a href="#cite_note-Pae2008-61">[61]</a> and may make headache syndromes worse.<a href="#cite_note-62">[62]</a><a href="#cite_note-63">[63]</a> Long-term opioid use is associated with well known dependency, addiction, and withdrawal syndromes.<a href="#cite_note-64">[64]</a> Prescription of opioid medication may additionally lead to further delay in differential diagnosis, undertreatment, and mismanagement.<a href="#cite_note-Pae2008-61">[61]</a> <div class="mw-heading mw-heading3"><h3 id="Other_2">Other</h3>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=21" title="Edit section: Other">edit</a>]</div> Intranasal <a href="/wiki/Lidocaine" title="Lidocaine">lidocaine</a> (sprayed in the ipsilateral nostril) may be an effective treatment with patient resistant to more conventional treatment.<a href="#cite_note-CHandM2019-11">[11]</a> <a href="/wiki/Octreotide" title="Octreotide">Octreotide</a> administered subcutaneously has been demonstrated to be more effective than placebo for the treatment of acute attacks.<a href="#cite_note-65">[65]</a> Sub-occipital steroid injections have shown benefit and are recommended for use as a transitional therapy to provide temporary headache relief as more long term prophylactic therapies are instituted.<a href="#cite_note-66">[66]</a> <div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=22" title="Edit section: Epidemiology">edit</a>]</div> Cluster headache affects about 0.1% of the general population at some point in their life.<a href="#cite_note-Fis2008-5">[5]</a> Males are affected about four times more often than females.<a href="#cite_note-Fis2008-5">[5]</a> The condition usually starts between the ages of 20 and 50 years, although it can occur at any age.<a href="#cite_note-Nesbitt2012-1">[1]</a> About one in five of adults reports the onset of cluster headache between 10 and 19 years.<a href="#cite_note-Abu-Arafeh2016-67">[67]</a> <div class="mw-heading mw-heading2"><h2 id="History">History</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=23" title="Edit section: History">edit</a>]</div> The first complete description of cluster headache was given by the London neurologist <a href="/wiki/Wilfred_Harris" title="Wilfred Harris">Wilfred Harris</a> in 1926, who named the disease migrainous neuralgia.<a href="#cite_note-68">[68]</a><a href="#cite_note-69">[69]</a><a href="#cite_note-70">[70]</a> Descriptions of cluster headache date to 1745 and probably earlier.<a href="#cite_note-71">[71]</a> The condition was originally named Horton's cephalalgia after <a href="/wiki/Bayard_Taylor_Horton" title="Bayard Taylor Horton">Bayard Taylor Horton</a>, a US neurologist who postulated the first theory as to their pathogenesis. His original paper describes the severity of the headaches as being able to take normal men and force them to attempt or die by suicide; his 1939 paper said:<link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1244412712"><blockquote class="templatequote">"Our patients were disabled by the disorder and suffered from bouts of pain from two to twenty times a week. They had found no relief from the usual methods of treatment. Their pain was so severe that several of them had to be constantly watched for fear of suicide. Most of them were willing to submit to any operation which might bring relief."<a href="#cite_note-72">[72]</a></blockquote> CH has alternately been called erythroprosopalgia of Bing, ciliary neuralgia, <a href="/wiki/Erythromelalgia" title="Erythromelalgia">erythromelalgia</a> of the head, Horton's headache, histaminic cephalalgia, petrosal neuralgia, sphenopalatine neuralgia, vidian neuralgia, Sluder's neuralgia, Sluder's syndrome, and hemicrania angioparalyticia.<a href="#cite_note-73">[73]</a> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=24" title="Edit section: Society and culture">edit</a>]</div> Robert Shapiro, a professor of neurology, says that while cluster headaches are about as common as <a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a> with a similar disability level, as of 2013, the US <a href="/wiki/National_Institutes_of_Health" title="National Institutes of Health">National Institutes of Health</a> had spent $1.872 billion on research into multiple sclerosis in one decade, but less than $2 million on cluster headache research in 25 years.<a href="#cite_note-Unlocking-74">[74]</a> <div class="mw-heading mw-heading2"><h2 id="Research_directions">Research directions</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=25" title="Edit section: Research directions">edit</a>]</div> Some case reports suggest that ingesting tryptamines such as <a href="/wiki/LSD" title="LSD">LSD</a>, <a href="/wiki/Psilocybin" title="Psilocybin">psilocybin</a> (as found in hallucinogenic mushrooms), or <a href="/wiki/N,N-Dimethyltryptamine" title="N,N-Dimethyltryptamine">DMT</a> can abort attacks and interrupt cluster headache cycles.<a href="#cite_note-Sun2011-75">[75]</a><a href="#cite_note-Vollenweider2010-76">[76]</a> The hallucinogen DMT has a chemical structure that is similar to the triptan sumatriptan, indicating a possible shared mechanism in preventing or stopping migraine and TACs.<a href="#cite_note-:1-51">[51]</a> In a 2006 survey of 53 individuals, 18 of 19 psilocybin users reported extended remission periods. The survey was not a blinded or a controlled study, and was "limited by recall and selection bias".<a href="#cite_note-Sun2011-75">[75]</a> The safety and efficacy of psilocybin is currently being studied in cluster headache, with the extension phase of one randomized controlled trial demonstrating reduced cluster attack burden after a 3-dose pulse of psilocybin.<a href="#cite_note-77">[77]</a><a href="#cite_note-78">[78]</a><a href="#cite_note-79">[79]</a> <a href="/wiki/Fremanezumab" title="Fremanezumab">Fremanezumab</a>, a humanized <a href="/wiki/Monoclonal_antibody" title="Monoclonal antibody">monoclonal antibody</a> directed against <a href="/wiki/Calcitonin_gene-related_peptide" title="Calcitonin gene-related peptide">calcitonin gene-related peptides</a> alpha and beta, was in phase 3 clinical trials for cluster headaches, but the studies were stopped early due to a futility analysis demonstrating that a successful outcome was unlikely.<a href="#cite_note-80">[80]</a><a href="#cite_note-81">[81]</a> <div class="mw-heading mw-heading2"><h2 id="References">References</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=26" title="Edit section: References">edit</a>]</div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-Nesbitt2012-1">^ <a href="#cite_ref-Nesbitt2012_1-0">a</a> <a href="#cite_ref-Nesbitt2012_1-1">b</a> <a href="#cite_ref-Nesbitt2012_1-2">c</a> <a href="#cite_ref-Nesbitt2012_1-3">d</a> <a href="#cite_ref-Nesbitt2012_1-4">e</a> <a href="#cite_ref-Nesbitt2012_1-5">f</a> <a href="#cite_ref-Nesbitt2012_1-6">g</a> <a href="#cite_ref-Nesbitt2012_1-7">h</a> <a href="#cite_ref-Nesbitt2012_1-8">i</a> <style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFNesbittGoadsby2012" class="citation journal cs1">Nesbitt, A. 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G.; Haan, Joost; Ferrari, Michel D.; Fronczek, Rolf (1 February 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018790">"Pharmacotherapy for Cluster Headache"</a>. CNS Drugs. 34 (2): 171–184. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs40263-019-00696-2">10.1007/s40263-019-00696-2</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1179-1934">1179-1934</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7018790">7018790</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31997136">31997136</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=CNS+Drugs&rft.atitle=Pharmacotherapy+for+Cluster+Headache&rft.volume=34&rft.issue=2&rft.pages=171-184&rft.date=2020-02-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7018790%23id-name%3DPMC&rft.issn=1179-1934&rft_id=info%3Apmid%2F31997136&rft_id=info%3Adoi%2F10.1007%2Fs40263-019-00696-2&rft.aulast=Brandt&rft.aufirst=Roemer+B.&rft.au=Doesborg%2C+Patty+G.+G.&rft.au=Haan%2C+Joost&rft.au=Ferrari%2C+Michel+D.&rft.au=Fronczek%2C+Rolf&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7018790&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACluster+headache" class="Z3988"> </li> <li id="cite_note-78"><a href="#cite_ref-78">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://clinicaltrials.gov/ct2/show/NCT02981173">"Psilocybin for the Treatment of Cluster Headache - Full Text View - ClinicalTrials.gov"</a>. clinicaltrials.gov. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200527221712/https://clinicaltrials.gov/ct2/show/NCT02981173">Archived</a> from the original on 27 May 2020. Retrieved 15 February 2020.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=clinicaltrials.gov&rft.atitle=Psilocybin+for+the+Treatment+of+Cluster+Headache+-+Full+Text+View+-+ClinicalTrials.gov&rft_id=https%3A%2F%2Fclinicaltrials.gov%2Fct2%2Fshow%2FNCT02981173&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACluster+headache" class="Z3988"> </li> <li id="cite_note-79"><a href="#cite_ref-79">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSchindlerSewellGottschalkFlynn2024" class="citation journal cs1">Schindler, Emmanuelle A.D.; Sewell, R. Andrew; Gottschalk, Christopher H.; Flynn, L. Taylor; Zhu, Yutong; Pittman, Brian P.; Cozzi, Nicholas V.; D'Souza, Deepak C. (May 2024). <a rel="nofollow" class="external text" href="https://doi.org/10.1016/j.jns.2024.122993">"Psilocybin pulse regimen reduces cluster headache attack frequency in the blinded extension phase of a randomized controlled trial"</a>. Journal of the Neurological Sciences. 460: 122993. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jns.2024.122993">10.1016/j.jns.2024.122993</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0022-510X">0022-510X</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38581739">38581739</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+Neurological+Sciences&rft.atitle=Psilocybin+pulse+regimen+reduces+cluster+headache+attack+frequency+in+the+blinded+extension+phase+of+a+randomized+controlled+trial&rft.volume=460&rft.pages=122993&rft.date=2024-05&rft.issn=0022-510X&rft_id=info%3Apmid%2F38581739&rft_id=info%3Adoi%2F10.1016%2Fj.jns.2024.122993&rft.aulast=Schindler&rft.aufirst=Emmanuelle+A.D.&rft.au=Sewell%2C+R.+Andrew&rft.au=Gottschalk%2C+Christopher+H.&rft.au=Flynn%2C+L.+Taylor&rft.au=Zhu%2C+Yutong&rft.au=Pittman%2C+Brian+P.&rft.au=Cozzi%2C+Nicholas+V.&rft.au=D%27Souza%2C+Deepak+C.&rft_id=https%3A%2F%2Fdoi.org%2F10.1016%2Fj.jns.2024.122993&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACluster+headache" class="Z3988"> </li> <li id="cite_note-80"><a href="#cite_ref-80">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://clinicaltrials.gov/ct2/show/NCT02964338">"A Study Comparing the Efficacy and Safety of TEV-48125 (Fremanezumab) for the Prevention of Chronic Cluster Headache (CCH)"</a>. ClinicalTrials.gov. 28 January 2021. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200503040323/https://clinicaltrials.gov/ct2/show/NCT02964338">Archived</a> from the original on 3 May 2020. Retrieved 30 November 2017.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=ClinicalTrials.gov&rft.atitle=A+Study+Comparing+the+Efficacy+and+Safety+of+TEV-48125+%28Fremanezumab%29+for+the+Prevention+of+Chronic+Cluster+Headache+%28CCH%29&rft.date=2021-01-28&rft_id=https%3A%2F%2Fclinicaltrials.gov%2Fct2%2Fshow%2FNCT02964338&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACluster+headache" class="Z3988"> </li> <li id="cite_note-81"><a href="#cite_ref-81">^</a> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://clinicaltrials.gov/ct2/show/NCT02945046">"A Study to Evaluate the Efficacy and Safety of TEV-48125 (Fremanezumab) for the Prevention of Episodic Cluster Headache (ECH)"</a>. ClinicalTrials.gov. 2 July 2020. <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200501103107/https://clinicaltrials.gov/ct2/show/NCT02945046">Archived</a> from the original on 1 May 2020. Retrieved 30 November 2017.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=ClinicalTrials.gov&rft.atitle=A+Study+to+Evaluate+the+Efficacy+and+Safety+of+TEV-48125+%28Fremanezumab%29+for+the+Prevention+of+Episodic+Cluster+Headache+%28ECH%29&rft.date=2020-07-02&rft_id=https%3A%2F%2Fclinicaltrials.gov%2Fct2%2Fshow%2FNCT02945046&rfr_id=info%3Asid%2Fen.wikipedia.org%3ACluster+headache" class="Z3988"> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2>[<a href="/w/index.php?title=Cluster_headache&action=edit&section=27" title="Edit section: External links">edit</a>]</div> <a rel="nofollow" class="external text" href="https://clusterbusters.org/">Clusterbusters</a> patient support and advocacy <a rel="nofollow" class="external text" href="https://www.preventsuffering.org/cluster-headaches/">Organisation for the Prevention of Intense Suffering (OPIS)</a> resource page on 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style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q166907" class="extiw" title="d:Q166907">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/G44.0">G44.0</a></li><li><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=339.00">339.00</a>,<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=339.01">339.01</a>,<a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=339.02">339.02</a>,</li><li><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003027">D003027</a></li><li><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb2850.htm">2850</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000786.htm">000786</a></li><li><a href="/wiki/EMedicine" title="EMedicine">eMedicine</a>: <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/EMERG/229-overview">EMERG/229</a> <a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/1142459-overview">article/1142459</a></li><li><a href="/wiki/Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/cluster-headache">Cluster headache</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" 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.navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Central_nervous_system_disease" title="Template:Central nervous system disease"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Central_nervous_system_disease" title="Template talk:Central nervous system disease"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Central_nervous_system_disease" title="Special:EditPage/Template:Central nervous system disease"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Diseases_of_the_nervous_system,_primarily_CNS" style="font-size:114%;margin:0 4em">Diseases of the <a href="/wiki/Nervous_system" title="Nervous system">nervous system</a>, primarily <a href="/wiki/Central_nervous_system_disease" title="Central nervous system disease">CNS</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inflammation" title="Inflammation">Inflammation</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Brain" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalitis" title="Encephalitis">Encephalitis</a> <ul><li><a href="/wiki/Viral_encephalitis" title="Viral encephalitis">Viral encephalitis</a></li> <li><a href="/wiki/Herpesviral_encephalitis" class="mw-redirect" title="Herpesviral encephalitis">Herpesviral encephalitis</a></li> <li><a href="/wiki/Limbic_encephalitis" title="Limbic encephalitis">Limbic encephalitis</a></li> <li><a href="/wiki/Encephalitis_lethargica" title="Encephalitis lethargica">Encephalitis lethargica</a></li></ul></li> <li><a href="/wiki/Cavernous_sinus_thrombosis" title="Cavernous sinus thrombosis">Cavernous sinus thrombosis</a></li> <li><a href="/wiki/Brain_abscess" title="Brain abscess">Brain abscess</a> <ul><li><a href="/wiki/Amoebic_brain_abscess" title="Amoebic brain abscess">Amoebic</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Brain and <a href="/wiki/Spinal_cord" title="Spinal cord">spinal cord</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Encephalomyelitis" title="Encephalomyelitis">Encephalomyelitis</a> <ul><li><a href="/wiki/Acute_disseminated_encephalomyelitis" title="Acute disseminated encephalomyelitis">Acute disseminated</a></li></ul></li> <li><a href="/wiki/Meningitis" title="Meningitis">Meningitis</a></li> <li><a href="/wiki/Meningoencephalitis" title="Meningoencephalitis">Meningoencephalitis</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">Brain</a>/ <a href="/wiki/Encephalopathy" title="Encephalopathy">encephalopathy</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Extrapyramidal_system" title="Extrapyramidal system">Extrapyramidal</a> and <a href="/wiki/Movement_disorders" class="mw-redirect" title="Movement disorders">movement disorders</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Basal_ganglia_disease" title="Basal ganglia disease">Basal ganglia disease</a> <ul><li><a href="/wiki/Parkinsonism" title="Parkinsonism">Parkinsonism</a> <ul><li><a href="/wiki/Parkinson%27s_disease" title="Parkinson's disease">PD</a></li> <li><a href="/wiki/Postencephalitic_parkinsonism" class="mw-redirect" title="Postencephalitic parkinsonism">Postencephalitic</a></li> <li><a href="/wiki/Neuroleptic_malignant_syndrome" title="Neuroleptic malignant syndrome">NMS</a></li></ul></li> <li><a href="/wiki/Neurodegeneration_with_brain_iron_accumulation" title="Neurodegeneration with brain iron accumulation">NBIA</a> <ul><li><a href="/wiki/Pantothenate_kinase-associated_neurodegeneration" title="Pantothenate kinase-associated neurodegeneration">PKAN</a></li></ul></li> <li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Progressive_supranuclear_palsy" title="Progressive supranuclear palsy">PSP</a></li></ul></li> <li><a href="/wiki/Multiple_system_atrophy" title="Multiple system atrophy">Striatonigral degeneration</a></li> <li><a href="/wiki/Hemiballismus" title="Hemiballismus">Hemiballismus</a></li> <li><a href="/wiki/Huntington%27s_disease" title="Huntington's disease">HD</a></li> <li><a href="/wiki/Olivopontocerebellar_atrophy" class="mw-redirect" title="Olivopontocerebellar atrophy">OA</a></li></ul></li></ul> <ul><li><a href="/wiki/Dyskinesia" title="Dyskinesia">Dyskinesia</a> <ul><li><a href="/wiki/Dystonia" title="Dystonia">Dystonia</a> <ul><li><a href="/wiki/Status_dystonicus" title="Status dystonicus">Status dystonicus</a></li> <li><a href="/wiki/Spasmodic_torticollis" title="Spasmodic torticollis">Spasmodic torticollis</a></li> <li><a href="/wiki/Meige%27s_syndrome" title="Meige's syndrome">Meige's</a></li> <li><a href="/wiki/Blepharospasm" title="Blepharospasm">Blepharospasm</a></li></ul></li> <li><a href="/wiki/Athetosis" title="Athetosis">Athetosis</a></li> <li><a href="/wiki/Chorea" title="Chorea">Chorea</a> <ul><li><a href="/wiki/Choreoathetosis" title="Choreoathetosis">Choreoathetosis</a></li></ul></li> <li><a href="/wiki/Myoclonus" title="Myoclonus">Myoclonus</a> <ul><li><a href="/wiki/Myoclonic_epilepsy" title="Myoclonic epilepsy">Myoclonic epilepsy</a></li></ul></li> <li><a href="/wiki/Akathisia" title="Akathisia">Akathisia</a></li></ul></li></ul> <ul><li><a href="/wiki/Tremor" title="Tremor">Tremor</a> <ul><li><a href="/wiki/Essential_tremor" title="Essential tremor">Essential tremor</a></li> <li><a href="/wiki/Intention_tremor" title="Intention tremor">Intention tremor</a></li></ul></li> <li><a href="/wiki/Restless_legs_syndrome" title="Restless legs syndrome">Restless legs</a></li> <li><a href="/wiki/Stiff-person_syndrome" title="Stiff-person syndrome">Stiff-person</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Dementia" title="Dementia">Dementia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tauopathy" title="Tauopathy">Tauopathy</a> <ul><li><a href="/wiki/Alzheimer%27s_disease" title="Alzheimer's disease">Alzheimer's</a> <ul><li><a href="/wiki/Early-onset_Alzheimer%27s_disease" title="Early-onset Alzheimer's disease">Early-onset</a></li></ul></li> <li><a href="/wiki/Primary_progressive_aphasia" title="Primary progressive aphasia">Primary progressive aphasia</a></li></ul></li> <li><a href="/wiki/Frontotemporal_dementia" title="Frontotemporal dementia">Frontotemporal dementia</a>/<a href="/wiki/Frontotemporal_lobar_degeneration" title="Frontotemporal lobar degeneration">Frontotemporal lobar degeneration</a> <ul><li><a href="/wiki/Pick%27s_disease" class="mw-redirect" title="Pick's disease">Pick's</a></li></ul></li> <li><a href="/wiki/Lewy_bodies_dementia" class="mw-redirect" title="Lewy bodies dementia">Lewy bodies dementia</a></li> <li><a href="/wiki/Posterior_cortical_atrophy" title="Posterior cortical atrophy">Posterior cortical atrophy</a></li></ul> <a href="/wiki/Creutzfeldt%E2%80%93Jakob_disease" title="Creutzfeldt–Jakob disease">Creutzfeldt–Jakob disease</a> <ul><li><a href="/wiki/Vascular_dementia" title="Vascular dementia">Vascular dementia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Mitochondrial_disease" title="Mitochondrial disease">Mitochondrial disease</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Leigh_syndrome" title="Leigh syndrome">Leigh syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Demyelinating_disease" title="Demyelinating disease">Demyelinating</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/CNS_demyelinating_autoimmune_diseases" title="CNS demyelinating autoimmune diseases">Autoimmune</a></li> <li><a href="/wiki/Inflammatory_demyelinating_diseases_of_the_central_nervous_system" title="Inflammatory demyelinating diseases of the central nervous system">Inflammatory</a></li> <li><a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">Multiple sclerosis</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Demyelinating_diseases_of_CNS" title="Template:Demyelinating diseases of CNS">Template:Demyelinating diseases of CNS</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Episodic/ <a href="/wiki/Paroxysmal_attack" title="Paroxysmal attack">paroxysmal</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Epileptic_seizure" class="mw-redirect" title="Epileptic seizure">Seizures</a> and <a href="/wiki/Epilepsy" title="Epilepsy">epilepsy</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Focal_seizure" title="Focal seizure">Focal</a></li> <li><a href="/wiki/Generalized_epilepsy" title="Generalized epilepsy">Generalised</a></li> <li><a href="/wiki/Status_epilepticus" title="Status epilepticus">Status epilepticus</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Epilepsy" class="mw-redirect" title="Template:Epilepsy">Template:Epilepsy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Headache" title="Headache">Headache</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Migraine" title="Migraine">Migraine</a></li> <li><a class="mw-selflink selflink">Cluster</a></li> <li><a href="/wiki/Tension_headache" title="Tension headache">Tension</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Headache" title="Template:Headache">Template:Headache</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrovascular_disease" title="Cerebrovascular disease">Cerebrovascular</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Transient_ischemic_attack" title="Transient ischemic attack">TIA</a></li> <li><a href="/wiki/Stroke" title="Stroke">Stroke</a></li> <li>For more detailed coverage, see <a href="/wiki/Template:Cerebrovascular_diseases" title="Template:Cerebrovascular diseases">Template:Cerebrovascular diseases</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Sleep_disorders" class="mw-redirect" title="Sleep disorders">Sleep disorders</a> <ul><li>For more detailed coverage, see <a href="/wiki/Template:Sleep" title="Template:Sleep">Template:Sleep</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cerebrospinal_fluid" title="Cerebrospinal fluid">CSF</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Intracranial_pressure" title="Intracranial pressure">Intracranial hypertension</a> <ul><li><a href="/wiki/Hydrocephalus" title="Hydrocephalus">Hydrocephalus</a></li> <li><a href="/wiki/Normal_pressure_hydrocephalus" title="Normal pressure hydrocephalus">Normal pressure hydrocephalus</a></li> <li><a href="/wiki/Choroid_plexus_papilloma" title="Choroid plexus papilloma">Choroid plexus papilloma</a></li> <li><a href="/wiki/Idiopathic_intracranial_hypertension" title="Idiopathic intracranial hypertension">Idiopathic intracranial hypertension</a></li></ul></li> <li><a href="/wiki/Cerebral_edema" title="Cerebral edema">Cerebral edema</a></li> <li><a href="/wiki/Spontaneous_cerebrospinal_fluid_leak" class="mw-redirect" title="Spontaneous cerebrospinal fluid leak">Intracranial hypotension</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Brain_herniation" title="Brain herniation">Brain herniation</a></li> <li><a href="/wiki/Reye_syndrome" title="Reye syndrome">Reye syndrome</a></li> <li><a href="/wiki/Hepatic_encephalopathy" title="Hepatic encephalopathy">Hepatic encephalopathy</a></li> <li><a href="/wiki/Toxic_encephalopathy" title="Toxic encephalopathy">Toxic encephalopathy</a></li> <li><a href="/wiki/Hashimoto%27s_encephalopathy" title="Hashimoto's encephalopathy">Hashimoto's encephalopathy</a></li> <li><a href="/wiki/Fetal_alcohol_spectrum_disorder" title="Fetal alcohol spectrum disorder">Static encephalopathy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Both/either</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th id="Degenerative" scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurodegenerative_disease" title="Neurodegenerative disease">Degenerative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Spinocerebellar_ataxia" title="Spinocerebellar ataxia">SA</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Friedreich%27s_ataxia" title="Friedreich's ataxia">Friedreich's ataxia</a></li> <li><a href="/wiki/Ataxia%E2%80%93telangiectasia" title="Ataxia–telangiectasia">Ataxia–telangiectasia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Motor_neuron_diseases" title="Motor neuron diseases">MND</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Upper_motor_neuron" title="Upper motor neuron">UMN</a> only: <ul><li><a href="/wiki/Primary_lateral_sclerosis" title="Primary lateral sclerosis">Primary lateral sclerosis</a></li> <li><a href="/wiki/Pseudobulbar_palsy" title="Pseudobulbar palsy">Pseudobulbar palsy</a></li> <li><a href="/wiki/Hereditary_spastic_paraplegia" title="Hereditary spastic paraplegia">Hereditary spastic paraplegia</a></li></ul></li></ul> <ul><li><a href="/wiki/Lower_motor_neuron" title="Lower motor neuron">LMN</a> only: <ul><li><a href="/wiki/Distal_hereditary_motor_neuronopathies" title="Distal hereditary motor neuronopathies">Distal hereditary motor neuronopathies</a></li> <li><a href="/wiki/Spinal_muscular_atrophies" title="Spinal muscular atrophies">Spinal muscular atrophies</a> <ul><li><a href="/wiki/Spinal_muscular_atrophy" title="Spinal muscular atrophy">SMA</a></li> <li><a href="/wiki/Spinal_and_bulbar_muscular_atrophy" title="Spinal and bulbar muscular atrophy">SMAX1</a></li> <li><a href="/wiki/X-linked_spinal_muscular_atrophy_type_2" title="X-linked spinal muscular atrophy type 2">SMAX2</a></li> <li><a href="/wiki/Distal_spinal_muscular_atrophy_type_1" title="Distal spinal muscular atrophy type 1">DSMA1</a></li> <li><a href="/wiki/Congenital_distal_spinal_muscular_atrophy" title="Congenital distal spinal muscular atrophy">Congenital DSMA</a></li> <li>Spinal muscular atrophy with lower extremity predominance (SMALED) <ul><li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_1" title="Spinal muscular atrophy with lower extremity predominance 1">SMALED1</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2A" title="Spinal muscular atrophy with lower extremity predominance 2A">SMALED2A</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_lower_extremity_predominance_2B" title="Spinal muscular atrophy with lower extremity predominance 2B">SMALED2B</a></li></ul></li> <li><a href="/wiki/Pontocerebellar_hypoplasia" title="Pontocerebellar hypoplasia">SMA-PCH</a></li> <li><a href="/wiki/Spinal_muscular_atrophy_with_progressive_myoclonic_epilepsy" title="Spinal muscular atrophy with progressive myoclonic epilepsy">SMA-PME</a></li></ul></li> <li><a href="/wiki/Progressive_muscular_atrophy" title="Progressive muscular atrophy">Progressive muscular atrophy</a></li> <li><a href="/wiki/Progressive_bulbar_palsy" title="Progressive bulbar palsy">Progressive bulbar palsy</a> <ul><li><a href="/wiki/Fazio%E2%80%93Londe_disease" title="Fazio–Londe disease">Fazio–Londe</a></li> <li><a href="/wiki/Infantile_progressive_bulbar_palsy" title="Infantile progressive bulbar palsy">Infantile progressive bulbar palsy</a></li></ul></li></ul></li></ul> <ul><li>both: <ul><li><a href="/wiki/Amyotrophic_lateral_sclerosis" class="mw-redirect" title="Amyotrophic lateral sclerosis">Amyotrophic lateral sclerosis</a></li></ul></li></ul> </div></td></tr></tbody></table><div></div></td></tr></tbody></table><div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Headache" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Headache" title="Template:Headache"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Headache" title="Template talk:Headache"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Headache" title="Special:EditPage/Template:Headache"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Headache" style="font-size:114%;margin:0 4em"><a href="/wiki/Headache" title="Headache">Headache</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#Primary_headaches" title="International Classification of Headache Disorders">Primary</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_1,_ICD10_G43:_Migraine" title="International Classification of Headache Disorders">ICHD 1</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Migraine" title="Migraine">Migraine</a> <ul><li><a href="/wiki/Familial_hemiplegic_migraine" title="Familial hemiplegic migraine">Familial hemiplegic</a></li></ul></li> <li><a href="/wiki/Retinal_migraine" title="Retinal migraine">Retinal migraine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_2,_ICD10_G44.2:_Tension-type_headache_(TTH)" title="International Classification of Headache Disorders">ICHD 2</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Tension_headache" title="Tension headache">Tension</a> <ul><li><a href="/wiki/Mixed_tension_migraine" title="Mixed tension migraine">Mixed tension migraine</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_3,_ICD10_G44.0:_Cluster_headache_and_other_trigeminal_autonomic_cephalalgias" title="International Classification of Headache Disorders">ICHD 3</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a class="mw-selflink selflink">Cluster</a></li> <li><a href="/wiki/Chronic_paroxysmal_hemicrania" title="Chronic paroxysmal hemicrania">Chronic paroxysmal hemicrania</a></li> <li><a href="/wiki/SUNCT_syndrome" title="SUNCT syndrome">SUNCT</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_4.2C_ICD10_G44.80:_Other_primary_headaches" title="International Classification of Headache Disorders">ICHD 4</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hemicrania_continua" title="Hemicrania continua">Hemicrania continua</a></li> <li><a href="/wiki/Thunderclap_headache" title="Thunderclap headache">Thunderclap headache</a></li> <li><a href="/wiki/Sexual_headache" title="Sexual headache">Sexual headache</a></li> <li><a href="/wiki/New_daily_persistent_headache" title="New daily persistent headache">New daily persistent headache</a></li> <li><a href="/wiki/Hypnic_headache" title="Hypnic headache">Hypnic headache</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#Secondary_headaches" title="International Classification of Headache Disorders">Secondary</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_5.2C_ICD10_G44.88:_Headache_attributed_to_head_and/or_neck_trauma" title="International Classification of Headache Disorders">ICHD 5</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Migralepsy" title="Migralepsy">Migralepsy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_7.2C_ICD10_G44.82:_Headache_attributed_to_non-vascular_intracranial_disorder" title="International Classification of Headache Disorders">ICHD 7</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ictal_headache" title="Ictal headache">Ictal headache</a></li> <li><a href="/wiki/Post-dural-puncture_headache" title="Post-dural-puncture headache">Post-dural-puncture headache</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_8.2C_ICD10_G44.4_or_G44.83:_Headache_attributed_to_a_substance_or_its_withdrawal" title="International Classification of Headache Disorders">ICHD 8</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hangover" title="Hangover">Hangover</a></li> <li><a href="/wiki/Medication_overuse_headache" title="Medication overuse headache">Medication overuse headache</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/International_Classification_of_Headache_Disorders#ICHD_13.2C_ICD10_G44.847.2C_G44.848.2C_or_G44.85:_Cranial_neuralgias_and_central_causes_of_facial_pain" title="International Classification of Headache Disorders">ICHD 13</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Trigeminal_neuralgia" title="Trigeminal neuralgia">Trigeminal neuralgia</a></li> <li><a href="/wiki/Occipital_neuralgia" title="Occipital neuralgia">Occipital neuralgia</a></li> <li><a href="/wiki/External_compression_headache" title="External compression headache">External compression headache</a></li> <li><a href="/wiki/Cold-stimulus_headache" title="Cold-stimulus headache">Cold-stimulus headache</a></li> <li><a href="/wiki/Optic_neuritis" title="Optic neuritis">Optic neuritis</a></li> <li><a href="/wiki/Postherpetic_neuralgia" title="Postherpetic neuralgia">Postherpetic neuralgia</a></li> <li><a href="/wiki/Tolosa%E2%80%93Hunt_syndrome" title="Tolosa–Hunt syndrome">Tolosa–Hunt syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eye_strain" title="Eye strain">Eye strain</a></li> <li><a href="/wiki/Orthostatic_headache" title="Orthostatic headache">Orthostatic</a></li> <li><a href="/wiki/Vascular_headache" title="Vascular headache">Vascular</a></li></ul> </div></td></tr></tbody></table></div>    </div><noscript><img src="https://login.wikimedia.org/wiki/Special:CentralAutoLogin/start?type=1x1" alt="" width="1" height="1" style="border: none; position: absolute;"></noscript> <div class="printfooter" data-nosnippet="">Retrieved from "<a dir="ltr" href="https://en.wikipedia.org/w/index.php?title=Cluster_headache&oldid=1243052249">https://en.wikipedia.org/w/index.php?title=Cluster_headache&oldid=1243052249</a>"</div></div> <div id="catlinks" class="catlinks" data-mw="interface"><div id="mw-normal-catlinks" class="mw-normal-catlinks"><a href="/wiki/Help:Category" title="Help:Category">Categories</a>: <ul><li><a href="/wiki/Category:Ailments_of_unknown_cause" title="Category:Ailments of unknown 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