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In episodic cluster headache, these headaches occur once or more daily, often at the same times each day, for a period of several weeks, followed by a headache-free period lasting weeks, months, or even years. Approximately 10-15% of cluster headache sufferers are chronic; they can experience multiple headaches every day for years. Cluster headaches are occasionally referred to as "alarm clock headaches", as they can occur at night and wake a person from sleep. Other synonyms for cluster headache include Horton's syndrome and "suicide headaches" (a reference to the excruciating pain and resulting desperation).

Medically, cluster headaches are considered benign, but they are extremely painful and can be debilitating. The location and type of pain has been compared to a ' brain-freeze' headache from rapidly eating ice cream; this analogy is limited, but may offer some insight into the cluster headache experience. Persons who have experienced both cluster headaches and other painful conditions (childbirth, migraines) report that the pain of cluster headaches is far worse. During a cluster headache attack, a person often alternates between pacing and laying still. Sensitivity to light (seeking the dark) is more typical of a migraine, as is vomiting but they can be present in some sufferers of cluster headache.

Whereas other headaches, such as migraines occur more often in women, cluster headaches occur in men at a rate 2.5 to 3 times greater than in women. Between 1 and 4 people per thousand experience cluster headaches in the U.S. and Western Europe; statistics for other parts of the world are fragmentary. Latitude plays a role in the occurrence of cluster headaches, which are more common as one moves away from the equator towards the poles. It is believed that greater changes in day length are responsible for the increase.

While the immediate cause of pain is in the trigeminal nerve, the true cause(s) of cluster headache is complex and not fully understood. Among the most widely accepted theories is that cluster headaches are due to an abnormality in the hypothalamus. This can explain why cluster headaches frequently strike around the same time each day, and during a particular season, as one of the functions the hypothalamus performs is regulation of the biological clock. Certain immune dysfunctions and metabolic abnormalities have also been reported in patients. There is a genetic component to cluster headaches, although no single gene has been identified as the cause. As a group, cluster headache patients are more likely to have suffered brain trauma than the general population. Sinus problems, damage to the jaw, and sleep apnea are also more common in cluster headache patients, but these factors do not adequately explain the disease.

Many doctors are unfamiliar with this disease, and cluster headaches often go undiagnosed for many years. Paroxysmal Hemicrania (PH) is a condition similar to cluster headache, but PH responds well to treatment with the anti-inflammitory drug indomethacin and the attacks are very much shorter, often lasting seconds only.

Over the counter pain medications (such as aspirin, acetaminophen, and ibuprofen) have no effect on the pain from a cluster headache. Some have reported partial relief from narcotic pain killers, but the frequency of their use in a cluster cycle (1-3 times a day) often disqualifies them from use. However, some newer medications like fentanyl have shown great promise in early studies and use.

Medications to treat cluster headaches are classified as either abortives or prophylactics (preventatives). The most successful abortives include breathing pure oxygen (12-15 liters per minute in a non-rebreathing apparatus) and triptan drugs like sumitriptan and zolmitriptan. A wide variety of prophylactic medicines are in use, and patient response to these is highly variable. Preventitives include muscle relaxants, lithiumThis article is about Lithium, the element. For the article on mood-stabilizing drugs, see Lithium salt. Lithium is the chemical element with symbol Li and atomic number 3. In the periodic table, it is located in group 1, among the alkali metals. Lithium, calcium channel blockers such as Verapimil, ergotAn ergot kernel occurs when a normal grain kernel is replaced by a sclerotium, or fungal body, as a result of infection by the Claviceps purpurea fungus. Ergot can affect a number of cereals and grasses, including rye (its most common host), triticale, wh compounds, anti-seizure medicines, and atypical anti-psychotics.

There is substantial anecdotal evidence that psilocybinPsilocybin 4-phosphoryloxy-N,N-di methyl tryptamine is a psychedelic alkaloid of the tryptamine family. It is present in many species of fungi, notably Psilocybe cubensis and Psilocybe semilanceata (Liberty Caps). Psilocybin-containing mushrooms are commo (mushrooms) and LSDD-Lysergic Acid Diethylamide commonly called acid LSD or LSD-25 is a powerful semisynthetic hallucinogen and psychedelic entheogen. A typical dose of LSD is only 100 micrograms, a tiny amount equal to one-tenth the weight of a grain of sand. LSD causes of may be able to abort cluster cycles. A clinical study under the auspices of MAPS is being developed at Harvard University.

Some people with extreme headaches of this nature (especially if they are not unilateral) may actually have something else: an ictal headacheIctal headaches are headaches associated with seizure activity. They may occur either before (pre-ictal), after (post-ictal), or most rarely during a seizure. Many cases of ictal headache may be misdiagnosed as migraine with aura, or even cluster headache. Anti-convulsant medications can significantly improve this condition, so make sure you talk with your doctor about this possibility if you think you might be affected.