Cluster headache and related disorders

Cluster headache is a well-known primary headache syndrome occurring much less frequently than migraine, with a prevalence of approximately 5/10,000 of the adult population and a strongly male predilection. Cluster headache is the most prevalent of a group of unilateral headache syndromes known as trigeminal autonomic cephalalgias and can be differentiated from migraine by clinical and pathophysiological features. Cluster headache also exhibits a differing therapeutic response to medications when compared with migraine. Cluster attacks are known for their brief intense unilateral excruciating pain with unilateral autonomic features often associated with restlessness in contrast to migraine. The great majority of patients are successfully managed with medical therapy. Treatment is pharmacologic, both as abortive treatments for an ongoing attack and daily prophylactic treatment. Prophylaxis aims to induce and maintain a remission. Health care professionals familiar with the features of cluster headache should have no trouble making the diagnosis and creating a treatment plan.