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Cluster headache, the most severe of headache conditions, can be effectively treated when a proper diagnosis is made. The diagnosis matters because many of the medications used for migraine are ineffective for cluster headache. Even experienced physicians can misdiagnose cluster headache if they don’t ask all the right questions. For this reason, a well–informed patient who correctly identifies the tell–tale symptoms of cluster headache can make an important contribution to his or her own care.

Migraine versus cluster
Cluster headache, unlike migraine, is much more frequent in males than females. Women who do have cluster headache often have features of migraine as well, complicating the diagnosis. While migraine can involve both sides of the head or switch from one side to the other, cluster headache is strictly unilateral (one–sided). During a headache period, or cluster period, the pain will remain on the same side and area of the head.

Also unlike migraine, cluster headache rarely runs in families. Many physicians who treat cluster headache patients have noticed common behavior and personality features. A majority of male patients are very heavy smokers–two to three packs of cigarettes a day. Some are also heavy drinkers, and most notice that alcohol will trigger an attack during a cluster period. It is not clear whether smoking is a cause of cluster headache, since quitting does not appear to have a direct benefit.