The painful attacks are as if having been stroked by a hatchet into the forehead, the temple and behind the eye, and they practically never change the side. They often occur every day or preferably night at the same time. The pain is so strong that the patient cannot tolerate lying in the bed but has to get up and run about, banging his head. The pain lasts from ten minutes to two hours. Because of the very acute beginning and the relatively short endurance cluster headache is often confounded with trigeminal neuralgia.
Cluster headache is rare.
It may become chronic. A rare form of chronic unilateral temporal headache similar to chronic cluster headache but occurring mostly with females is probably of spondylogetic origin. It responds specifically to non steroid antirheumaticals, especially Indomethacine. There is no known technical diagnostic tool that will allow the positive diagnosis of a cluster headache. However, you might be happy with a normal blood sedimentation rate to distinguish it from a Horton's arteritis.