Cluster headache is diagnosed from a highly characteristic pattern: severe one-sided pain around or behind the eye, lasting fifteen minutes to three hours, with tearing, a red eye, nasal congestion or a drooping eyelid on the same side, occurring in bouts.
Cluster headache is diagnosed from a highly characteristic pattern: severe one-sided pain around or behind the eye, lasting fifteen minutes to three hours, with tearing, a red eye, nasal congestion or a drooping eyelid on the same side, occurring in bouts.
The pain is strictly one-sided, centred around or behind the eye or the temple, and it is severe. Attacks last between roughly fifteen minutes and three hours untreated, and recur from once every other day up to several times daily. They frequently strike at the same time each day, often waking people at night. Unlike migraine, where people want to lie still in the dark, cluster headache typically makes people restless, pacing or rocking, because staying still is intolerable.
The diagnosis requires accompanying signs on the same side as the pain: a watering or red eye, a blocked or running nostril, sweating of the forehead or face, a drooping eyelid, or a constricted pupil. These are what distinguish cluster headache from migraine and from other one-sided headaches. Attacks occurring in bouts lasting weeks to months, separated by remission periods, is the classic rhythm that gives the condition its name.
Imaging is generally arranged at least once, because a structure near the cavernous sinus or pituitary can mimic the syndrome closely. It is performed externally since these offices have no imaging suite. Cluster headache is frequently misdiagnosed for years as sinusitis, dental problems or migraine, partly because it is uncommon and partly because the autonomic features get attributed to sinus disease. Describing the strict one-sidedness, the timing and the restlessness usually resolves it quickly.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: headache; American Academy of Neurology; National Institute of Neurological Disorders and Stroke.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.