cluster headaches vs migraines

What’s the Difference Between Migraines & Cluster Headaches?

Understanding the Head Pains

Nothing is quite as debilitating as the struggle with migraines or cluster headaches, but how do you know which one you’re experiencing? Both have similar symptoms, but there are some differences. Below we’ll outline everything you need to know about the similarities and differences between cluster headaches and migraines.

What is a Migraine?

I’ve only experienced one migraine in my life, and it was one time too many! It happened when I was in university writing a French exam when suddenly the whole middle of my paper disappeared in front of my eyes. After a few minutes, I experienced a wave of nausea and intense head pain that was completely new to me. The pain was so intense that I could do nothing but lay there in the dark of my room, unable to even sleep away the discomfort.

Migraines are different from other types of headaches because they tend to be more intense, painful and debilitating than a regular headache (though, as we’ll see below cluster headaches can sometimes be worse). If you’re experiencing a migraine, the pain can often make it impossible to go about your day and, as happened with me, to even fall asleep. While you may be able to go about your day with a headache, migraines often get worse during activities, such as climbing stairs.

Symptoms of migraines may also be located throughout the body and not isolated to just your head. However, the pain in your head is likely to be focused on one side at a time as opposed to throughout the whole head. Unfortunately, they also tend to impact women at a rate three times higher than men. One of the most frustrating symptoms of a migraine is that it can last anywhere from four hours to three days if you don’t seek treatment.

What Are the Warning Signs & Symptoms of Migraines?

Warning signs for migraines can appear up to two days in advance–these signs are called prodrome symptoms and include:

  • Frequent yawning.
  • Mood changes, most likely from depression to euphoria.
  • Neck stiffness.
  • Food cravings.
  • Constipation.
  • Fluid retention.
  • Increased urination.

Not everyone who experiences migraines will have prodrome symptoms. It’s also important to note that there can be two types of aural and non-aural. Auras refer to specific neurological symptoms that can occur before or during a migraine, such as the vision loss I experienced during my exam. They are not permanent but can be an indicator that a migraine is coming. Other aura symptoms include:

  • Seeing spots, shapes or bright flashes.
  • Vision loss or disturbance.
  • Trouble speaking.
  • Issues with alertness or concentration.
  • Numbness or tingling in your arms, face and/or legs.
  • Numbness or weakness on one side of your body or face.
  • Changes in smell, touch or taste.

Finally, symptoms of a migraine include:

  • Pain on one side of the head, typically behind the ear or eye.
  • Increased sensitivity to sound and/or light.
  • Vomiting.
  • Nausea.
  • Throbbing pain in the head.

What is a Cluster Headache?

As you might have guessed from the name, cluster headaches are characterized by the "cluster" pattern of the onset of symptoms. As opposed to a migraine that can come on once and never again or which may have long periods between each one, cluster headaches occur in cyclical patterns or cluster periods. They can last from weeks to months, and unfortunately, you may experience headaches every day during this time or even multiple headaches a day. They are believed to be one of the most painful types of headaches.

Some people find there is a seasonal pattern to their cluster periods, while others can experience cluster headache episodes lasting for weeks or months followed by a remission of up to a year. Sadly, since there is still much that is unknown about these types of headaches, there is no way to determine how long a cluster period may last. It’s also impossible to guess if or when the cluster headache will go into remission or how long the pain-free period may last.

Unlike migraines, which can have prodromal symptoms up to two days in advance, cluster headaches often come suddenly and without warning. Some people may experience nausea or aural symptoms before an attack, but they aren’t reliable indicators that one is coming. These headaches can last anywhere from fifteen minutes to three hours and often occur at the same time every day.

Symptoms of Cluster Headaches

Common symptoms of cluster headaches include:

  • Intense pain is often located on one side of the head behind the eye. Unlike migraines, this pain
  • may radiate to other parts of the head and neck.
  • Restlessness or the urge to pace to reduce the pain.
  • Possible sensitivity to sound and light.
  • Flushing or paleness of the face.
  • Facial or forehead sweating.
  • Swelling, droopiness, tearing and/or redness of the affected eye.
  • Localized stuffiness or runniness of the nose on the side the headache started on.

How Do Cluster Headaches & Migraines Differ?

Both migraines and cluster headaches can be debilitating headache disorders. Similarities between the two include:

  • One-sided pain in the head, often starting behind the eye.
  • Nausea.
  • Aura symptoms.

Several differences can help you reliably deduce whether you are experiencing a migraine or a cluster headache. It’s more likely that migraines will cause throbbing pain in the head, and they may be less intense and painful than cluster headaches. Migraines may often have a trigger, such as weather changes or certain foods, that can be pinpointed, whereas cluster headaches seemingly develop out of nowhere. While cluster headaches don't usually last as long as migraines, they can be more frequent due to the clustering pattern.

If you experience either of these headache disorders regularly, you must work with your doctor on a prevention and treatment plan, as both can interfere with daily function.

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