cluster headache in children

6 March 2020

Cluster Headache Often Starts Early

A recent study of cluster headache patients around the world shows that early onset cluster is more common than previously thought.

Typically, cluster headache symptoms start between the ages of 20 and 40. At least, that’s been the common belief. But are we missing a significant number of patients who actually get cluster earlier?

A presentation at the 61st Annual Scientific Meeting of the American Headache Society in 2019 shows that the answer may be yes. Although a typically starting in the late 20s, 22% of respondents reported “pediatric onset”, most of these experiencing their first attack during the teenage years (although a significant number did report their first attack in childhood).

This is very important, because cluster is often misdiagnosed. Catching it earlier can certainly lead to a significant improvement in quality of life in the future. In my opinion, it is especially important to improve that quality of life early – not just because there are more potential years of cluster, but because childhood and teenage years are so formative for your future life.

Another interesting aspect of this study is the estimated level of pain. Now some migraine sufferers may actually balk at the fact that migraine comes so far down the list. Yes, many women have reported that migraine pain is worse than childbirth. However, it’s important to remember that migraine may include mild headache, though typically moderate to severe.

So we’re talking about averages. An individual migraine attack may indeed be worse than labour pains. But on average, it’s not. And there is no doubt that the average pain of a cluster headache is worse than the average pain of a migraine headache.

In fact, cluster is one of the worst kinds of pain, as shown on the chart below, based on the study.

You can view the study for yourself in pdf format here: Cluster Headache Is One of the Most Painful Human Conditions: Epidemiology of Cluster Headache and Probable Cluster Headache from a Large International Sample.

20 June 2016

Yes, Children Get Cluster Headache Too

James Information, Resources, Treatments 2

Although cluster headache usually starts in your 20s or 30s, children can, and do, get cluster too. Usually the symptoms start after the age of 10, but children with cluster have been reported as young as 6 years old.

The fact that cluster headache is extremely rare in children is no comfort to children who get it and their families who are trying to help them. Although we’ve talked about cluster headache in children before, it’s time for an update.

As with adult cluster, more males are diagnosed than females. However, a surprising number of girls get cluster as well.

But one of the biggest challenges is diagnosis. A study in 2009 of eleven children found that, on average, their symptoms began at the age of 8.5, but they went two years without a proper diagnosis.

Sadly, headaches in children are often considered to be caused by “stress” or “attitude”. However, a specialist who know what questions to ask can get to the truth a lot faster.

Another challenge is that cluster headache is not usually constant. Attacks typically last from 15 minutes to three hours. But they also go into remission. Headaches may occur once or several times a day for a while, and then disappear for months or years.

Symptoms in children tend to be similar to those in adults. That would include agitation and restless movement, one sided pain, congestion, and facial flushing and sweating. (For more detail, see Cluster Headache Symptoms)

Treatments for cluster are also similar to treatments in adults, partly because precious little study has been done specifically for children. One study found that oxygen, methysergide, verapamil, zolmitriptan and dihydroergotamine were particularly helpful for children, but that paracetamol/acetaminophen, ibuprofen and codeine with paracetamol/acetaminophen were not particularly helpful.

For more information:

3 April 2009

Cluster Headache in Children

James Information 1

Cluster headache in children is not common, but sadly some children do experience it. It’s extremely rare in children under 10, and also in girls under 18. Cluster is much more common in males than in females, so most of the cluster headaches in children hit males over 10.

It’s been estimated that about 1 child in 1,000 has cluster between the ages of 10 and 18.

Cluster headaches get their name from their timing. They tend to be short-lived headaches (usually 15 minutes to 3 hours), one sided, but extremely intense. But they come in cluster periods. That is, you get a whole bunch of them in a cycle lasting usually from 1 to 12 weeks, but then there will be nothing for months or years, until the next cluster period begins.

Unlike migraine attacks, cluster headaches make the child restless. Lying down in a dark room is not what the patient wants to do – more often they will pace.

Every child is different, but common symptoms of cluster headache in children include:

Severe, one-sided pain, usually around one eye
The eye may be red, or the eyelid may droop or swell. The one pupil may also be smaller than the other
Forehead swelling
Congestion, runny nose

Treatment for children is similar to that of adults. Oxygen during an attack may be helpful. Triptan drugs may also be used – some have been studied more than others for children, so ask your doctor what she would recommend. DHE-45 is another drug that has been used successfully for cluster. Read more about cluster headache treatment.

Though cluster headache in children is often treated in a similar way to cluster headache in adults, there are some treatments that have been more successful than others, and there are special concerns with some medications when it comes to children. It’s wise to find a specialist who has treated cluster headache in children before. It might be a challenge, since the condition is rare, but finding an experienced specialist can make a big difference in these incredibly painful episodes.