The most common trigeminal autonomic headache is cluster headache. The word “cluster” is derived from English and means “group” or “heap” (synonyms: Bing-Horton neuralgia; Horton headache; Horton neuralgia; Horton syndrome; ICD-10-GM G44.0: cluster headache). The pain occurs in attacks and is unilateral and severe. It is usually located behind the eye.
It is a phasic headache. These phases can last from seven days to a year. However, headache phases of four to twelve weeks are most common. During this time, headache attacks occur up to 8 times a day. Concentrated attacks also occur at night. Such an attack can last between 15 minutes and three hours. Between the headache phases there are always inactive phases that last at least two weeks.
Seasonal clustering of the disease: The attacks occur more frequently in spring or autumn.
Cluster headache is termed chronic cluster headache when attacks occur throughout the year without a headache-free period of 4 weeks duration or longer.
Sex ratio: Male to female is 3: 1.
Frequency peak: The disease occurs predominantly between the 28th and 30th year of life. In rare cases, the disease may occur in childhood.
The prevalence (frequency of disease) is approximately 0.1-0.9%.
The incidence (frequency of new cases) is approximately 7-119 cases per 100,000 inhabitants per year (in Germany).
Course and prognosis: Occurrence of short unilateral head and/or facial pain attacks (pain in the area of the eye and temple, only on one side of the face). Attacks last from 15 minutes to 3 hours. On the affected side, symptoms may include a watery or red eye (conjunctival redness), a stuffy or runny nose (rhinorrhea/nasal runny and/or nasal congestion), and increased sweating in the area of the forehead and face. Predominantly, the same side of the face is always affected. Often the affected persons show restlessness in movement. In 12-20% of cases, the disease is chronic. In old age, however, the frequency of attacks decreases. With adequate therapy started early, the acute pain attacks can be well treated and the frequency and severity reduced.