Cluster or Horton's headache (Paediatrics)

Low urgency
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It is a very intense headache around the eyes when the ophthalmic branch of the trigeminal nerve is affected on one side of the cranium. It occurs most frequently in males over 10 years old.

The exact cause is unknown, although it is thought to be the result of a combination of genetic predisposition and exposure to environmental factors such as perfumes.

It presents with a very intense headache in the form of outbreaks that last from fifteen minutes to three hours. It usually recurs at the same time of day. It is accompanied by tearing and reddening of one eye, drooping of the eyelid, runny nose and sweating on the same side of the face.
Diagnosis is clinical, by interrogation and physical examination.
Pain should be controlled with analgesics, oxygen inhalation and relaxation techniques. Triptans (migraine medication) have been shown to be effective in reducing pain. In recurrent cases, it can be prevented with medication such as verapamil +/- cortisone.

Bibliographic references
  1. Daniel J Bonthius, Andrew G Lee, Andrew D Hershey. Headache in children: Approach to evaluation and general management strategies. UpToDate. Aug 18, 2015.
  2. Arne May. Cluster headache: Epidemiology, clinical features, and diagnosis. UpToDate. May 22, 2014.
  3. Nesbitt AD, Goadsby PJ. Cluster headache. BMJ 2012; 344:e2407.
  4. Russell MB. Epidemiology and genetics of cluster headache. Lancet Neurol 2004; 3:279.
  5. Goadsby PJ. Raskin NH. Migraña y otras cefaleas primarias. Harrison. Principios de Medicina Interna. Volumen 2. 19º Edición: 2594-2596.
Author
Dr. Sara Vitoria
Copyright
© TeckelMedical 2026

Symptoms

    Localised headache


    Headache


    Headache behind the eyes


    Headache at night and/or when waking up


    Redness in only one eye

Symptoms to watch out for

Fever (temperature higher than 38 ºC)
Neck stiffness
If it is accompanied by seizures
Loss of sensitivity and/or motility in limbs
If you have suffered a trauma.
Blurry vision
Vomiting

Self-care

Take over-the-counter analgesics and check with your general practitioner to discuss other treatments.
Avoid caffeine, alcohol, smoking and/or screens.