Understanding Cluster Headaches & Autonomic Symptoms

Cluster headaches are frequently accompanied by autonomic symptoms that make these types of painful headaches even more unbearable. Here is a description of the kind of autonomic symptoms that commonly occur with cluster headaches and how to effectively manage those symptoms.

What are Autonomic Symptoms?

Autonomic neuropathy controls important bodily functions like heart rate, breathing rate, and body temperature. When the autonomic nervous system is damaged, the symptoms can be mild to life-threatening. There are certain autonomic symptoms that are closely associated with cluster headaches, including a watering eye, nasal congestion, and swelling around one eye. According to a recent study published in the Journal of Neuropsychiatric Disease and Treatment, “Symptoms of CH include severe unilateral orbital, supraorbital and/or temporal pain lasting from 15 minutes to 180 minutes if untreated, associated with at least one of the autonomic symptoms, such as conjunctival injection, lacrimation, nasal congestion and rhinorrhea, facial sweating, miosis, ptosis, and eyelid edema.” The most common autonomic symptoms that a cluster headache sufferer may experience are pupil constriction, conjunctiva redness, a drooping eyelid, and a runny nose. In rarer cases, autonomic symptoms of blushing and sweating may appear on one side of the head as well.

Why Cluster Headaches Cause Autonomic Symptoms

Cluster headaches are a type of headache disorder classified as trigeminal autonomic cephalalgias. These headaches involve activity of the trigeminal nerve, which carries sensations from the face to the brain. When this nerve is activated, the eye pain associated with a cluster headache occurs. This nerve is also connected to the parasympathetic autonomic system to regulate the heart, blood vessels, and other involuntary muscle activity. Autonomic symptoms, like nasal congestion and tearing of the eye result when the trigeminal nerve stimulates the body’s autonomic system. When two or more autonomic symptoms are present with a severe periocular headache, doctors are more likely to confirm a cluster headache diagnosis. This is a good way to distinguish cluster headaches from migraines and prevent a misdiagnosis. Cluster headaches that are not accompanied by autonomic symptoms represent milder forms of the condition.

How Autonomic Symptoms Can Be Managed

Since there is no cure for cluster headaches, it is important to be able to manage autonomic symptoms in an effective way. Oxygen inhalation and triptan drug injections are recommended for severe cluster headaches during an attack, as well as nasal sprays of dihydroergotamine and lidocaine. Surgical interventions may be considered in severe cases if no other methods of therapy have been effective. To manage autonomic dysfunction, it is important to treat the specific autonomic symptoms that one is suffering from. Treatment recommendations are based on what part of the body is most affected by nerve damage. For some patients, avoidance of alcohol, medications that decrease perspiration, isometric exercises, and artificial tears are recommended. Individuals with autonomic dysfunction may also benefit from taking a fiber supplement and consuming four to five small meals per day. Maintaining a regular sleep schedule, stopping smoking, and practicing good hygiene may also help prevent the onset of some autonomic symptoms.