Cluster headache.

Cluster headache is characterized by regular periodicity, high frequency during a cluster period, relative brevity, and extreme intensity. Lancinations, as in trigeminal neuralgia, are rare. An important behavioral difference between migraine and cluster headache is that the patient is usually hyperactive during a cluster headache, whereas the migraineur retreats to a dark, quiet room. Cluster headache is more common in middle-aged men; migraine is more common in young women. Intermediate or overlap syndromes occur. Many of the same prophylactic and abortive treatments are effective in both, although in cluster headache there is a premium on rapid action.