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Could this be cluster headache?

A short screening tool based on ICHD-3 diagnostic criteria. It cannot diagnose you, but it can help you decide whether to ask your GP specifically about cluster headache.

Awaiting clinical review · This page is awaiting completed review by a New Zealand neurologist. It is based on ICHD-3 criteria and published clinical guidelines, and is not a substitute for medical advice. How we prepare clinical content

Headache types can present differently in different people. If you have any concerns about your headache (including any change in headache character, or a new headache), discussing it with your GP is an excellent place to start.

Answer based on your typical untreated attacks. If medicines, oxygen or other treatments shorten the attack, think about how long it would usually last without treatment.

This tool is not a diagnostic test. It cannot diagnose cluster headache, rule out any other condition, or tell you whether your headache is dangerous. Only a doctor can do that after examining you. It's designed to help you organise your symptoms clearly, so your answers become a conversation starter with your GP, not a result.

0/7 screening answers matched so far

Before you continue: check these warning signs first

A few symptoms need urgent medical care, not a self-screening tool. Stop and call 111 or go to your nearest emergency department if:

  • Your headache hit full, worst-ever intensity within seconds, with little or no build-up, often described as "the worst headache of your life." (A cluster attack is severe, but it usually builds over several minutes; this is different.)
  • You have new weakness, confusion, fainting, a seizure, new vision loss, or trouble speaking.
  • You have a fever, stiff neck, rash, or feel severely unwell alongside the headache.
  • This is a new pattern of severe headaches starting for the first time after age 50.

If you're not sure whether any of this applies to you, call Healthline free, any time, on 0800 611 116. If none of this applies, continue with the questions below.

Compare your attacks with ICHD-3 criteria

Cluster headache is diagnosed clinically, using the pattern and features of your attacks.

Have you had at least 5 attacks with this same pattern?

ICHD-3 requires at least 5 attacks.

Cluster headache is usually recognised by repeated attacks with a very similar pattern. If this is your first ever severe headache, get medical advice even if several answers sound like cluster headache.

Is each attack severe to extreme and strongest on one side around the eye, above the eye or at the temple?

This means orbital, supraorbital or temporal pain.

Validated cluster-headache screening research, including the Erwin Test, found pain intensity to be one of the strongest screening domains. Cluster headache pain is usually severe or extreme and centred around one eye, above the eye or at the temple.

Does an untreated attack usually last 15 to 180 minutes?

That is 15 minutes to 3 hours. Validated screeners also ask whether attacks are under 4 hours.

ICHD-3 uses 15 to 180 minutes for untreated cluster headache attacks. The Erwin Test uses a broader under-4-hours duration question, which helps separate cluster headache from many migraine attacks without pretending duration alone can diagnose it.

During attacks, do you get same-side eye redness, tearing, blocked or runny nose, eyelid swelling, sweating, small pupil or droopy eyelid?

The symptom should be on the same side as the pain.

These are cranial autonomic symptoms. They matter because cluster headache is a trigeminal autonomic cephalalgia: the pain and eye/nose signs often happen together on the same side.

During attacks, do you feel restless or agitated, such as pacing, rocking or being unable to lie still?

Restlessness can satisfy the same ICHD-3 criterion as autonomic symptoms.

Many people with migraine want to lie still. Many people with cluster headache cannot. Pacing, rocking, pressing the head or needing to move can be a useful clue.

During an active period, do attacks occur between once every 2 days and 8 times per day?

This is the ICHD-3 frequency range.

Cluster headache attacks tend to repeat during an active period, often daily or more than daily, then may disappear for weeks, months or years in episodic cluster headache.

Do your symptoms fit cluster headache better than other explanations such as migraine, sinusitis or a dental problem?

A clinician still needs to rule out other causes.

This is not asking you to diagnose yourself. It asks whether the pattern still makes sense as cluster headache after considering common lookalikes such as migraine, sinus, dental pain and other one-sided headache disorders.

Add details for your GP summary

These answers do not change the score, but they make the summary more useful.

Answer the questions to see how closely your pattern matches.

Your result will appear here. The tool checks how closely your pattern matches the core ICHD-3 features of cluster headache.

This result is not a diagnosis. If your symptoms change, worsen, or match any of the warning signs above, seek urgent care now: call 111 or Healthline free on 0800 611 116, regardless of this result.

GP discussion summary