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What exactly is a Cluster Headache?
A cluster headache (according to International Headache Society criteria {Cephalgia 2004;24 (Suppl 1)} has to satisfy the following criteria:
1) Severe unilateral headache in the orbital, supraorbital, or temporal region lasting 15 minutes to 3 hours.
2) The frequency of headache must vary between one every other day, up to 8 per day.
3) The headache must be associated with either:
- Lacrimation (eye tearing)
- Nasal congestion
- Rhinorrhea (runny nose)
- Forehead/facial swelling
- Miosis (small pupil)
- Ptosis (eyelid partially closed)
- Eyelid edema
- Conjunctival injection (redness in the white part of the eye)
- Sense of restlessness or agitation during the headache
4) No other associated disease
Cluster headaches are considered episodic if they come for 7 days to one year apart with at least a 2-week, pain free break. They are considered chronic if they last longer than one year without a 2-week pain-free break.
So what is paroxysmal hemicrania?
Chronic paroxysmal hemicrania is, for all practical purposes, a “cluster-like” headache that responds completely to the drug indocin. Clues that it is paroxysmal hemicrania instead of cluster headaches are:
- The headaches are shorter and tend to occur more frequently.
- Not all of the headaches are severe.
It is important to keep an accurate history of the headaches in order to help Dr. Loftus or your neurologist correctly diagnose the headaches.
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Shea P.(Patient Since 2012)
I would very highly recommend Dr Loftus. He is caring, knowledgeable and prompt. His staff is wonderful as well. 5 stars!!!
Kathy T.(Patient Since 2017)
For 20+ years I have been told I have Migraines, which was amended to chronic cluster headaches. I have taken numerous medications, given myself shots, applied diets free of caffeine and chocolate, had sinus and neck surgeries, acupuncture, cortisone shots in my head, MRI’s, CAT scans, not to mention all countless visits to the ER, all to no avail. Within 10 minutes speaking with Dr Loftus, he informed me that I had been misdiagnosed all these years, he knew what was wrong, and he has a game plan to help me. I feel extremely confident in his diagnosis and believe I may actually be going in the right direction for once! Thank you so very much Doc, you ROCK! Fingers crossed that he is correct and I will finally have some relief…

Providing headache and hyperhidrosis care & wellness for over 25 years.
Dr. Brian Loftus, M.D.
Dr. Loftus is Board Certified in Headache Medicine as well as Neurology. In private practice since 1994, Dr. Loftus’ practice has gotten busier and he has decided to concentrate his practice in areas that he can make a particular difference compared to other neurologist. Therefore, Dr. Loftus has chosen to focus his neurology practice on headaches & head pain, headaches during pregnancy, and hyperhidrosis. In the spring of 2006, Dr. Loftus relocated his practice from the Texas Medical Center to Bellaire, just 5 miles west. He has been named a Texas Monthly “Super Doctor” and an H Texas magazine “Top Doctor” multiple times.