sofidexFor patientsAre you a clinician? Clinical site
Ask Sofi
Listen
Patient SupportEmergencies & Reporting
Log inSign up

Warning-sign checks

Cluster headache: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Call emergency services for a sudden “worst-ever” headache, loss of consciousness, seizure, confusion, weakness, trouble speaking, severe vision loss, fever with neck stiffness, or thoughts of immediate self-harm.

    And for anyone, someone who:

    • has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • has had a seizure that will not stop, or does not wake up afterwards
    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact the treating clinician sooner if attacks are becoming more frequent, lasting longer, changing sides or character, or no longer responding to the usual plan.

    A return of attacks after remission also deserves review because treatment may need to restart promptly.

    Seek urgent medical advice for a new or substantially different headache, new persistent symptoms between attacks, or an eye that remains red and painful with vision changes.

    And for anyone, someone who:

    • has a fever with a stiff neck, a rash that does not fade under pressure, or severe headache
    • is vomiting and cannot keep fluids down
    • has a new severe headache unlike any they have had before
  3. 3

    Does any of this apply?

    Book an appointment

    Arrange routine follow-up after treatment begins or changes.

    A clinician can review the headache diary, confirm that acute treatment works quickly enough, check for side effects, and decide how long preventive treatment should continue.

    Monitoring may include ECGs or blood tests, depending on the medicine.

    These situations are different from routine cluster headache follow-up.

Every sign above is quoted from the sofidex article on Cluster headache. If you are not sure, err upward — it is always reasonable to be checked.