International Headache Society Diagnostic Criteria for Cluster Headache

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A. At least five attacks fulfilling criteria B-D.

B. Severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15-180 minutes if untreated.3

C. Headache is accompanied by at least one of the following:

1. Ipsilateral conjunctival injection and/or lacrimation.

2. Ipsilateral nasal congestion and/or rhinorrhea.

3. Ipsilateral eyelid edema.

4. Ipsilateral forehead and facial sweating.

5. Ipsilateral miosis and/or ptosis.

6. A sense of restlessness or agitation.

D. Attacks have a frequency from one every other day to eight per day.*

E. Not attributed to another disorder.c

3During part (but less than half) of the time-course of cluster headache, attacks may be less severe and/or of shorter or longer duration.

*During part (but less than half) of the time-course of cluster headache, attacks may be less frequent. cHistory and physical and neurological examinations do not suggest any of the disorders listed in groups 5-12, or history and/or physical and/or neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but attacks do not occur for the first time in close temporal relation to the disorder.

(Adapted with permission from Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004;24:S9-S60, and from Blackwell Publishing.)

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