Fast Five Quiz: Test Your Clinical Knowledge of Various Types of Headaches

Amy Kao, MD

Disclosures

November 27, 2018

Typically, a patient experiences one or two cluster periods per year, each lasting 2 weeks to 3 months.

The IHS classifies cluster headache as episodic or chronic on the basis of duration, as follows:

  • Episodic cluster headache occurs in periods lasting from 7 days to 1 year; cluster attacks are separated by pain-free intervals at least 3 months long

  • Chronic cluster headache persists for more than 1 year either without remission or with remissions shorter than 3 months; it may be de novo or evolve from episodic cluster headache

According to the diagnostic criteria developed by the IHS, cluster headache has the following characteristics:

  • The patient experiences attacks of severe or very severe, strictly unilateral pain (orbital, supraorbital, or temporal pain) that last 15-180 minutes and occur from once every other day to eight times a day

  • The attacks are associated with a sense of restlessness or agitation and/or one or more of the following (all ipsilateral): conjunctival injection and/or lacrimation, nasal congestion and/or rhinorrhea, forehead and facial sweating, miosis and/or ptosis, and eyelid edema

About 80% of patients with episodic cluster headache maintain the episodic form of the disorder. In 4%-13%, episodic cluster headache eventually transforms into chronic cluster headache. Intermediate (mixed) forms may also develop.

During an attack of cluster headache, as many as 90% of patients may become agitated and extremely restless. They do not like to lie down to rest; instead, they prefer to pace or move around. In desperation, patients may rock, sit, pace, bang themselves against a hard surface, scream in pain, or crawl on the floor.

For more on cluster headaches, read here.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....