Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • repeated attacks of unilateral pain
  • excruciating pain
  • lacrimation, rhinorrhea, and partial Horner syndrome
  • agitation
  • nausea, vomiting
  • photophobia, phonophobia
  • migrainous aura

Risk factors

  • male gender
  • family history
  • head injury
  • cigarette smoking
  • heavy drinking

Diagnostic investigations

1st investigations to order

  • brain CT scan or MRI
  • erythrocyte sedimentation rate (ESR)
  • pituitary function tests
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Clinical Research Fellow

Headache Group

National Hospital for Neurology and Neurosurgery

London

UK

Disclosures

SM declares that she has received an educational grants from St Jude Medical and Medtronic. SM has received payment for educational presentations from Allergan and Autonomic Technologies, Inc.

Consultant Neurologist

Southern General Hospital

Glasgow

UK

Disclosures

AT has been on advisory boards for Allergan and electroCore. AT has received organisational payments from eNeura, Allergan, and electroCore.

Senior Lecturer and Honorary Consultant Neurologist

Headache Group

National Hospital for Neurology and Neurosurgery

London

UK

Disclosures

MSM serves on the advisory board for Allergan and electroCore. MSM has received research grant funding from Allergan, and he has received hospitality payments from Allergan, eNeura, and electroCore.

Dr Sarah Miller, Dr Alok Tyagi, and Dr Manjit S. Matharu would like to gratefully acknowledge the assistance of Dr Marc S. Husid and Dr Davis L. Mellick. MSH and DLM declare that they have no competing interests.

Peer reviewers VIEW ALL

Director of Headache and Pain Medicine

Professor of Neurology, Anesthesiology, and Rehabilitation Medicine

Icahn School of Medicine at Mount Sinai

New York

NY

Disclosures

MWG declares that he has no competing interests.

Professor

Family and Community Medicine

University of Kansas School of Medicine

Wichita

KS

Disclosures

AW declares that she has no competing interests.

Department Head

Department of Neurology and Pain Medicine

Konventhospital Barmherzige BrĂ¼der Linz

Linz

Austria

Disclosures

CL declares that he has no competing interests.

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