Short-lasting primary headaches (except HC) with a common clinical phenotype consisting of trigeminal pain with autonomic signs, which may include lacrimation, rhinorrhoea and miosis.
- Cluster headache (M/C)
- Paroxysmal hemicrania (PH)
- Hemicrania continua (HC)
- Continuous unilateral headache that waxes and wanes in its intensity without complete resolution
- Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)/short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)
Trigeminal-autonomic reflex with parasympathetic activation (hallmark feature):
- Trigeminal-autonomic reflex: Consists of a brainstem connection between the trigeminal nerve and facial cranial nerve parasympathetic outflow
All present with unilateral pain in the distribution of the trigeminal nerve with associated cranial autonomic features ipsilateral to the pain.
Short lasting (except HC) attacks of unilateral severe headache with severe ipsilateral cranial autonomic symptoms.
- Patient is restless during attack
- Ipsilateral cranial autonomic symptoms present
Ipsilateral cranial autonomic symptoms:
- Conjunctival injection and/or lacrimation
- Nasal congestion and/or rhinorrhea
- Eyelid oedema
- Forehead & facial sweating
- Aural fullness
International Classification of Headache Disorders-3 beta (2013) diagnostic criteria: