Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
According to the National Institute for Health and Care Excellence (NICE) guidelines, which inform the diagnosis of primary headaches in the UK, cluster headache is diagnosed based on specific headache features NICE CG150. These features are consistent with the International Classification of Headache Disorders (ICHD) criteria, though the provided context directly references the NICE guideline's table NICE CG150.
- Pain Location: The pain is typically unilateral, occurring around the eye, above the eye, and along the side of the head or face NICE CG150.
- Pain Quality: The quality of pain can vary, described as sharp, boring, burning, throbbing, or tightening NICE CG150.
- Pain Intensity: The pain is severe or very severe NICE CG150.
- Effect on Activities: Individuals often experience restlessness or agitation NICE CG150.
- Associated Symptoms: On the same side as the headache, there are usually associated symptoms such as a red and/or watery eye, nasal congestion and/or a runny nose, a swollen eyelid, forehead and facial sweating, and a constricted pupil and/or drooping eyelid NICE CG150.
- Duration: Each headache attack typically lasts between 15 and 180 minutes NICE CG150.
- Frequency: For episodic cluster headaches, attacks occur from once every other day to 8 times a day, followed by a pain-free period of more than one month NICE CG150. Chronic cluster headaches involve attacks occurring from once every other day to 8 times a day, with a continuous pain-free period of less than one month within a 12-month period NICE CG150.
For a first bout of cluster headache, specialist confirmation of the diagnosis and neuroimaging may be needed NICE CKS.