Cluster Headache: Classification

Cluster headache belongs to the trigeminal autonomic headache (TAK) group according to the 2013 revised IHS classification:

  • Episodic and chronic cluster headache (CK).
  • Episodic and chronic paroxysmal hemicrania (CPH).
  • SUNCT syndrome (short-lasting unilateral neuralgiform headache with conjunctival injection and tearing).
  • SUNA syndrome (short-lasting unilateral neuralgiform headache with autonomic symptoms).
  • Hemicrania continua (HC)

Diagnostic criteria: Cluster headache (ICHD-3 beta 2013).

A At least 5 attacks that meet criteria B-D.
B Severe or very severe unilateral pain localized orbital (belonging to the orbit) , supraorbital (“located above the orbit”), and/or temporal (“located in the temporal region”), lasting (untreated) 15 to 180 minutes.
C One or both of the following are present:
1. ipsilateral (on the same side) to the pain, at least one of the following symptoms or signs is found:

  1. Conjunctival injection (bright red, clearly visible conjunctival vessels with increased filling) and/or lacrimation (production and secretion of lacrimal fluid).
  2. Nasal congestion (“stuffy nose“) and/or rhinorrhea (runny nose).
  3. Eyelid edema (swelling (edema) of the eyelids caused by fluid leakage into the tissue).
  4. Sweating in the area of the forehead or face.
  5. Redness in the area of the forehead or face
  6. Fullness in the ear
  7. Miosis (disfigurement of the pupil) and/or ptosis (visible drooping of an upper eyelid).

2. feeling of restlessness or agitation.
D Attack frequency ranges from 1 attack every 2nd day to 8 / day for more than half of the active cluster period.
E Not better explained by another ICHD-3 diagnosis.

Diagnostic criteria: episodic cluster headache (ICHD-3 beta 2013).

A Attacks that meet the criteria for cluster headache and occur in phases (cluster periods).
B At least 2 cluster periods lasting from 7 days to 1 year (if untreated) separated by pain-free remission periods of at least 1 month duration.