Cluster Headache: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin and mucous membranes
      • Eyes: concomitantly, at least one of the following characteristics occurs ipsilaterally (on the same side of the face):
        • Red or watery eye (conjunctival redness).
        • Miosis (temporary pupillary constriction) and ptosis (drooping upper eyelid).
        • Eyelid edema
        • Stuffy or runny nose (rhinorrhea/nasal flow and/or nasal congestion).
        • Sweating on the face (rarely also side-different).
    • Auscultation (listening) of the heart.
    • Auscultation of the lungs
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
  • Ophthalmological examination – including tonometry (measurement of intraocular pressure) [due todifferential diagnosis: glaucoma attack – eye disease with seizure-like increased intraocular pressure].
  • ENT medical examination – including inspection of the nasal (sinuses) cavities [due todifferential diagnoses: nasal cavity tumors, paranasal sinus tumors].
  • Neurological examination – including review/examination.
    • Sensorimotor function and reflexes
    • Cranial nerve functions
    • Paresis (paralysis)?, paresthesias (insensations)?
    • Visual disturbances?, bulbar pressure?, movement pain of the eyes?
    • Palpation of the trigeminal exit sites
    • Mobility of the cervical spine?
    • Meningismus (neck stiffness)?
    • Signs of a seizure event?
    • Vigilance (wakefulness)?
    • Orientation, memory, mental state
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.