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Cluster Headache

Cluster headache symptoms are rarely confused for TMD although it remains important to identify these as they are treatable. Most forms of cluster headache will have symptomatic orbital or ocular involvement, and patients will give a description of an episodic pattern to the headache as well as a sensation of restlessness. The condition is more common in males and often associated with rhinorrhea, epiphora, and flushing of the skin.

The primary treatment for cluster headache is the administration of oxygen. If oxygen is unsuccessful, many of the medications used to treat migraine can be considered as well as surgical sympathectomy (Box 1.5).

Box 1.5: Cluster Headache [2]

A. At least five attacks fulfilling criteria B-D

B. Severe or very severe unilateral orbital, supraorbital, and/or temporal pain lasting 15-180 minutes (when untreated)

C. Either or both of the following:

  • 1. At least one of the following symptoms or signs, ipsilateral to the headache:
    • (a) Conjunctival injection and/or lacrimation
    • (b) Nasal congestion and/or rhinorrhea
    • (c) Eyelid edema
    • (d) Forehead and facial sweating
    • (e) Forehead and facial flushing
    • (f) Sensation of fullness in the ear
    • (g) Miosis and/or ptosis
  • 2. A sense of restlessness or agitation

D. Attacks have a frequency between one every other day and eight per day for more than half of the time when the disorder is active

E. Not better accounted for by another ICHD-3 diagnosis

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