Which headache type presents as unilateral, orbital headaches with autonomic symptoms such as lacrimation and rhinorrhea?

Which headache type presents as unilateral, orbital headaches with autonomic symptoms such as lacrimation and rhinorrhea?

• A. Migraine
• B. Tension-type
• C. Cluster
• D. Temporal arteritis

Answer: (C)

Unilateral orbital headaches with autonomic symptoms are classic for cluster headaches, a type of trigeminal autonomic cephalalgia. The pain is severe and one-sided around the eye or orbit, lasting short bursts (about 15 minutes to 3 hours) and often accompanied by restlessness. On the same side, autonomic signs such as tearing and a runny nose commonly occur, and may be accompanied by eye redness, drooping of the eyelid, or constricted pupil. Attacks tend to come in groups or “clusters” over weeks to months, with remission periods in between, and they often strike at night. Migraine can be unilateral but is typically pulsatile and associated with nausea, photophobia, or phonophobia, not the prominent orbital autonomic symptoms described. Tension-type headaches are usually bilateral and pressing in quality, without autonomic features. Temporal arteritis occurs in older adults and features like jaw claudication or vision changes, not the ipsilateral lacrimation and rhinorrhea characteristic of cluster headaches.

Unilateral orbital headaches with autonomic symptoms are classic for cluster headaches, a type of trigeminal autonomic cephalalgia. The pain is severe and one-sided around the eye or orbit, lasting short bursts (about 15 minutes to 3 hours) and often accompanied by restlessness. On the same side, autonomic signs such as tearing and a runny nose commonly occur, and may be accompanied by eye redness, drooping of the eyelid, or constricted pupil. Attacks tend to come in groups or “clusters” over weeks to months, with remission periods in between, and they often strike at night.

Migraine can be unilateral but is typically pulsatile and associated with nausea, photophobia, or phonophobia, not the prominent orbital autonomic symptoms described. Tension-type headaches are usually bilateral and pressing in quality, without autonomic features. Temporal arteritis occurs in older adults and features like jaw claudication or vision changes, not the ipsilateral lacrimation and rhinorrhea characteristic of cluster headaches.