QuestionSBA
QuestionChoice
Migraines are twice as common in women as in men. They are characterised by a unilateral throbbing headache sometimes preceded by an aura, such as visual (eg. lines, zigzags) or sensory (paraesthesia spreading from fingers to face) symptoms. The headache may last 4-72 hours and is associated with photophobia and phonophobia. This contrasts with the shorter headache duration and presence of lacrimation seen in this patient.
10008016
b
Migraine
QuestionChoice
Trigeminal neuralgia is characterised by recurrent short episodes of severe stabbing pain, affecting one side of the face, in the trigeminal nerve distribution. The pain may be triggered by touching the face, eating, or talking. Patients are typically over the age of 50.
10008018
d
Trigeminal neuralgia
QuestionChoice
The most common cause of chronic recurring head pain, tension headaches are more likely to affect women than men. They present as bilateral, non-pulsatile headaches that can be described as a tight band around the head. They may be associated with tenderness of the scalp muscles, as it is thought that their contraction is the primary source of the pain.
10008017
c
Tension headache
QuestionChoice
This is a type of headache associated with the long-term use of analgesics. This patient is not on any regular medication, making this option incorrect.
10008019
e
Medication-overuse headache
QuestionChoice
Cluster headaches are one of the few primary headaches that affect men predominantly, as well as those who smoke. They are characterised by recurrent attacks of sudden-onset unilateral periorbital pain, associated with a watery and bloodshot eye, lacrimation, rhinorrhoea, miosis, ptosis, lid swelling, and facial flushing. Headaches last 15 minutes to 3 hours, typically occurring once or twice a day over a period of 4-12 weeks. They are often followed by a pain-free period of months before the next cluster begins.
10008015
a
Cluster headache
Concept
Chapter
2693
3948
Headache
Topic
141
Neurology
14150
A 35-year-old man presents to the GP with severe pain behind his left eye. The pain occurs intermittently, lasting between 30 minutes and 2 hours. When the episodes start, they tend to occur several times a day over the first few months, but then seem to reduce in frequency over the following months. During the episodes, his left eye becomes red and watery.

He is otherwise well, with no past medical history and no regular medications. He does not drink alcohol but has been a heavy smoker for the past 20 years.

Which of the following is the most likely diagnosis?
a