QuestionSBA
QuestionChoice
This is a typical presentation of cluster headaches. The question describes a unilateral headache, worse around the eye and occurring in episodes/clusters over time. Cluster headaches are associated with a bloodshot eye, rhinorrhoea, lid swelling, and facial flushing. Attacks typically last from 15 minutes to 3 hours.
10007675
a
Cluster headaches
QuestionChoice
Tension headaches present as bilateral and non-pulsatile in nature. They are often described as feeling like a tight band around the head. Although they can be associated with tenderness of the scalp, tension headaches do not cause a painful or red and watery eye. Cluster headache is the most likely diagnosis.
10007677
c
Tension headache
QuestionChoice
Migraines typically present as a unilateral throbbing headache associated with photophobia and phonophobia. Episodes of migraine last longer than cluster headaches, typically ranging from 4-72 hours. Migraines are commonly preceded by an aura, such as visual (e.g lines zigzags) or sensory (paraesthesia) symptoms. You can also look out for migraine triggers, such as oral contraceptives or chocolate.
10007679
e
Migraine
QuestionChoice
This classically presents as a temporal headache alongside jaw claudication (pain on chewing food), scalp tenderness, and sometimes visual impairment. Examination may reveal a thickened tender temporal artery. You should also look out for a patient with symmetrical proximal muscle weakness and oligoarthritis, as giant cell arteritis is often associated with polymyalgia rheumatica.
10007678
d
Giant cell arteritis
QuestionChoice
Trigeminal neuralgia presents as short episodes of sharp, stabbing pain. It affects one side of the face in the trigeminal nerve distribution. They are triggered by talking, eating, or touching the face. By contrast, the headache in this question is not described as following the trigeminal nerve distribution, and it is accompanied by autonomic symptoms more suggestive of a cluster headache.
10007676
b
Trigeminal Neuralgia
Concept
Chapter
2693
3948
Headache
Topic
141
Neurology
14082
A 30-year-old female attends the GP practice complaining of episodes of pain around her left eye and forehead. She tells you that during these episodes she gets a red and watery eye and feels 'stuffy' with a runny nose. The episodes of pain last around an hour and have occurred at random, several times during the last week. Her physical examination is unremarkable.

Which of the following is the most likely diagnosis?
a