Persistent, strictly unilateral headache, associated with ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhoea, forehead and facial sweating, miosis, ptosis and/or eyelid oedema, and/or with restlessness or agitation. The headache is absolutely sensitive to indomethacin.

Diagnostic criteria:

A. Unilateral headache fulfilling criteria B-D
B. Present for >3 months, with exacerbations of moderate or greater intensity
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 rhinorrhoea
c) eyelid oedema
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, or aggravation of the pain by movement

D. Responds absolutely to therapeutic doses of indomethacin
E. Not better accounted for by another ICHD-3 diagnosis.


Headache Classification Committee of the International Headache Society (IHS) (2013). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33: 9-807.


  1. Omg, I’ve only had two. The first, I thought of the “wasabi baby”, and imagined myself writing the word “help” on a piece of paper and slipping it to an emergency room physician. Googled “aneurysm” faster than you can say “shoot me”, thought I had about 60 seconds to say goodbye to everybody. At least with the second one I realized I probably would not die. Where can I score some of this drug? Be auae this pain is bullshit.

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