Clinical reference · Card 02 of 11 · Diagnosis
ICHD-3 criteria for cluster headache
ICHD-3 §3.1 — all five criteria must be met. Reproduced as published. Tick as you go.
AAt least five attacks fulfilling criteria B–D.
BSevere 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, ipsilateral to the headache: conjunctival injection and/or lacrimation; nasal congestion and/or rhinorrhoea; eyelid oedema; forehead and facial sweating; miosis and/or ptosis(2) a sense of restlessness or agitation.
DOccurring with a frequency between one every other day and eight per day for more than half of the time the disorder is active.
ENot better accounted for by another ICHD-3 diagnosis.
3.1.1 EPISODICAt least two cluster periods lasting 7 days to 1 year when untreated, separated by pain-free remission periods of ≥3 months.
3.1.2 CHRONICAttacks fulfilling 3.1 occurring for ≥1 year without remission, or with remission periods lasting <3 months.
Criterion C is an OR, not an ANDA patient with no autonomic signs still meets criterion C if they are restless or agitated during attacks. Restlessness was added as an alternative in ICHD-3 precisely because autonomic features are occasionally absent.
SOURCES Headache Classification Committee of the IHS. The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1–211, §3.1, 3.1.1, 3.1.2. Criteria reproduced as published.
Cluster headache tracking and analysis for patientsmyclusters.nlGet the printed setAll 11 cards, A6, printed back to back. The print-ready PDF unlocks when you request.