A3.3 Short-lasting unilateral neuralgiform headache attacks (alternative criteria)

Diagnostic criteria
  1. At least 20 attacks fulfilling criteria B–D
  2. Moderate or severe unilateral head pain, with orbital, supraorbital, temporal and/or other trigeminal distribution, lasting for 1–600 seconds and occurring as single stabs, series of stabs or in a saw-tooth pattern
  3. At least one of the following cranial autonomic symptoms or signs, ipsilateral to the pain:
    1. conjunctival injection and/or lacrimation
    2. nasal congestion and/or rhinorrhoea
    3. eyelid oedema
    4. forehead and facial sweating
    5. forehead and facial flushing
    6. sensation of fullness in the ear
    7. miosis and/or ptosis
  4. Occurring with a frequency of at least one a day1
  5. Not better accounted for by another ICHD-3 diagnosis.
Note:

During part, but less than half, of the active time-course of A3.3 Short-lasting unilateral neuralgiform headache attacks, attacks may be less frequent.

Comment:

Opinion is divided on inclusion of C5 and C6. Experts in the working group believe it improves sensitivity without significant loss of specificity, but formal field testing has not been performed to support the change in criteria.