2nd September 2020

A 32 year old smoker presents to you. He has been suffering with painful headaches for the last 2 weeks

A 32 year old smoker presents to you. He has been suffering with painful headaches for the last 2 weeks. They come on suddenly, he has about 4 attacks a day, with each lasting around an hour. He has noticed that he always gets the first episode just after breakfast.  He describes them as extremely painful, he can’t sit still when they happen. The pain is always on the right side of his face. When the pain occurs, his right eye will tear up and his nose starts to stream. His partner has also noticed that the patient’s right eye lid will droop and that his pupil becomes smaller than on the left. He had a similar episode of frequent headaches about 6 weeks ago. 

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.