10th June 2021

A 52-year-old woman attends her GP, complaining of a headache

A 52-year-old woman attends her GP, complaining of a headache. She describes having episodes lasting around 2 hours, which begin abruptly and can occur several times a day. The pain is severe and localises to her left eye and forehead. She has had this headache every day for the past several weeks. Before the headaches begin, she experiences tingling in her fingers, and her vision darkens. She has a history of hypertension, and her mother and sister suffer with migraines, and the patient thinks she is suffering the same. However, the GP tells her that they think it is more likely to be cluster headaches.

Which THREE of the following features would suggest a diagnosis of cluster headaches rather than migraine?  Select THREE options only.