Diagnostic criteria for paroxysmal hemicrania

At least 20 attacks fulfilling criteria B through E

Severe unilateral orbital, supra-orbital, and/or temporal pain lasting 2 to 30 minutes

Either or both of the following:
1. At least one of the following symptoms or signs, ipsilateral to the headache:
  - Conjunctival injection and/or lacrimation
  - Nasal congestion and/or rhinorrhea
  - Eyelid edema
  - Forehead and facial sweating
  - Miosis and/or ptosis
2. A sense of restlessness or agitation

Attacks have a frequency >5 per day*

Prevented absolutely by therapeutic doses of indomethacin

Not better accounted for by another ICHD-3 diagnosis

Episodic paroxysmal headache

Attacks of paroxysmal hemicrania occurring in periods lasting from seven days to one year, separated by pain-free periods lasting at least three months

Chronic paroxysmal headache

Attacks of paroxysmal hemicrania occurring for more than one year without remission, or with remission periods lasting less than three months

ICHD-3: International Classification of Headache Disorders, 3^rd edition.
* During part, but less than half, of the active time course of paroxysmal hemicrania, attacks may be less frequent.

Reproduced with permission of the International Headache Society. From: Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018; 38:1. Copyright © 2018 International Headache Society. https://ihs-headache.org/en/. https://journals.sagepub.com/home/cep.

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Diagnostic criteria for paroxysmal hemicrania