Question

26 yo M presents with severe right temporal headaches associated with ipsilateral rhinorrhea, eye tearing, and redness. Episodes have occurred at the same time every night for the past week and last for 45 minutes most likely dx?

Answer 1

The likely diagnosis for the patient described with predictable, severe, unilateral headaches and associated autonomic symptoms is cluster headache.

Step-by-step explanation:

The symptoms described: severe right temporal headaches, associated with ipsilateral rhinorrhea, eye tearing, and redness, occurring at the same time every night, and lasting for 45 minutes, are suggestive of a cluster headache. This type of headache is particular due to its cyclical pattern and excruciating pain often localized around one eye, which can cause redness and tearing, as well as nose symptoms on the same side. Unlike migraines and tension headaches, which can be more widespread and vary in timing and triggers, cluster headaches tend to occur at consistent times and are relatively short-lived but intensely painful.