Which physical findings are characteristic of cluster headache (CH)?

Updated: Jun 07, 2019
  • Author: Michelle Blanda, MD; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Characteristic findings include the following:

  • Distinctive facial appearance - Leonine facies, multifurrowed and thickened skin with prominent folds, a broad chin, vertical forehead creases, and nasal telangiectasias

  • Parasympathetic overactivity - Ipsilateral lacrimation, conjunctival injection, rhinorrhea or congestion

  • Ocular sympathetic paralysis - Mild Horner syndrome (eg, ptosis, miosis, and anhidrosis), which may persist between attacks

  • Bradycardia

  • Facial flushing or pallor

  • Scalp and facial tenderness

  • Ipsilateral carotid tenderness (in some patients)

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