A 39-year old man comes to the physician because he has had an intense, stabbing pain behind his left eye for 5 nights. The headaches generally begin 1 hour after he goes to bed and last for about 1 hour. During the pain, he has left-sided nasal stuffiness and tearing from his left eye. He had a similar series of nightly headaches for 6 weeks several years ago. Which of the following is the most likely diagnosis?
A. Cluster headache B. Factitious disorder C. Generalized anxiety disorder D. Sinusitis E. Temporal arteritis F. Tension-type headache
Cluster headaches: recurrent brief attacks of sudden severe unilateral peri-orbital pain. Can occur unexpectedly, often at a specific time of day/year, particularly during sleep. Causes excruciating pain behind the eyes. Idiopathic