Evaluation of clinical criteria for cluster headache with special reference to the classification of the International Headache Society.

The diagnostic criteria issued by the International Headache Society (IHS) (1988) and those of the World Federation of Neurology (WFN) (1969) were evaluated vis-à-vis 163 consecutive cases of cluster headache diagnosed according to the criteria of Ekbom (1970). The agreement between the IHS and Ekbom criteria was very good (96.9%). The difference was explained by five patients who all lacked local autonomous symptoms and signs (conjunctival injection, lacrimation, etc.). At least one of these signs is mandatory according to the IHS and thus the patients escaped a definite diagnosis. Agreement between the WFN and Ekbom criteria was 84.0% (n = 163) and between the WFN and IHS criteria only 76.0% (n = 158).