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Hemiplegic Cluster Headache.

Ivy Liger Riso1, Mario Fernando Prieto Peres2, Fred Cohen3,4

  • 1Institute of Psychiatry, Hospital Israelita Albert Einstein, São Paulo, Brazil. draivyliger@gmail.com.

Current Pain and Headache Reports
|November 27, 2025
PubMed
Summary
This summary is machine-generated.

Hemiplegic Cluster Headache (HCH) is a rare variant of cluster headache. New diagnostic criteria may improve recognition and treatment of HCH, a condition that can be mistaken for other neurological disorders.

Keywords:
Cluster headacheHemiplegic clusterHemiplegic migraineMigraine

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Area of Science:

  • Neurology
  • Headache Medicine

Background:

  • Cluster headache (CH) is a severe, debilitating primary headache disorder.
  • Atypical presentations, including aura, are increasingly recognized in CH.
  • Hemiplegic Cluster Headache (HCH) is a rare variant characterized by CH symptoms and temporary unilateral weakness.

Purpose of the Study:

  • To review and synthesize existing literature on Hemiplegic Cluster Headache (HCH).
  • To propose diagnostic criteria for HCH based on identified clinical features and treatment responses.
  • To enhance the recognition and understanding of this rare headache variant.

Main Methods:

  • Systematic review of published case reports of HCH.
  • Analysis of clinical features, treatment responses, and potential pathophysiology.
  • Development of proposed diagnostic criteria for HCH.

Main Results:

  • Eight cases of HCH with consistent clinical features and treatment outcomes were identified.
  • Shared pathophysiology between HCH and hemiplegic migraine is suggested.
  • Proposed diagnostic criteria were formulated based on literature findings.

Conclusions:

  • HCH is rare and potentially underdiagnosed.
  • Accurate diagnosis is crucial, as motor weakness may stem from various causes.
  • The proposed criteria aim to improve HCH recognition, treatment, and future research.