A 22 year old man presents with a recurrent, severe headache in the left periorbital region for 5 months, which occurred between 5 to 10 times each day. The episodes were abrupt in onset, lasted between 30 minutes to 2 hours, and were accompanied by lacrimation and rhinorrhea. There was no aura or any obvious precipitating factors. His medical and surgical histories are unremarkable. He had self-medicated himself with acetaminophen (paracetamol) and ibuprofen so far.
No structural or vascular lesions are detected.
You realize that a temporal artery biopsy is probably not indicated here.
A PET scan will be arranged tomorrow.
The CSF fluid analysis is completely normal.