- caused by superficial temporal artery smooth muscle hyperperactivity to 5HT
- commoner in male
- rapid onset severe pain around one eye which may become watery and bloodshot with lid swelling, lacrimation, facial flushing, rhinorrhoea, and occasionally transient Horner syndrome
- unilateral, lasts 15-160mins, often nocturnal (waking sufferers at onset of REM sleep)
- treatment: acute attack (100% oxygen at 10-12L/min for 15mins and s/c sumatriptan 6mg or nasal spray sumatriptan 20mg) , prophylaxis (verapamil 120-160mg tds, topiramate)
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