Abstract text (incl. figure legends and references)

Introduction

Cluster headache (CH) is trigeminal autonomic headache presented by the recurrence of unilateral short duration (15-180min) pain attacks with coexisting same-side cranial autonomic symptoms. The atypical form of cluster headache associated with transient hemi-motor, sensory or even visual and aphasic symptoms analogically to migraine is called hemiplegic cluster headache (HCH). This rare form of trigeminal autonomic cephalalgia is not recognised by the International Classification of Headache Disorders (ICHD). Since the first published case series in 2002, only a few cases have been presented so far.

Case presentation

We presented a case of a 50-year-old male that fulfilled the ICHD criteria for episodic CH who experienced atypical attacks characterized by concomitant acute onset of hemi-sensory and hemi-motor symptoms. Using extensive diagnostic panel we excluded the secondary cause of the headache. Exploring the localisation of motor and sensory pathways affectation we used the sensory and motor evoked potentials method.

Conclusion

Neurophysiological parameters show that during the cluster period there is a transient affectation of sensory and motor pathways in the projections of the brain stem and medulla oblongata. This points to potential differences in the mechanism of neural pathway involvement among HCH and different types of primary headaches with coexisting motor and sensory symptomatology.