title: Evaluation of the new ICHD-III beta cluster headache criteria.
abstract: OBJECTIVE
  In the revised criteria of the International Classification of Headache Disorders (ICHD-III beta) the following items are added to the diagnostic criteria of cluster headache: ipsilateral sensation of fullness in the ear and ipsilateral forehead/facial flushing. We evaluated the possible additional value of these symptoms for diagnosing cluster headache.
  
  
  METHODS
  In this cross-sectional cohort study of (potential) cluster headache patients we investigated these additional symptoms using a Web-based questionnaire. Patients not fulfilling the ICHD-II criteria for cluster headache but fulfilling the ICHD-III beta criteria were interviewed.
  
  
  RESULTS
  Response rate was 916/1138 (80.5%). Of all 573 patients with cluster headache according to ICHD-II criteria, 192 (33.5%) reported ipsilateral ear fullness and 113 (19.7%) facial flushing during attacks. There was no difference in reporting ipsilateral ear fullness and facial flushing between patients who received a diagnosis of cluster headache and patients who did not. None of the patients who did not fulfill all ICHD-II criteria could be categorized as cluster headache according to the ICHD-III beta criteria.
  
  
  CONCLUSIONS
  The results of this study do not support the addition of ear fullness and facial flushing to the new ICHD-III beta criteria.
authors.affiliation: Department of Neurology, Leiden University Medical Center, the Netherlands g.m.terwindt@lumc.nl.
authors.forename: I F
authors.initials: IF
authors.lastname: de Coo
authors.affiliation: Department of Neurology, Leiden University Medical Center, the Netherlands.
authors.forename: L A
authors.initials: LA
authors.lastname: Wilbrink
authors.affiliation: Department of Neurology, Leiden University Medical Center, the Netherlands Department of Neurology, Alrijne Hospital, the Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Haan
authors.affiliation: Department of Neurology, Leiden University Medical Center, the Netherlands.
authors.forename: M D
authors.initials: MD
authors.lastname: Ferrari
authors.affiliation: Department of Neurology, Leiden University Medical Center, the Netherlands.
authors.forename: G M
authors.initials: GM
authors.lastname: Terwindt
mesh_terms: D000328:Adult; D000368:Aged; D003027:Cluster Headache / Q000150:complications / Q000175:diagnosis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004427:Ear Diseases / Q000453:epidemiology; D005260:Female; D005483:Flushing / Q000453:epidemiology; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: Cluster headache; ICHD criteria; classification; diagnosis; ear fullness; facial flushing