Differential Diagnosis for Headache Syndrome
Single Most Likely Diagnosis
- Short-Lasting Unilateral Neuralgiform Headache with Conjunctival Injection and Tearing (SUNCT) or Short-Lasting Unilateral Neuralgiform Headache with Autonomic Features (SUNA): These conditions are characterized by brief, severe headaches that can be triggered by specific actions, including eye closure. The pain typically resolves upon eye opening, making it a plausible explanation for the described symptoms.
Other Likely Diagnoses
- Cluster Headaches: While not exclusively triggered by eye closure, cluster headaches can exhibit autonomic features such as conjunctival injection and lacrimation, which might worsen with eye closure due to increased intraocular pressure or other mechanisms.
- Trigeminal Neuralgia: This condition involves sudden, severe facial pain, typically triggered by specific actions like chewing or, less commonly, eye movements. It's conceivable that eye closure could trigger pain in some cases, which might alleviate upon opening.
Do Not Miss Diagnoses
- Giant Cell Arteritis: Although less likely, this condition can cause headaches and visual disturbances. It's crucial to consider due to the risk of vision loss if left untreated. The temporal relationship with eye closure is less clear, but any new headache in older adults warrants investigation for giant cell arteritis.
- Acute Angle-Closure Glaucoma: This is a medical emergency that can cause severe eye pain, often accompanied by blurred vision, nausea, and vomiting. While the pain isn't typically described as worsening with eye closure, the condition's urgency necessitates its inclusion in the differential diagnosis.
Rare Diagnoses
- Idiopathic Stabbing Headache: Characterized by brief, stabbing pains, this condition can occur in any part of the head, including the eye region. While it's less likely to be directly triggered by eye closure, its unpredictable nature means it cannot be entirely ruled out.
- Hemicrania Continua: A rare headache disorder with continuous pain on one side of the head, which can be exacerbated by specific movements or actions. It's a less common condition but should be considered in the differential diagnosis due to its unique characteristics and potential for autonomic features.