Clinical Reasoning: A Teenager with Right-Sided Headache and Periorbital Changes

While migraine is the most common headache disorder in children and adolescents presenting to a neurologist, other primary headache disorders are important to recognize. Trigeminal autonomic cephalalgias represent a rare group of primary headache disorders with different characteristics, workup, and management. In this study, we present an adolescent with 1 common and 1 unique headache phenotype, followed by a guided discussion of the differential diagnoses, workup, treatments, and a brief summary of further management considerations.