The Four Headache Syndromes


These are based on the frequency and duration of attacks. Regarding frequency, less than 15 days a month is episodic, greater than 15 days chronic. Regarding duration, less than 4 hours is short and greater than 4 hours long.

  1. Episodic short-duration headaches: Trigeminal autonomic cephalgias, such as cluster, SUNCT, SUNA, hypnic headache, stabbing headaches.
  2. Episodic long-duration headaches: Migraine and tension-type headache.
  3. Chronic short-duration headaches: Chronic cluster and chronic paroxysmal hemicrania.
  4. Chronic long-duration headaches: Chronic migraine, chronic tension-type headache, new daily persistent headache, hemicrania continua. If a headache in this group is unilateral, a trial of indomethacin is indicated, and if effective, the patient has hemicrania continua.

Dr. Florin is committed to treating all patients compassionately with state-of-the-art techniques while maintaining their dignity and independence. He views each patient encounter as a collaboration. Dr Florin has over 35 years of experience. He is Adjunct Clinical Professor at Keck School of Medicine (USC) and is the founder and medical director of the Fullerton Neurology and Headache Center. He has been recognized by the Orange County Medical Association as a Physician of Excellence in Neurology. US News and World Report ranks him in the top 10% of neurologists nationwide.

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