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Diagnostic criteria:

  1. Headache, no typical characteristics known, fulfilling criteria C-E
  2. Presence of panic disorder fulfilling DSM-IV criteria:
    1. recurrent unexpected panic attacks followed by a month or more of worry about having another attack, worry about the implications of an attack or a change in behaviour because of the attack
    2. panic attack is defined as a discrete period of intense fear or discomfort in which at least four of the following symptoms develop abruptly and reach a peak within 10 minutes:
      • palpitations
      • pounding heart or accelerated heart rate
      • sweating, trembling or shaking
      • sensations of shortness of breath or smothering
      • feelings of choking, chest pain or discomfort
      • nausea or abdominal distress
      • feeling dizzy, unsteady, light-headed or faint
      • derealisation or depersonalisation
      • fear of losing control or going crazy
      • fear of dying
      • paraesthesias
      • chills or hot flushes
    3. panic attacks are not due to the physiological effects of a medical condition or substance
  3. Headache occurs exclusively during panic attacks
  4. Headache resolves, and does not recur, after panic disorder remits
  5. Headache is not attributed to another cause

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