Patients with hemiplegic headache and orbital pain should consider cluster headache or painful ophthalmic palsy, as well as glaucoma. In general, painful ophthalmoplegia is characterized by unilateral pain in the orbital area, irritated tearing, and redness and congestion of the eye. The main treatment is to give pain medication to relieve the headache. If the headache is considered to be caused by glaucoma, ophthalmology should be consulted and eye drops should be given to reduce the eye pressure to relieve the headache, and if necessary, surgery may be required to reduce the eye pressure to treat the headache. If painful ophthalmoplegia is considered, the patient may experience impaired eye movement or incomplete eyelid closure during the acute phase. In the acute phase, glucocorticoids should be given for treatment. Dexamethasone shock, which is commonly used, is generally very effective in relieving painful ophthalmoplegia.