Condition: Headache Syndromes

Headaches are one of the commonest medical complaints. Your symptoms will often help determine the cause and appropriate treatment. The commonest causes include:

• Migraine
• Tension headaches
• Trigeminal autonomic cephalgias such as cluster headaches, paroxysmal hemicrania and others
• Medication overuse headaches

The majority of the time, the headaches are not the result of a life-threatening illness but nevertheless can be very disabling. Effective treatments are available which can reduce the frequency and severity of the headaches, improving quality of life.

It is important that headaches are assessed by a specialist to rule out causes of secondary headaches due to serious underlying disorders which include:

• Vascular such as aneurysms, dissections, clots, high blood pressure
• Cancer
• Infection
• Inflammation

These vary depending on the type of headache that you have, and these can be evaluated further by your specialist. Symptoms may include:

• head/facial pain (can feel throbbing, sharp, dull, burning, stabbing etc)
• nausea/vomiting
• light/sound/smell/movement sensitivity
• visual symptoms (including flashing lights, zig-zag lines, blurred vision)
• dizziness
• tearing from the eyes
• runny nose, nasal congestion

It is advised to contact a healthcare professional or your GP if you are experiencing:

• headaches that are your affecting your quality of life
• new persistent headache or a change in your usual headache symptoms
• headaches that wakes you up at night
• headaches triggered by coughing, bending or strenuous exercise
• having more than four days per month with headaches
• the need to take pain relief regularly for headaches

The following need immediate medical care:

• sudden severe headache
• a new headache if you are pregnant or over 55 years of age
• headache immediately after head injury or accident
• a headache associated with any of the following:

o   weakness

o   numbness

o   change in vision

o   personality change

o   confusion

o   seizures

o   loss of consciousness

o   fever, rash, neck stiffness

There are many effective treatment options available and these will be recommended to by your specialist depending on the type of headache you have. For primary headaches, these include:

• lifestyle measures such as stress reduction and sleep management
• tablet medications – several options available
• injections such as Botox, greater occipital nerve (GON) injections
• calcitonin gene-related peptide (CGRP) monoclonal antibody treatments
• non-invasive transmagnetic stimulation
• non-invasive Gammacore vagal nerve stimulation