Hemicrania continua is defined as a constant one sided (and always on the same side) headache of moderate intensity with exacerbations and which responds to Indomethacin. Other possible symptoms include redness of the eye, a watery or teary eye, a blocked or runny nostril and drooping of the eyelid.
But we have case reports which show [...]
Interesting to note a case study reporting that the head pain of a patient suffering hemicrania continua was temporarily reproduced and resolved by neck movements and later by blocking or injecting the greater occipital nerve. These two features are key diagnostic signs of cervicogenic or neck related headache and indeed this respected researcher concludes this.
Cheers
Dean
Consultant [...]
Generally routine neck xrays are uninformative for headache or migraine sufferers. However, this does not exclude neck disorders as the source of headache or migraine.
Therefore xrays as a form of diagnosis are not highly regarded. Nevertheless it is very important that neck xrays be undertaken in the event of any significant head or neck trauma [...]
Q. What do diagnosing headache and migraine and a dog’s breakfast have in common?
A. It’s all over the place!
This is expressed in a recent article by Sun-Edelstein et al 2008. Since the diagnostic classification was published, there have been many attempts to confirm or otherwise the accuracy of the criteria. Because of the multiple revisions [...]
I mentioned recently that blocking the greater occipital nerve and eliminating head pain is key sign of cervicogenic or neck headache and that this has been demonstrated repeatedly in migraine sufferers.
This procedure (injecting nerves) however is not necessary to diagnose cervicogenic headache which is just as well because after all it is invasive, not readily [...]
There are numerous case studies which have shown that injecting local anesthetic around the greater occipital nerve the pain of migraine is eased. This is also a key finding in cervicogenic headache and confirms the diagnosis of cervicogenic headache. So why is it that, in this situation, almost invariably the interpretation is that the sufferer [...]
It has been claimed that the effectiveness of the triptans in someone experiencing facial pain does not exclude a diagnosis of ‘sinus’ headache because it has been shown that the ‘triptans’ do relieve the pain of sinusitis. Whilst this is true (because abnormal information from a diseased, infected sinus will sensitise the brainstem and the [...]
Of 2991 patients with a self-described or physician diagnosis of ‘sinus’ headache, an overwhelming 88% were diagnosed as migraine!
Clearly, as the researchers concluded, migraine (not to mention tension-type headache) should be considered and indeed the most likely cause of facial pain.
Cheers
Dean
Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South [...]
Over 90% of diagnosed sinus headaches present in the same way as migraine headache and that given that the majority of ‘sinus’ headaches respond to the ‘triptans’, they can be classified as migraine. Why then are 61% of patients given antibiotics for a non-infectious condition?!
It is more responsible to identify the source of the sensitisation [...]
Cheers
Dean
Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South Australia; PhD Candidate, Murdoch University, Western Australia
Headache Migraine
