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HEADACHE

Headaches are a very common condition that most people will experience many times during their lives. The main symptom of a headache is a pain in your head or face. This can be throbbing, constant, sharp or dull. Headaches can be treated with medication, stress management and bio-feedback. Headaches are a major cause of absenteeism from work and school. They also take a toll on social and family life. For some people, continually battling headaches can lead to feeling anxious and depressed.

Type of Headache

There are more than 150 types of headache. They fall into two main categories: primary and secondary headaches.

Primary headaches
  1. Cluster headaches.
  2. Migraine
  3. New daily persistent headaches (NDPH).
  4. Tension headaches.
Secondary headaches
  1. Disease of blood vessels in the brain.
  2. Head injury.
  3. High blood pressure (hypertension).
  4. Infection.
  5. Medication overuse.
  6. Sinus congestion.
  7. Trauma.
  8. Tumor.

Migraine Headaches

A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.

What’s a migraine?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches?

  • Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn’t happen.
  • Migraine without head pain: “Silent migraine” or “acephalgic migraine,” as this type is also known as, includes the aura symptom but not the headache that typically follows.
  • Hemiplegic migraine: You’ll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation and dizziness or vision changes. Sometimes it includes head pain and sometimes it doesn’t.
  • Retinal migraine (ocular migraine): You may notice temporary, partial or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue.
  • Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently.
  • Migraine with brainstem aura. With this migraine, you’ll have vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears and vomiting.
  • Status migrainosus. This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine.

What are the four stages or phases of a migraine?

The phases are:

  • Prodrome:The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
  • Aura:The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
  • Headache:About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
  • Postdrome:The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.

It can take about eight to 72 hours to go through the four stages.

What are cranial neuropathies?

Nerves power your entire body. But those nerves can be damaged by injury or an illness such as diabetes. Neuropathy is a disorder caused by nerve damage. It affects your ability to feel and move. Exactly how your body and your movement are affected depends on where in the body the damaged nerves are located. When nerves in the brain or brainstem are affected, it is called cranial neuropathy.

The cranial nerves are those that arise directly from your brain or brainstem. They often affect areas like the face and eyes. Some of the different types of cranial neuropathies are:

  • Bell palsy.This health problem occurs when the facial nerve (seventh cranial nerve) is affected.
  • Microvascular cranial nerve palsy.This health problem affects one or more nerves, typically those that go to the eye. It is most common in people who have diabetes and high blood pressure.
  • Third nerve palsy.This condition affects the third cranial nerve. This nerve helps manage muscles that control eye movement as well as the size of the pupil.
  • Fourth nerve palsy.This is also called superior oblique palsy. It affects the superior oblique muscle, which helps you converge your eyes (to look at the tip of your nose).
  • Sixth nerve palsy.This is also called cranial nerve VI or abducens palsy. It affects the sixth cranial nerve, which also helps control eye movement.

What causes cranial neuropathies?

Cranial neuropathy can develop for many different reasons. These include:

  • Infections in the spinal fluid can irritate cranial nerves. For example, Lyme disease often affects the seventh nerve. But it can cause problems with any cranial nerve.
  • Cancer cells can spread to the spinal fluid and damage one or more cranial nerves. Sometimes cancer can press on cranial nerves as they run through the skull.
  • Increased intracranial pressure from a tumor, head trauma, or brain swelling. This can injure cranial nerves. Pressure can also be raised in certain headaches. Cranial nerves 3, 4, and 6 are most often affected.
  • Congenital cranial neuropathies. These are nerve injuries from trauma that occurs at birth. Or they can occur before birth from developmental problems or infection.
  • Microvascular cranial nerve palsy. This can develop in people who have high blood pressure or other vascular risks, such as diabetes or smoking. Poor circulation to the cranial nerves injures them. It most often affects cranial nerves 3, 4, and 6.
  • Autoimmune abnormalities.These occur when the immune system attacks one’s own cranial nerves. This can happen in Guillain-Barré syndrome or lupus.
  • This can press on nearby nerves. It most often affects cranial nerves, 3, 4, and 6.
  • Inflammatory diseases.These include sarcoidosis and multiple sclerosis.

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