Headache

Primary headache syndromes (International Headache Society Classification)

  • Tension-type: bilateral, pressure-like pain of mild–mod intensity, not throbbing or aggra-vated by physical activity. A/w photophobia or phonophobia, not N/V. Freq a/w myofascial sensitivity in neck/head. Triggers: stress, sleep deprivation, dehydration, hunger. Episodic HA Rx: NSAIDs, acetaminophen (risk of med overuse HA); chronic HA Rx: TCAs.
  • Cluster HA and other trigeminal autonomic cephalalgias (TACs) (Continuum 2018;24:1137)
    • Characterized by unilateral headache a/w ipsilateral autonomic sx (rhinorrhea, red/tearing eye, miosis, ptosis, lid edema, sweating), subtypes differentiated by timing.
    • Cluster: ♂ > ♀, unilateral pain w/ stlessness; attacks 15 min–3 h, up to 8/d (circadian). Ppx: CCB (verapamil). Rx: high-flow O