Question

Headaches - disorder template

Answer 1

1) Ans)
Headache disorders, characterized by recurrent headache, are among the most common disorders of the nervous system. Headache itself is a painful and disabling feature of a small number of primary headache disorders, namely migraine, tension-type headache, and cluster headache. Headache can also be caused by or occur secondarily to a long list of other conditions, the most common of which is medication-overuse headache

Types of headache disorders

Migraine, tension-type headache and medication-overuse headache are of public health importance since they are responsible for high population levels of disability and ill-health.

Migraine

A primary headache disorder.

Migraine most often begins at puberty and most affects those aged between 35 and 45 years.

It is more common in women, usually by a factor of about 2:1, because of hormonal influences.

It is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.

Migraine is recurrent, often life-long, and characterized by recurring attacks.

Attacks typically include:

headache, which is:

of moderate or severe intensity

one-sided

pulsating in quality

aggravated by routine physical activity

with duration of hours to 2-3 days

nausea (the most characteristic associated feature);

attack frequency is anywhere between once a year and once a week; and

in children, attacks tend to be of shorter duration and abdominal symptoms more prominent.

Tension-type headache (TTH)

TTH is the most common primary headache disorder.

Episodic TTH,occurring on fewer than 15 days per month, is reported by more than 70% of some populations.

Chronic TTH, occurring on more than 15 days per month, affects 1-3% of adults.

TTH often begins during the teenage years, affecting three women to every two men.

Its mechanism may be stress-related or associated with musculoskeletal problems in the neck.

Episodic TTH attacks usually last a few hours, but can persist for several days.

Chronic TTH can be unremitting and is much more disabling than episodic TTH.

This headache is described as pressure or tightness, often like a band around the head, sometimes spreading into or from the neck.

Cluster Headache (CH)

A primary headache disorder.

CH is relatively uncommon affecting fewer than 1 in 1000 adults, affecting six men to each woman.

Most people developing CH are in their 20s or older.

It is characterized by frequently recurring (up to several times a day), brief but extremely severe headache, usually focused in or around one eye, with tearing and redness of the eye, the nose runs or is blocked on the affected side and the eyelid may droop.

CH has episodic and chronic forms.

Diagnostic test:

A CT scan of the head may be recommended to rule out other conditions if you are getting daily or almost daily headaches. MRI. This test produces very clear pictures, or images, of the brain without the use of X-rays. MRI uses a large magnet, radio frequency (RF), and a computer to produce these images

Treatment:

Appropriate treatment of headache disorders requires training of health professionals, accurate diagnosis and recognition of the conditions, appropriate treatment with cost-effective medications, simple lifestyle modifications, and patient education. The main classes of drugs to treat headache disorders include: analgesics, anti-emetics, specific anti-migraine medications, and prophylactic medications.

Complications

If you have chronic daily headaches, you're also more likely to have depression, anxiety, sleep disturbances, and other psychological and physical problems.

Prevention

Taking care of yourself might help ease chronic daily headaches.

Avoid headache triggers. Keeping a headache diary can help you determine what triggers your headaches so that you can avoid the triggers. Include details about every headache, such as when it started, what you were doing at the time and how long it lasted.

Avoid medication overuse. Taking headache medications, including over-the-counter medications, more than twice a week can increase the severity and frequency of your headaches. Consult your doctor about how to wean yourself off the medication because there can be serious side effects if done improperly.

Get enough sleep. The average adult needs seven to eight hours of sleep a night. It's best to go to bed and wake up at the same time every day. Talk to your doctor if you have sleep disturbances, such as snoring.

Don't skip meals. Eat healthy meals at about the same times daily. Avoid food or drinks, such as those containing caffeine, that seem to trigger headaches. Lose weight if you're obese.

Exercise regularly. Regular aerobic physical activity can improve your physical and mental well-being and reduce stress. With your doctor's OK, choose activities you enjoy — such as walking, swimming or cycling. To avoid injury, start slowly.