DESCRIPTION: Headache is a common and frequently recurrent disorder that can seriously disrupt a person's life. Headache pain may be generalized (all over) or localized (in one area) and may range from mild to severe. Some headaches have a known cause while others, like migraine headaches, do not. Postural changes, prolonged coughing, sneezing, or exposure to sunlight may contribute to headache. Sometimes a headache may be a symptom of a serious underlying problem (such as stroke or brain tumor) and may call for prompt medical care. Serious headaches include those that are sudden and severe, associated with convulsions or seizures, accompanied by confusion or loss of consciousness, associated with a blow on the head or pain in the eye or ear, or persistent in a person who was previously headache-free. Recurring headaches in children, those associated with fever, or those that interfere with normal life should be checked by a doctor. The most common types of headaches include migraine, cluster, and tension-type.

Migraines produce throbbing pain on one or both sides of the head. Symptoms, besides pain, may include nausea, vomiting, light and noise sensitivity, fever, chills, flu-like achiness, and sweating. Some sufferers have warnings before a migraine, such as visual disturbances. Migraine attacks may last from a few hours to days, and may recur several times a week or once every few years.

Cluster headaches, which mainly occur in men, occur as a series of one-sided headaches that are sudden and excruciating and may continue for 15 minutes to 4 hours. Symptoms on the painful side may include nasal congestion, drooping eyelid, and irritated, watery (teary) eye.

Tension-type headaches, which are the most common headache type, produce a dull, achy pain that feels like pressure is being applied to the head or neck. These headaches may be associated with muscle tenderness and increased electromyogram (EMG) activity.

TREATMENT: For many people, analgesics may provide relief. Antidepressants may be used to relieve stress-related headaches. Muscle relaxants may benefit chronic tension headache sufferers. Ergotamine tartrate or sumatriptin taken at the beginning of a migraine headache may reduce the severity of the headache. Other therapeutic options may include supportive measures such as regular exercise, biofeedback, and physical therapy. Chronic and repetitive use of headache treatments may increase headache frequency in some individuals. Monitoring by a physician experienced with treating headache is helpful.

RESEARCH: The NINDS supports and conducts research aimed at improving the diagnosis of headaches and finding ways to prevent and treat them.

These articles, available from a medical library, are sources of in-depth information on headache:

Farley, D. "Headache Misery May Yield to Proper Treatment." FDA Consumer, Food and Drug Administration, Rockville, MD, pp. 26-31 (September 1992).

Mathew, N. "Cluster Headache." Neurology, 42 (Suppl 2):3; 22-31

(March 1992).

Silberstein, S. "Tension-type and Chronic Daily Headache." Neurology, 43:9; 1644- 1649 (September 1993).

Stewart, W, et al. "Prevalence of Migraine Headache in the United States." Journal of the American Medical Association, 267:1; 64-69 (January 1, 1992).

Welch, K. "Drug Therapy of Migraine." The New England Journal of Medicine, 329:20; 1476-1483 (November 11, 1993).

Information is available from the following organizations:

Am. Council for Headache Education (ACHE)
875 Kings Highway, Ste. 200
Woodbury, NJ 08096
(609) 845-0322
(800) 255-ACHE

American Chronic Pain Association
P.O. Box 850
Rocklin, CA 95677
(916) 632-0922

The National Headache Foundation
428 West St. James Place
Chicago, IL 60614
(312) 388-6399
(800) 523-8858

National Chronic Pain Outreach Assoc.
7979 Old Georgetown Road, Ste. 100
Bethesda, MD 20814-2429
(301) 652-4948

Information provided by NIH.
July 18, 1997