Causes of primary headaches – principles of differentiation
Primary headaches are characterized by characteristic signs, they do not progress and are not accompanied by pathological symptoms. Diagnosis of primary headaches is based on the identification of characteristic symptoms.
Primary headaches in adults. Primary headaches are characterized by a complex of symptoms, including localization, duration of pain, and a behavioral response to the headache.
It must be remembered that patients with chronic headaches, who regularly take prescription and non-prescription drugs to relieve pain more often than 3 days a week, often develop drug headache. In these patients, it is important to identify a drug-induced headache. 2 months after the patient stops taking the medication regularly, during which the nature of the headaches is likely to change, the diagnosis needs to be reconsidered.
Tension headache
Tension headache is a moderate, usually bilateral pain that does not affect habitual activity. The duration of such pain is often from one to several days, and some patients report a daily or almost daily appearance of pain.
Hypersensitivity to external stimuli is also not characteristic of tension headaches. Due to weak intensity, tension headaches are rarely diagnosed in everyday medical practice.
Beam (cluster) headache
Cluster headaches often occur in series (bundles), appear periodically 1-2 times a year with a duration of attacks of about 6 weeks and have spring and autumn seasonality. During the cluster period, seizures appear 90 minutes after falling asleep, during a nap.
Patients wake up from severe pain in the eye socket, forcing literally to jump out of bed. During an attack, the patient is usually thrown, covered in sweat and smokes. Many patients strongly press on the eye, hit their head against a wall, or hit books on the head. Fortunately, the duration of each painful attack is relatively short and amounts to 30-90 minutes.
During the period of pain, daytime bouts can be provoked by the use of nicotine or alcohol. During the night, patients have an average of from one to three episodes of severe cluster pain, and seizures are less common at the beginning and end of the cluster period.