Headaches, migraine, facial pain

About 42% of adults often have headaches. The most common diseases include migraine and tension headache.

Migraine is a multifactorial disease with a genetic basis. It can affect the quality of life of patients; reduces the performance of daily activities, reduces the ability to work, increases sickness absence, increases the risk of depression, increases the risk of hypertension and ischemic stroke. Migraine attacks usually last for 4-72 hours. The first attacks usually appear in adolescence.

A typical migraine attack occurs in 4 phases:

  1. Preliminary symptoms, heralding: the patient feels irritable, depressed or tired, anxious, nausea, appetite and mood disorders, blurred vision, e.g. a blurred image, neck stiffness may occur.
  2. Aura: the set of symptoms that precede the attack last between 15 and 30 minutes and usually end at about half an hour before the onset of migraine pain.

The most common are visual disturbances (bright zigzags, light spots in the middle of the field of view), less frequent numbness of the mouth, tongue, half of the face and body. These symptoms gradually develop and disappear in reverse. Aura symptoms occur in about 20% of patients.

  1. Headache: medium to high intensity, rapid and pulsating, may occur on the one hand or cover the entire head. They increase during physical exertion, relief and rest bring relief. Often comrades to them:
  • photophobia
  • hypersensitivity to sounds
  • nausea
  1. Final symptoms: fatigue, irritability and depressed mood.

Tension headache

usually occurs in the area of  the forehead, temple, occiput, it can also cover the entire head.

it is bilateral, diffuse, wrapping, can be dull, compressing or crushing, sometimes compared to the feeling of a tightening band or cap,

lasts from half an hour to several days,

it grows slowly, sometimes up to the migraine,

there may be a feeling of tension and compression within the neck muscles,

does not get worse under the influence of physical effort,

They are often accompanied by:

  • sleep disorders,
  • chronic fatigue syndrome,
  • hypersensitivity to noise,
  • lowering the appetite,
  • rarely: nausea, vomiting, photophobia.

Cluster headache

occurs much less often than migraine or tension pain. It often remains unrecognized or is confused with other types of ailments.

It is most common in men between 30 and 40 years of age. The reasons for its occurrence are still not fully explained.

Cluster headache appears suddenly and is very strong

covers the orbital area, temple, cheek, jaw,

occurs always on one side,

seizures last from 15 to 80 minutes,

the frequency of seizures varies from 1 to even 8 times a day,

The characteristic accompanying symptoms include:

  • tearing, redness of the conjunctiva,
  • drooping or swelling of the eyelid,
  • miosis, weakening corneal reflex,
  • feeling of nasal congestion, discharge from the nose,
  • one-sided sweating and redness of the face,
  • acceleration or relief of heart rate,
  • nausea and vomiting,
  • psychomotor agitation.

Factors provoking the occurrence of headache are dependent on gender, age, hormone influence, weather, but also mood, life situation, family and professional situation.

The most common are:

  • emotions, eg stress, anxiety, anger,
  • fatigue,
  • too much or too little sleep,
  • hunger, overeating; no or delayed meal, irregular meal rhythm, too small amount of water consumed,
  • wrong diet eg chocolate, nuts containing sodium nitrates, onion, citrus, products containing tyramine (wine, ripening cheese, legumes) and caffeine (coffee, tea), alcohol,
  • environmental factors, e.g. pressure changes, wind,
  • bright glimmering light (disco, strobe, sharp sun),
  • noise,
  • strong smells,
  • radiation from the TV and computer screens

Headaches can also be associated with medications, e.g. oral contraception, cardiac drugs, vasodilators, nitrates. In case of headaches, consultation with a neurologist is always recommended. Neuroimage diagnostics (CT, MRI) allows to exclude organic causes, e.g. aneurysm or other neoplastic lesions. Proper diagnosis and classification of the disease allows for effective treatment. The primary goal of treatment is to stop the attack. In the case of frequent, strong and resistant to treatment attacks and headaches, treatment is necessary.

THE PATIENT’S COUNCIL

  • Do not give up searching for the right treatment
  • Do not overuse medication
  • Do not be afraid to talk and inform about your problem
  • Prepare to visit the doctor; migraine calendar
  • Live normally, healthy, calm

Written by

Gregory Taylor