About headache disorders
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Headache disorders, characterized by recurrent headaches, 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 a medication-overuse headache.
Globally, it has been estimated that prevalence among adults of current headache disorder (symptomatic at least once within the last year) is about 50%.
Half to three-quarters of adults aged 18–65 years in the world have had headaches in the last year and, among those individuals, 30% or more have reported migraines. Headache on 15 or more days every month affects 1.7 4% of the world’s adult population.
Despite regional variations, headache disorders are a worldwide problem, affecting people of all ages, races, income levels, and geographical areas.
About headache disorders
Key facts about headache disorders.
- Headache disorders are among the most common disorders of the nervous system.
- It has been estimated that almost half of the adult population have had a headache at least once within the last year.
- Headache disorders, which are characterized by recurrent headache, are associated with personal and societal burdens of pain, disability, damaged quality of life, and financial cost.
- Worldwide, a minority of people with headache disorders are diagnosed appropriately by a health-care provider.
- Headache has been underestimated, under-recognized and under-treated throughout the world.
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.
Cluster Headache (CH)
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.
Medication-overuse headache (MOH)
Medication-overuse headache (MOH)
- MOH is caused by chronic and excessive use of medication to treat headache.
- MOH is the most common secondary headache disorder.
- It may affect up to 5% of some populations, women more than men.
- MOH occurs by definition on more days than not, is oppressive, persistent and often at its worst on awakening.
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.
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Migraine
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);
- headache, which is:
- 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)
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.