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Migraine Headaches

Migraine is a common, multifactorial, disabling, recurrent, hereditary neurovascular headache disorder affecting 15% of the population during the formative and most productive periods of their lives, between the ages of 22 and 55 years. It usually strikes sufferers a few times per year in childhood and then progresses to a few times per week in adulthood, particularly in females. Attacks often begin with warning signs (prodromes) and aura (transient focal neurological symptoms) whose origin is thought to involve the hypothalamus, brainstem, and cortex.

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Occipital Neuralgia

Occipital neuralgia is defined as a paroxysmal shooting or stabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation or dysesthesia in the affected area. The pain originates in the suboccipital region and radiates over the vertex. A suggestive history and clinical examination with short-term pain relief after infiltration with local anesthetic confirm the diagnosis.

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Chronic Migraine

Chronic migraine is defined as headache on more than 15 days per month in patients with migraine. Chronic migraine is difficult to treat and requires a multidisciplinary approach. Only two pharmacological treatments have been shown to be effective in placebo-controlled randomized trials: topiramate and local injection of botulinum toxin.

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Headaches

Headache accounts for 4.4% of consultations in primary care (6.4% females and 2.5% males). Unless a correct diagnosis is made, it is not possible to provide the most effective treatment.

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