How can you diagnose your Headache Syndrome ?


Image courtesy : https://thewhoot.com/newsletter/migraine-remedies




Headache is a symptom and not a disease or a disorder. Not all headache are dangerous. Most of the headaches that you have might come into the category of the Benign Headache syndromes and would be easily managed by medications and lifestyle modifications.


Patient 1 : A patient comes to the clinic with episodic headaches that change sites , are sensitive to sunlight and sound, are associated with nausea and vomitings and is relieved by rest.


Diagnosis : Migraine


Patient 2 : A patient comes to emergency with sudden onset headache throughout the head and has never occured previously. He loses consciousness after 1 hour and had to brought to emergency.


Diagnosis : Acute Headache – Red alert for Brain Imaging

Patient 3 : Patient presents with headache that is more prominent over the eyes and forehead and more in the lying down position and in morning.


Diagnosis : Sinusitis


Patient 4 : Episodes headache that travel through the head that is associated with tingling and numbness in the scalp. These headaches are usually associated with stress either physical and psychological.


Diagnosis : Tension Type Headache


If you read about these four scenarios, these are all different and the diagnosis are different in all of these. Understanding that all headaches are different and are not brain tumours would help you calmly create a strategy around managing your headaches.


Maintaining a HEADACHE LOG ( given below) especially in cases where the headaches are regular or episodic might help you understand what are the specific triggers that provokes your headaches.


Even before approaching the Doctor / Healthcare professional – try answering these questions about your headache and you would realise there is less to panic about and more about rational management of Headache episodes.


Questions

  • How long have you been having headaches ?

  • Are the episodic/ Fluctuating/ persistant ?

  • What is the Frequency of these episodes ?

  • What is the duration of the episodes ?

  • What is the site and side of the Headache ?

  • Does it change or stays on the same side ?

  • Is the headache throbbing/ stretching / associated with tingling, numbness or sensitivity of the scalp ?

  • Is there any visual blurring / any visual phenomenon like flickering lights , scintillating lights that are seen before, during or after the headache ?

  • Is the Headache more on the forehead ?

  • Is there any eye pain, nasal congestion, lacrimation associated with the headache ( either or both the sides of the face ) ?

  • Is it more in the morning/ afternoon/ evening ?

  • Is there any seasonal variation or does your headache in clusters as per the seasons? Can you tell if there are any specific triggers of the headaches ? See Migraine article to understand more about the triggers.

  • Is there any postural change in headache?

  • Is there any nausea and vomiting associated with headache ?

  • How does your headache gets better ? With medicines, rest etc.

  • Is there any family history of episodic headaches in your family ?

  • How does sleep affects your headaches ?


Understanding the answer to these questions would help you segregate your headaches and help you get clarity about your Headache Diagnosis.





Further Reading :


1. Headache disorders: differentiating and managing the common subtypes. Br J Pain. 2012 Aug; 6(3): 124–132. doi: 10.1177/2049463712459691

2. https://www.webmd.com/migraines-headaches/headache-location-types#1

3. https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/symptoms-causes/syc-20370891





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