Headache

Also see Facial neuralgia page 355, Jaw joint pain page 413

Just about three out of four persons suffer from headache each year. Headache is seldom a symptom of an underlying brain disease, even when the pain is intense. The two main types of headache are migrane and tension headache which are described in the following pages.

Headache-migraine
Migraine

Migrane, a common and painful headache that typically occurs on one side of head, often begins at puberty or early adulthood, runs in families and tends to recur. More women than men suffer from migraines (about 75% of the cases), usually before menstruation, with the attacks tapering off after menopause.

Symptoms
Migraine without aura:

• Pain, usually felt on one side of the head. It gradually builds up to full throbing intensity and is aggravated by movement, light or noise.
• Nausea.
• Vomiting.

Migraine with aura:

• An aura (unusual sensation) coming about 20 minutes before the headache. The symptoms may include nausea, vomiting, enlarging blind spots, flashing or zigzagging light, strange noises or smells, and numbness in one side of the body.
• Same symptoms as common migraine, but the onset of pain is more abrupt.
• Sensitivity to light.
• In rare cases, paralysis on one side of the body.

Cause
Not yet fully known, but attributed by many experts to chemical inflammation of the dural blood vessels, which stimulate the nerve endings. Factors that trigger the condition include:

• Stress (eg. anger, changes in climate, distress, overexertion, shock).
• Certain kinds of beverages, food, and food additives (eg. alcohol, chicken liver, citrus fruits, monosodium glutamate, nitrites, red wines).
• Head injury.
• Sensory stimulation (eg. bright light, blaring sounds).
• Overexertion.
• Hunger
• Hormonal imbalance, oral contraceptives.

What you can do

• Lie down and sleep or rest in a dark, quiet room.
• Apply an ice pack to the painful area.
• Take a cold shower.
• Take simple painkilllers.
• Try to identify the factors that trigger the headache and avoid them.
• Consult a doctor if the pain is unbearable or if the recommended measures offer no relief.

What your doctor can do

• Rule out serious underlying causes of headaches.
• Prescribe stronger painkillers.
• Prescribe prophylactic (preventive) medicine for migrane.
• Prescribe medicine to stop the migraine.

Prevention tips

• Avoid the factors that can trigger the headache.

Helplines
Headache Society of Malaysia 03-757 6588

For other products see Painkillers & antifever medicines page 439


Headache-tension headache
Tension headache, Neck ache
A tension headache, unlike a migraine, is characterised by generalized pain, a feeling of fullness or pressure over the top of the head or at back of the neck. It can occur everyday, is not associated with vomiting and is not aggravated by movement. The disorder is the most common type of headache, affecting people of all ages.

Symptoms

• Dull, sometimes intense pain over the top of the head, the temples, or at the back of the neck.
• Sore scalp and neck muscles.

Cause
Not yet fully known. Factors that trigger the condition include:

• Stress (eg. anger, changes in climate, distress, overexertion, shock).
• Poor posture; not moving for a long period.
• Depression.
• Lack of sleep.
• Eye strain.

What you can do

• Apply an ice pack to the head.
• Take a hot or cold shower.
• Massage head, neck, and shoulders.
• Do stretching and other relaxation exercises.
• Discontinue or minimize your intake of caffeine (eg. coffee, tea).
• Avoid the glare of strong sunlight. Wear sunglasses if you have to stay outdoors.
• Take simple painkillers.
• Consult a doctor if:

1. The headache is continuous or recurs frequently.
2. The headache is accompanied by fever and stiff neck (may be meningitis), numbness or weakness in the limbs and visual or speech disorders (may be a stroke).
3. Slight exertion brings on an attack.

What your doctor can do

• Rule out serious underlying causes of headaches.
• Prescribe muscle relaxants.
• Prescribe stronger painkillers.

Prevention tips

• Relax. Learn relaxation techniques and meditation. Do stretching and relaxation exercises in between extended periods of work or sitting.
• Exercise regularly.
• Avoid or minimize stress.
• Try to get enough sleep.
• Minimize your intake of caffeine (eg. coffee, tea).
• Avoid excessive sunlight by staying indoors on bright, sunny days or wearing sunglasses outdoors.

For products see Painkillers & antifever medicines page 439

This article is reffered to Malaysia Healthcare-The family health guide MIMS 2nd edition 1997 page 392-394.