Headache is one of the most common medical complaints of adolescents. Estimates are as high as 40 to 70% of the population having some form of headache with up to 75% of 15 year - olds having experienced of significant headaches. While it is apparent that recurrent headache causes significant functional disability, a majority of adolescents with recurrent headache are not likely to seek a medical care. The diagnosis is often overlooked because of this tendency to regard headache as a minor nuisance rather than true disease or the physician's inability to appreciate its impact on the patient. In dealing with headaches in adolescents, physician must consider both physical and psychological factors in determining the correct diagnosis. The pathophysiology of specific headache type must be understood in order to provide the optimal treatment program. This article discuss the current classification and comprehensive management for chronic headache in adolescents.
Adolescent ; Headache ; Headache Disorders ; Humans

Objective: This case control study was undertaken to ascertain the frequency of subclinical and overt hypothyroidism in patients with various types of primary headache disorders in Kashmir, North India. Methods: The study was conducted in a tertiary care (university of Kashmir) hospital of North India. The study subjects consisted of 250 patients with primary headache disorders. This was compared with an age-sex matched control of 500 subjects. Thyroid function tests were performed by new automated immunochemiluminometric assay. Results: Among patients with primary headache disorders, subclinical hypothyroidism was present in 22% and overt hypothyroidism in 7.2%. On the other hand, subclinical hypothyroidism was observed in 11.2% and overt hypothyroidism in 1.2% of cases in the control group, the differences between primary headache and control group was statistically significant (p<0.05). Frequency of hypothyroidism was more in chronic headache disorders (chronic tension-type headache and migraine). The frequency of hypothyroidism in patients with primary headache disorders was higher among females than males, but this was not statistically significant (p> 0.05). Conclusion: Hypothyroidism is found to be a co-morbidity or predisposes to the development of chronic headache (tension-type headache and migraine) in this North Indian study.
Headache Disorders ; Hypothyroidism ; Migraine Disorders

Headaches are one of the most common conditions associated with temporomandibular disorder (TMD). In the present paper, we evaluated the relationship between headache and TMD, determined whether headache influences the symptoms of TMD, and reported two cases of TMD accompanied by headache. Our practical experience and a review of the literature suggested that headache increases the frequency and intensity of pain parameters, thus complicating dysfunctional diseases in both diagnostic and treatment phases. Therefore, early and multidisciplinary treatment of TMD is necessary to avoid the overlap of painful events that could result in pain chronicity.
Headache* ; Temporomandibular Joint Disorders*

No abstract available.
Child* ; Headache Disorders* ; Humans

This report describes a 35-year-old female suffering from a cluster-tic syndrome and bilateral internuclear ophthalmoplegia as the initial manifestation of multiple sclerosis. Magnetic resonance imaging of the brain revealed multiple pontine hyperintense lesions. To our knowledge, there is no previous report of multiple sclerosis presenting as cluster-tic syndrome and bilateral internuclear ophthalmoplegia in the literature. The cluster headache attacks and peri-ocular neuralgiform pain resolved after treatment with intravenous methyl-prednisolone and oral carbamazepine.
Multiple Sclerosis ; Headache Disorders

Middle turbinate headache syndrome is rare, and the true incidence of headache from this cause is unknown. Pneumatization or hypertrophy of the middle turbinate can result in its contact with the septum or the lateral nasal wall and may give rise to headache in the periorbital region. It may occur in the absence of inflammatory sinus disease. Clinical history, nasal endoscopic examination, and coronal CT -scan should point to the diagnosis. Treatment is achieved by relieving the contact point by medical or surgical means. The authors experienced a case of middle turbinate headache syndrome, therefore we report this case with a review of literature.
Diagnosis ; Headache Disorders* ; Headache* ; Hypertrophy ; Incidence ; Turbinates*

Hypnic headache is a unique headache disorder that occurs exclusively during sleep and often with "alarm-clock" consistency. It is a rare, benign, moderately severe, enduring headache syndrome that occurs in middle-aged to elderly adults and affects both sexes. The pathophysiology of hypnic headache is unknown, but its circardian periodicity and responsiveness to lithium suggest chronobiologic sleep disturbance contributing to the genesis of hypnic headache. We have recently experienced 2 cases of hypnic headache. They showed the characteristic signs of hypnic headache. We present our cases and discuss the pathophysiology of hypnic headache.
Adult ; Aged ; Headache Disorders ; Headache Disorders, Primary* ; Humans ; Lithium ; Periodicity

Migraine is a common cause of episodic headache disorder, and multiple factors are associated with the pathogenic mechanism underlying migraine. Recent studies suggest that genetic determinants influence migraine, most likely as part of a multifactorial mechanism. Due to the similarity in clinical features and pathophysiological mechanisms between familial hemiplegic migraine (FHM) and migraine with aura, FHM can be used as a model for migraine and aura. Mutations in the CACNA1A gene on chromosome 19p13 (FHM1), in the ATP1A2 gene at 1q23 (FHM2), and in the SCNA1A gene at 2q24 (FHM3) are responsible for most of the representative types of FHM. The recent beta version of the third edition of the International Classification of Headache Disorders contains revised diagnostic criteria for FHM, which include the above-three genetic factors. In this review we discuss the clinical and genetic features of FHM.
Classification ; Epilepsy ; Genetics ; Headache ; Headache Disorders ; Migraine Disorders ; Migraine with Aura*

Migraine is a common cause of episodic headache disorder, and multiple factors are associated with the pathogenic mechanism underlying migraine. Recent studies suggest that genetic determinants influence migraine, most likely as part of a multifactorial mechanism. Due to the similarity in clinical features and pathophysiological mechanisms between familial hemiplegic migraine (FHM) and migraine with aura, FHM can be used as a model for migraine and aura. Mutations in the CACNA1A gene on chromosome 19p13 (FHM1), in the ATP1A2 gene at 1q23 (FHM2), and in the SCNA1A gene at 2q24 (FHM3) are responsible for most of the representative types of FHM. The recent beta version of the third edition of the International Classification of Headache Disorders contains revised diagnostic criteria for FHM, which include the above-three genetic factors. In this review we discuss the clinical and genetic features of FHM.
Classification ; Epilepsy ; Genetics ; Headache ; Headache Disorders ; Migraine Disorders ; Migraine with Aura*

Migraine is a very common headache disorder. The international headache society subdivides migraine into the ones with and without aura. The migraine attack can consist of premonitory, aura, headache, and resolution phases. Diagnosis is based on the characteristics of headache and associated symptoms. There are many abortive and preventive migraine treatments. Abortive treatment is either specific for the disease or nonspecific such as analgesics. The migraine specific therapies are representative of new migraine abortive medications, which act as serotonin agonist-triptan and ergot. Stratified care and early treatment are also cost-effective. Increased headache frequency is an indication for a preventive treatment. Preventive treatment decreases migraine frequency and improves quality of life. More treatments are being developed. Several new treatments are reviewed in this article.
Analgesics ; Epilepsy ; Headache ; Headache Disorders ; Migraine Disorders ; Quality of Life ; Serotonin