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What types of headaches are most common?

The International Classification of Headache Disorders, 3rd edition (ICHD-3), categorizes primary headache disorders into four main types: migraine, tension-type headache (TTH), cluster headache, and other trigeminal autonomic cephalalgias (TACs). Migraines are characterized by moderate to severe pulsating pain, often unilateral, and can be accompanied by nausea, photophobia, and phonophobia. Migraine attacks can last from a few hours to several days and may include an aura with visual disturbances. Tension-type headaches are the most common, presenting as a bilateral, pressing or tightening pain of mild to moderate intensity, typically without nausea or the sensory sensitivities seen in migraines. Cluster headaches are severe, unilateral headaches, often around the eye, occurring in clusters over weeks or months, with accompanying autonomic symptoms like lacrimation and nasal congestion. Other TACs, such as paroxysmal hemicrania and SUNCT/SUNA syndromes, involve shorter, more frequent headache attacks with similar autonomic features. These classifications help in the accurate diagnosis and management of headache disorders, facilitating targeted treatment approaches .

Primary Headache Disorders

Migraine

  •  Moderate to severe pulsating headaches

  • Headaches last hours to days

  • Often accompanied by nausea, vomiting, and sensitivity to light and sound

  •  Triggers for migraines can include stress, certain foods, hormonal changes, and environmental factors

Tension Type Headache

  • Most common primary headache disorder

  • Bilateral, pressing or tightening pain of mild to moderate intensity

  • Can last from 30 minutes to several days

  • Feels like a tight band around the head

  • Triggers include stress, poor posture, and muscle tension

Trigeminal Autonomic Cephalgia

  • A group of primary headache disorders characterized by severe, unilateral headache pain accompanied by autonomic symptoms

  • Localized around the eye or forehead with lacrimation, nasal congestion, and ptosis

  • Include cluster headache,  paroxysmal hemicrania, SUNCT and SUNHA

  • TACs often mimic other disorders, such as trigeminal neuralgia

What should I do if I have these symptoms?

If you do not yet have a diagnosis or plan for management, schedule your appointment today. Facial pain, TMJ disorders and headache are interconnected, and finding the right diagnosis can be tricky without the appropriate training. While NJ TMJ and Facial Pain is not a headache clinic, Dr. Bijal Shah is trained to recognize and make the appropriate referral to the right physician who can help with your needs. Schedule your consult today!

References:
Headache Classification Committee of the International Headache Society (IHS). (2018). The International Classification of Headache Disorders, 3rd edition. Cephalalgia, 38(1), 1-211.
Ashina, M., Katsarava, Z., Do, T. P., Buse, D. C., Pozo-Rosich, P., Silberstein, S., & Lipton, R. B. (2021). Migraine: epidemiology and systems of care. The Lancet, 397(10283), 1485-1495.
Olesen, J. (2018). International Classification of Headache Disorders. The Lancet Neurology, 17(5), 396-397.

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