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Question: Types of headache disorders

Answer: Migraine, tension-type headache and medication-overuse headache are of public health importance since they are responsible for high population levels of disability and ill-health.

1. Migraine
- A primary headache disorder.
- Migraine most often begins at puberty and most affects those aged between 35 and 45 years.
- It is more common in women, usually by a factor of about 2:1, because of hormonal influences.
- It is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.
- Migraine is recurrent, often life-long, and characterized by recurring attacks.
- Attacks typically include:
a. headache, which is:
- of moderate or severe intensity
- one-sided
- pulsating in quality
- aggravated by routine physical activity
- with duration of hours to 2-3 days
b. nausea (the most characteristic associated feature);
c. attack frequency is anywhere between once a year and once a week; and
d. in children, attacks tend to be of shorter duration and abdominal symptoms more prominent.

2. Tension-type headache (TTH)
- TTH is the most common primary headache disorder.
- Episodic TTH,occurring on fewer than 15 days per month, is reported by more than 70% of some populations.
- Chronic TTH, occurring on more than 15 days per month, affects 1-3% of adults.
- TTH often begins during the teenage years, affecting three women to every two men.
- Its mechanism may be stress-related or associated with musculoskeletal problems in the neck.
- Episodic TTH attacks usually last a few hours, but can persist for several days.
- Chronic TTH can be unremitting and is much more disabling than episodic TTH.
- This headache is described as pressure or tightness, often like a band around the head, sometimes spreading into or from the neck.

3. Cluster Headache (CH)
- A primary headache disorder.
- CH is relatively uncommon affecting fewer than 1 in 1000 adults, affecting six men to each woman.
- Most people developing CH are in their 20s or older.
- It is characterized by frequently recurring (up to several times a day), brief but extremely severe headache, usually focused in or around one eye, with tearing and redness of the eye, the nose runs or is blocked on the affected side and the eyelid may droop.
- CH has episodic and chronic forms.

4. Medication-overuse headache (MOH)
- MOH is caused by chronic and excessive use of medication to treat headache.
- MOH is the most common secondary headache disorder.
- It may affect up to 5% of some populations, women more than men.
- MOH occurs by definition on more days than not, is oppressive, persistent and often at its worst on awakening.

(Source: World Health Organization, 02 Dec 2020)

Source Link: https://www.who.int/news-room/fact-sheets/detail/headache-disorders