Vision and headaches No specific mechanism exists in the eye itself that causes headache, except in
Similarly many pains of the face are transferred from the muscles in the neck and the
farsighted people where there is a spasm of the muscle that focuses the lens.
muscles responsible for posture. These pains would typically occur during working hours. A chiropractor will be able to locate the muscle trigger point and prescribe simple
Eye strain headache has a character of a mild tension headache, localized to the brow
exercises to prevent or control this type of headache.
region. Squinting to try and see better and in bright sunlight may contribute to these symptoms. Fixed posture and mental concentration with prolonged near-point tasks
Diagnosis and management
may be part of the headache "trigger", especially in computer users. Headaches
Paying careful attention to one's headache symptoms may help the practitioner to
occurring with a change in task may reflect stress related to intellectual demands, but
identify the type of headache from which you are suffering.
are often attributed to use of the eyes. Visual headaches always improve with rest. Infrequent attacks of sharp lightning pain in the eye, or short stabbing pain behind the
Taking note of the following is very useful:
eye is relatively common, but there is no known cause. • Provocative factors Migraine headache
In other words, what do you think causes the headache or makes it worse?
The typical migraine headache consists of throbbing or pulsating pain of moderate to
• Factors that make it better, apart from medication
severe intensity on one side. It may also be accompanied by nausea, vomiting and
Identify the things that ease the headache, e.g. rest, sleep or relaxation in a quiet
light and sound sensitivity. Migraine sufferers are sensitive to light and sound even
when they are headache-free. Visual disturbances may precede the headache. • Quality of the pain
Throbbing or pulsing pain, points to a blood vessel source. Burning or aching,
Cluster headache
indicates a muscular cause. Sharp or shooting pain usually originates from a nerve. A
Cluster headache is a rare disorder that occurs more often in men than in women. A
pressure-like sensation has a chamber-derived (e.g. sinus cavity) origin. A brain
cluster attack consists of severe one-sided pain, either temporal, in the eye, or above
tumour headache is usually dull, aching and intermittent, although in some cases it is
the eye lasting 15 minutes to three hours. The headaches may occur every other day
or up to eight times a day. They are often associated with tearing of the eye, nasal
• Region
congestion, facial sweating, pupil dilation and lid swelling.
Migraine head pain is one-sided in about two out of three people, but in other cases it may be on both sides or involve the whole head. The "hatband" distribution of head
Tension headache
pain usually indicates a tension headache. Pain localized to the eye may be from either
Tension headache, the most common head pain syndrome, affects females more often
an eye disease, a cluster headache or referred muscle pain.
than males. It has gradual onset of bilateral, non-throbbing, aching pain over the front
• Severity
and side regions of the head, often spreading to involve the rear of the head and neck
The severity of pain and speed of onset and resolution are also important. Since most
musculature. The pain often worsens as the day goes on and is sometimes described
headaches vary in intensity during an attack and from one episode to another, it is
as "band-like". Reducing stress with relaxation, rest or sleep can help alleviate it.
useful to note the range of pain experienced during a headache. • Time of onset, frequency and duration Brain tumour headache
Most primary headache disorders begin in adolescence or early adulthood. Headaches
One in three brain tumour patients have headaches as a symptom at the time of
that begin later in life warrant greater suspicion and aggressive evaluation.
diagnosis; for many it is the chief presenting complaint. What is considered the classic brain tumour headache a severe, worse in the morning, headache accompanied by
Migraines typically last from 4 to 72 hours. Cluster headaches usually last from 15
nausea and vomiting occurs in only 17% of cases. More often the headache is
minutes to three hours. Headaches that last longer with each new episode require
intermittent, dull, aching, one-sided and relatively mild in the beginning. The headache
often worsens with a change in body position, coughing or straining, and with time, other neurological findings and complaints may become evident.
Changes in the frequency of a headache may also signal a brain lesion. Sinus headache • Are there associated symptoms and signs?
Migraine and tension headaches are often confused with sinus headaches because the
These include visual or somatic aura (suggesting a migraine); or tearing and nasal
pain occurs in the same place. The pain of sinusitis comes from engorged and
congestion (suggesting a cluster headache).
inflamed nasal structures. The headache that accompanies it usually has a deeper, dull, aching quality with a feeling of heaviness and fullness. Nausea and vomiting are
More than 90 percent of migraine patients have photophobia (light sensitivity), while
nausea and vomiting occur in up to 30 percent of migraine patients.
Depending on which sinus cavity is affected, the pain may be in the cheek, the gums
The treatment of migraine involves avoiding the factors precipitating the attack. Anti-
and the teeth of the upper jaw, between the eyes, and the eye itself may be tender with
inflammatory drugs such as Aspirin may help. Drugs that constrict the blood vessels
increased pain upon eye movement. Frontal sinusitis pain strikes mainly in the
such as caffeine and ergotamines are sometimes used and the four most common
forehead. Standing, walking, bending or coughing aggravates the pain. It often
prophylactic (preventative) drugs used are tricyclic antidepressants, beta-blockers,
interferes with sleep, and narcotics bring little relief.
calcium channel blockers and some anti-seizure medications. Mandibular joint dysfunction and other myo-facial pain
This brochure is by no means complete on the subject of headaches and should NOT be
A temporal headache upon wakening is often due to stress on the teeth during sleep.
used for self-diagnosis. The aim is to educate and help you take note of symptoms that
This is due to grinding of the teeth or incomplete alignment of the upper and lower jaw.
will help your practitioner to find the cause of your headaches.
A small tension suppression system placed in the front of the mouth has now been proven to work better that the traditional "biteplate". A dentist will be able to assess this need.
0860 847466 www.dvn.co.za
Accidents aigus des nouvelles toxicomanies Consensus d'actualisation SFAR - Médecine d'urgence 1999 P. Mols, N. Dedecker, G. Taton, M. Amuli Itegwa Service des urgences adultes, CHU Saint-Pierre, rue Haute 322, B -1000 Bruxelles, Belgique POINTS ESSENTIELS · Les amphétamines autorisées légalement sont soumises à prescription. Elles ont pour indication la narcolepsie, les troub
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