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• Vol.44 No.11
• CLINICA NEUROL, 44: 818−819, 2004
• Vol.44 No.11 contents

The 45th Annual Meeting of the Japanese Society of Neurology

Headache originating front-orbital area

Manabu Sakuta, M.D.

Dpt Neurology, Kyorin University Medical School

Headache originating front-orbital area can be divided to (1) Which has no autonomic symptoms such as lacrimation, rhinorrea, rhinostasis. This include psychogenic headache and epileptic headache.
In the case of psychogenic headache, pericranial tenderness is not observed, and headache is medium in intensity. Most often patient complains of a headache originating frontal area. There are more than five various symptoms such as general malaise, numbness, tingling sensation, vertigo, sleeplessness. However, although symptoms are multiple, patients spend a life commonly. In other words, a patient is protected by a headache against his or her stress. No medication is needed in such a case.
In epileptic headache, pressing type pain is felt over the forehead for several minutes to a few hours. Tremor or convulsion sometimes follow the headache. EEG shows spike and wave activities. In the case of focal epilepsy, headache occurs contralateral to the focus. Anti-epileptic drugs such as VPA or CBZ is a choice in such case, and headache as well as seizure disappears.
(2) Front-orbital headache with autonomic symptoms include various trigeminal autonomic cephalalgias. These include cluster headache, episodic paroxysmal hemicrania, hemicrania continua, among others.
Precise history taking is necessary for the treatment, because no drug is 100% effective.

(CLINICA NEUROL, 44: 818−819, 2004)
key words: intractable headache, psychogenic headache, epileptic headache, episodic paroxysmal hemicrania, hemicrania continua

(Received: 13-May-04)