Headache & Facial Pain. John F. Rothrock, M.D. Professor & Vice Chair, UAB Neurology. Headache Diagnosis: Primary vs Secondary. When is “migraine” really migraine?.
John F. Rothrock, M.D.
Professor & Vice Chair, UAB Neurology
When is “migraine” reallymigraine?
19 yo Female university coed reports 10 years of episodic, unilateral, pulsatile headache, often heralded by “sparkles & blind spots” in the right periphery of vision. Midrin no long helps.
… and many more
Table 1 Trigeminal Neuralgia: IHS Diagnostic Criteria
A. Paroxysmal attacks of facial or frontal pain which last a few seconds to less than two minutes
B. Pain has at least 4 of the following characteristics:
(1) distribution along one or more distributions of the trigeminal nerve.
(2) sudden, intense, sharp, superficial, stabbing or burning in quality.
C. No neurologic deficit
D. Attacks are stereotyped in the individual patient.
E. Exclusion of other causes of facial pain by history, physician examination and special investigations when necessary.