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HeadWay, Issue #047 -- The "other" headaches
June 21, 2007

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In this month's issue:

Headache classification part 4

So we've been talking about migraine art...

Say what?!  Ocular

Headache classification part 4 - Other Primary Headaches

Time to talk about some of the most mysterious headaches of all - the "others".

This is part 4 in our series on headache classifications from the International Headache Society. We've been talking about headaches and related diseases that are usually called primary headaches - in other words, they were not caused directly by something like a virus or head trauma. These include migraine, tension headache, and cluster.

Today we're going to finish with the primaries by briefly talking about the other headaches. These ones are poorly understood, not studied as much as the others - they're the headaches that just don't fit anywhere else. But it does help to know they they are a problem, and that you're not the only one in the world with these symptoms! We're just going to mention them briefly, as an introduction:

Primary stabbing headache

Stabbing pain, either one or several stabs of pain, from just one to several a day. The pain is mostly in the temple, eye area, or side of the head. Most stabs last 3 seconds or less. If you already have migraine or cluster, you're more susceptible, and will probably feel the pain in the same area as with your other attacks.

Primary cough headache

These headaches are brought on by coughing or straining. They're sudden, and may last for only a second, or they may last for half an hour. Often patients with Chiari Malformation type 1 get this kind of headache, but it's also more common in people over 40. Sometimes Indocin (an anti-inflammatory medication) is used for primary cough headache.

Primary exertional headache

This pulsating headache is brought on by exercise. It lasts anywhere from 5 minutes to 2 days, and more often occurs at high altitude or in hot weather. Sometimes actual migraine is brought on by exertion, and there is also overlap with cough headache (particularly in weight lifters). For more on treatment, read the article on after exercise headache.

Primary headache associated with sexual activity

This headache usually starts dull during sexual activity and can become suddenly intense at orgasm. Check here for more info on sex or orgasm headache.

Hypnic headache

This is a dull headache that wakes you up. It lasts at least 15 minutes after you wake up, and occurs often - more than 15 times per month. The attacks start in people older than 50. Sometimes caffeine and lithium are used to treat this alarm clock headache.

Primary thunderclap headache

Thunderclap headache is severe and sudden, reaching full power in less than a minute. It doesn't occur regularly, but can last from an hour to 10 days! Read more about thunderclap headaches.

Hemicrania continua

A persistant 1-sided headache. It never stops, though it can get worse and better, and lasts at least 3 months. When the headache is more intense, you may have teary eyes, a small pupil or a drooping eyelid. Hemicrainia continua always responds to indomethacin (Indocin).

New Daily persistent headache

Usually two sided, NDPH is tight, pressing pain. You may also be sensitive to light or sound, and even nauseous (not all three, just one). It's daily (of course) for more than 3 months, and starts fairly suddenly. It's similar to chronic tension type headache, but starts fairly suddenly and then doesn't stop, usually in persons with little previous headache "experience".

IMPORTANT: All of these headaches have a common thread. They're only diagnosed if other more serious possibilities have been ruled out. In other words, don't look at this list and say,"Oh, I guess I have [blank], so I'll just take some [blank] pills to feel better".

Before you're diagnosed with any of these, the doctor will check carefully, and look into your medical history, to see if your symptoms are indicating something else. Many of these symptoms are indications of something totally different. If you have any kind of new headache, always talk to a doctor you trust first.

So we've been talking about migraine art...

Migraines, headaches, pain, triumph, migraine aura - these are things that lead quite naturally to artistic expression. Recently I blogged about migraine art, and afterward discovered someone that is working on a migraine art book. The great thing is that the editor (Betsy Blondin) is still accepting contributions for the book! Betsy is herself a migraineur, and also a HeadWay subscriber. I asked if there was anything she would like to share with my readers, and here is what she wrote:

As a longtime migraine "overcomer," managing editor, and writer, I am publishing a coffee table-style artistic and creative book about migraine and currently compiling and editing all types of migraine art for it. I'm contacting as many individuals and organizations as possible and have been receiving wonderful and inspiring comments and submissions from around the world! I am particularly interested in helping to illustrate the positive and uplifting moments and events in the lives of people with migraine disease, because I feel that migraine doesn't define who we are all the time. People with migraine enjoy so many wonderful accomplishments in their lives.

Here's my Web site page about the project:

I am offering a nominal fee to contributors whose work is accepted for the book. Content will include visual art and photography, prose (2,500 words or less), poetry, and quotes. I've received a great many wonderful poems, drawings, paintings, and several photos and essays.

It would be fantastic to also receive quotes or expressions from children, family members, friends, and health care providers of migraineurs that illustrate their perspectives. And if writers and artists with migraines have migraine art as well as work that portrays who they are and what they do in spite of/without migraine, it would be lovely if they could submit both. The other helpful thing some people do with their submissions is tell me briefly about themselves, their experience with migraine and their creative piece(s).

I have included submission guidelines at the end of this newsletter, along with contact information. The current deadline is the end of July - why not get involved?

If you can't wait for the book, check out some migraine art here.

Say what?!  Ocular

Ocular (sometimes spelled occular) is a word that refers to eyes or eyesight. Sometimes the term ocular migraine is used to describe a migraine that has major eyesight related symptoms. For example, partial blindness, seeing flashing lights or zig zags, or double vision. This (ocular migraine) isn't an official headache classification from the document we've been discussing, but it is a term that has been used recently (by the Mayo Clinic, for example). Many headaches and migraines have ocular symptoms; some are signs of serious eye disease, others symptoms of migraine disease.
Have a comment? A suggestion for a future topic? Drop by the HeadWay MailRoom and use your password, nomoache!

Migraine Expressions submission guidelines

For All Submitted Works

Please include your name, location, contact information, and a little bit about yourself with any submission. If your work is accepted for publication, you will receive more details and an agreement to sign (you will retain ownership of your work and receive a fee). Artists and authors will be asked to confirm that the submission is their original work, that they own the rights to it and are therefore free to license us to print it in the book.

For Written Works: Quotes, Poetry, Prose (Essays, Short Stories)

Prose should be 2,500 words or less. Written material can be e-mailed to migraine [at] as attachments, preferably in Word documents or saved as plain text or rich text format. Please edit your work prior to submission. If your creative piece is accepted but needs editing, we will contact you.

For Works of Art: Drawings, Paintings, Photographs, or Other Media

Please send print/high-resolution (minimum 300 dpi, 4 to 5 inches) digital files of photographs or scanned work, preferably saved as jpg files. Smaller files can be e-mailed to migraine [at], and larger files (more than 5 by 7 inches) can be mailed on disk to Word Metro, P.O. Box 984, Carlsbad, CA 92018 USA. For further information, please visit or contact me at migraine [at] with any questions.

Thank you,
Betsy Blondin, Editor
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