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The general principles around headache as a cardinal symptom are covered elsewhere (Chap. 21); here we discuss disorders in which headache and associated features occur in the absence of any exogenous cause. The most common are migraine, tension-type headache, and the trigeminal autonomic cephalalgias, notably cluster headache; the complete list is summarized in Table 447-1.

TABLE 447-1Primary Headache Disorders, Modified from International Classification of Headache Disorders-III-Beta (Headache Classification Committee of the International Headache Society, 2013)


Migraine, the second most common cause of headache, and the most common headache-related, and indeed neurologic, cause of disability in the world, afflicts approximately 15% of women and 6% of men over a 1-year period. It is usually an episodic headache associated with certain features such as sensitivity to light, sound, or movement; nausea and vomiting often accompany the headache. A useful description of migraine is a recurring syndrome of headache associated with other symptoms of neurologic dysfunction in varying admixtures (Table 447-2). Migraine can often be recognized by its activators, referred to ...

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