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However, several areas of the head and neck do have pain receptors and can thus sense pain. These include the extracranial arteries, middle meningeal artery, large veins, venous sinuses, cranial and spinal nerves, head and neck muscles, the meninges, falx cerebri, parts of the brainstem, eyes, ears, teeth, and lining of the mouth.
The patient rotates their head to the affected side and extends their neck, while the examiners applies downward pressure to the top of the patient's head. A positive Spurling's sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally. [1] It is a type of cervical compression test.
The following diagnostic criteria are given for ophthalmodynia periodica: [medical citation needed]. Head pain occurring as a single stab or a series of stabs; Can be felt in the areas surrounding the eyes and temples but is "typically felt on the top, front, or sides of the head"
Cluster-like head pain may be diagnosed as secondary headache rather than cluster headache. [21] A detailed oral history aids practitioners in correct differential diagnosis, as there are no confirmatory tests for cluster headache. A headache diary can be useful in tracking when and where pain occurs, how severe it is, and how long the pain lasts.
Bilateral pain is particularly common in those who have migraine without aura. [33] Less commonly pain may occur primarily in the back or top of the head. [33] The pain usually lasts 4 to 72 hours in adults; [39] however, in young children frequently lasts less than 1 hour. [47]
They occur mostly in the orbital, supraorbital, or temporal region, but can also occur in the retro-orbital (behind the orbit of the eye) region, side, top, and back of head, second and third trigeminal divisions, teeth, neck, and ear. Only a negligible percentage of attacks (less than 2%) occur at night.
The pain is usually on both sides of the head (in 88–93% of people with NDPH), but may be unilateral, and may be localized to any head region. [5] The pain can fluctuate in intensity and duration, is daily, and lasts more than 3 months. [citation needed] There may be accompanying photophobia, phonophobia, lightheadedness or mild nausea.
The pain usually radiates from the lower back of the head, the neck, the eyes, or other muscle groups in the body typically affecting both sides of the head. Tension-type headaches account for nearly 90% of all headaches. Pain medications, such as paracetamol and ibuprofen, are effective for the treatment of tension headache.
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