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Patients with migraine and tension-type headaches report attacks that are preceded by warning symptoms. This phenomenon is most commonly seen by patients with migraine and cluster headache. Warning symptoms include nausea, lightheadedness, sensitivity to light or sound, and hiccuping having no known cause. These symptoms are not present in all patients and can be unreliable in relieving the symptoms, thus the treatment of headache is often delayed. It's important to note that many patients with primary headache, including migraine and tension type, have these symptoms associated with a prodrome that precedes the headache by a few hours and is usually worse than the headache itself. This typically lasts anywhere from hours to a day or longer before the headache begins and may last from about one day to a couple of days.
This five-day attack frequency/intensity calendar, also known as a weekly headache chart, is used to record and quantify headache attacks. This type of chart has also been found to be helpful for migraine prevention. Some migraine sufferers record headaches as they happen and some chronic migraineurs use the calendar method. With the calendar method, patients keep a diary listing the date, time and intensity of each headache. The patient could also keep a record of medication use. Each headache is rated on the severity (on a scale of 0-10 or 0-100) and duration (in hours). For patients with mild initial headache, it is important to record the severity and duration over the first and second day (first phase) as this will give an indication of how severe the headache will become. Some patients add a pain free day after the first phase. The second phase usually begins on the third day. It is very useful not to record headaches as mild symptoms as this will confuse things.
Headache dentists discuss the differential diagnosis of the headache with the patient and often with physicians. Although there may be subtle differences between these disorders, each results in pain that is relieved by pharmacologic interventions that target headache-relevant regions of the brain and central nervous system. The awareness of these disorders enables the appropriate management of the patient from the first office visit. d2c66b5586