The rare, unilateral headaches. Vågå study of headache epidemiology

Abstract

In the Vågå study of headache epidemiology, 1838 parishioners in the age group 18–65 years were included (88.6% of the relevant population). Each individual was questioned in a face-to-face situation. In this population, a search of rare unilateral headaches was also made, in spite of their presumed rarity. Trigeminal neuralgia was present in two cases. Two individuals with SUNCT traits were observed. Hemicrania continua may have been present in one individual. Also observed were: optic neuritis ( n =1), herpes zoster ( n =4); a case of unilateral headache upon neck rotation (chronic paroxysmal hemicrania variant? or "forme fruste" of the neck–tongue syndrome?); masseter muscle spasm ( n =1); temporo-mandibular joint dislocation ( n =1); and possible carotidynia ( n =3). A particularly intriguing form of headache was a unilateral, neuralgiform (?) pain, associated with ipsilateral, regular jabs and allodynia, a combination observed in eight females. A couple of conditions that entirely defy rubrication are also reported.

[18F] Fluorodeoxyglucose Positron-Emission Tomography-CT Imaging of Carotidynia

“…4,12,13 Other causes of unilateral neck pain include migraine, trigeminal neuralgia, pharyngitis, head and neck neoplasm, temporomandibular joint disease, cervical spondylosis, and Eagle syndrome (stylalgia). 3,4,11,14 Although these conditions account for many patients presenting with carotid pain, multiple reports have described a subset of patients with self-limiting carotidynia in whom none of these causes is found after careful work-up. MR, CT, and sonography imaging in these patients demonstrates amorphous enhancing soft tissue surrounding the carotid bifurcation without luminal compromise.…”

Diagnostic Distribution of 100 Unilateral, Side-Locked Headaches Consulting a Specialized Clinic

“…They classically include the different trigeminal-autonomic cephalgias (TACs), such as cluster headache, paroxysmal hemicranias and short-lasting uni-lateral neuralgiform headache attacks, which are character-ized by unilateral head pain and ipsilateral cranial auto-nomic features [4]. Strictly unilateral headaches, however, are not synonymous of TACs as a variety of primary head-aches and, what perhaps is more important, of secondary headaches can present with pain on just one side of the head [5]. To our knowledge, there is no analysis of the diagnostic distribution of patients consulting due to strictly unilateral headaches.…”

Clinical features of unilateral headaches beyond migraine and cluster headache and their response to indomethacin

“…In the general population, prevalence of primary stabbing headache is about 10%. Th e prevalence of paroxysmal hemicrania and hemicrania continua may lie around 5 per 10000 [12,16,17]. In hospital-based studies, primary stabbing headache was diagnosed in 13% of patients with short-duration headache [5] and unilateral tension-type headache was found in 4% and 18%, respectively [18].…”

“…Th e majority of studies on unilateral headaches beyond migraine and cluster headache have focussed on certain disorders such as paroxysmal hemicrania, SUNCT, primary stabbing headache or hemicrania continua [12][13][14]. To the best of our knowledge there is no case series available dealing with less common unilateral headaches on a broader basis.…”