Bob Johnson
CH.com Alumnus
 
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"Only the educated are free." -Epictetus
Posts: 5965
Kennett Square, PA (USA)
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Big time rule in science: just because two things occur together doesn't mean one caused the other.
Real easy to get confused if you don't attend to this idea. === Scan of medical literature show strikingly little material on headache (of all types) and eyes. There is one extensive nerve system which serves much of our head which is associated with many of the functions going on there and so, can lead to confusion about cause-and-effect events.
Not unusual for folks with new Cluster to see an eye doc thinking the pain must be from an eye disorder or to be told, "no". That's the substance of this material....
Semin Ophthalmol. 2008 May-Jun;23(3):169-77. Neuro-ophthalmologic manifestations of primary headache disorders. Shareef AH, Dafer RM, Jay WM. SourceLoyola University Medical Center, Maywood, IL 60153, USA.
Abstract Headaches are the most common disorders of the central nervous system affecting 46% of the adult population worldwide. Headaches may be lifelong illnesses, often associated with substantial disability for the individual and the population as a whole. The International Classification of Headache Disorders (ICHD-II) codifies headache disorders into fourteen categories, predominantly primary headaches and secondary headache disorders. Primary headache disorders, mainly migraine and trigeminal autonomic cephalgias (TACs), are frequently associated with neuro-ophthalmologic manifestations. Ophthalmologists are often the first physicians to be involved in the deciphering of headache-related visual disturbances. This article reviews two major primary headache disorders, migraine and trigeminal autonomic cephalgias, and discusses their neuro-ophthalmic complications, clinical presentation, and treatment.
PMID:18432543[PubMed] Curr Pain Headache Rep. 2010 Feb;14(1):62-72. Headache attributable to disorders of the eye. Friedman DI, Gordon LK, Quiros PA. SourceFlaum Eye Institute, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. Deborah_Friedman@urmc.rochester.edu
Abstract Sensory innervation to the eye and periocular area arises from the ophthalmic branch of the trigeminal nerve. Thus, ocular, orbital, and systemic disorders may produce head pain with ocular signs and symptoms. Whereas some of these entities have characteristic diagnostic features, others mimic primary headache disorders such as migraine and cluster headache. This article reviews common ocular and neuro-ophthalmic conditions that are accompanied by pain in or near the eye.
PMID:20425216[PubMed] ------ Med Clin North Am. 1991 May;75(3):693-706.
Ophthalmologic aspects of headache.
Tomsak RL.
Case Western Reserve University School of Medicine, Cleveland, Ohio.
Pain around the eye can be caused by local ophthalmic disorders or by disease of other structures sharing trigeminal nerve sensory innervation. In general, most ocular causes for pain also cause the eye to be red, thus alerting the examiner to the focality of the problem. However, conditions like eyestrain, intermittent angleclosure glaucoma or neovascular glaucoma, and low-grade intraocular inflammation can be painful and not be associated with obvious redness. Ocular signs and symptoms also occur with numerous other causes of headache. Double vision in association with periocular pain can result from orbital lesions, isolated cranial neuropathies, and cavernous sinus lesions. Pupillary abnormalities like Horner's syndrome may result from a variety of painful conditions, including cluster headache, parasellar neoplasms or aneurysms, internal carotid dissection or occlusion, and Tolosa-Hunt syndrome. Pain with a dilated and unreactive pupil may reflect a benign condition like Adie's syndrome or ophthalmoplegic migraine, or it may herald the presence of a life-threatening posterior communicating artery aneurysm. Headache and transient visual loss can be manifestations of classic migraine, or be symptoms of ocular hypoperfusion from ipsilateral internal carotid occlusion or increased intracranial pressure from pseudotumor cerebri. In a young patient, head pain with a fixed visual deficit may result from optic neuritis, in an older adult, temporal arteritis may be the culprit.
OPHTHALMOLOGIC ASPECTS OF HEADACHE THUS ENCOMPASS PROBLEMS THAT RANGE FROM SIMPLE AND BENIGN TO COMPLEX AND FORMIDABLE.
Publication Types: Review
PMID: 2020223 [PubMed] ======= One major study revealed that 50% of new cases of Cluster were, in fact, not headache disorders but other problems which mimic headache. Point being: need to be cautious about accepting quick diagnoses for you may end up treating (and failing) the wrong disorder.
See: Link to: cluster-LIKE headache. Section, "Medications, Treatments, Therapies --> "Important Topics" --> "Cluster-LIKE headache"
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