Homeostatic Headaches

Headache is an exceedingly common painful symptom that affects everyone at some time in his or her life and competes with backache for seeking medical help and attention. Headaches are divided into two categories, the primary (tension, migraine and cluster headaches and their variants) and the secondary headaches.The latters are due to other medical conditions, i.e., are caused by other than primary headaches. Secondary headaches include different etiologies: a) Cranial or cervical vascular insults, b) Intracranial nonvascular disorders, c) Disorder of cranium appendixes, d) Substance use / withdrawals and medications, e) Angle closure glaucoma, f) Trauma, g) Psychiatric disorders, h) TMG disease and i) Metabolic/systemic disorders.In fact, many headaches result from metabolic or systemic rather than neurologic diseases. The term of metabolic or systemic headaches was first coined by the first edition of the international headache society (HIS), international classification of headache disorders (ICHD)-1 (1988). ICHD-3 (beta version, 2013) stated that if a headache occurs for the first time in close temporal relation to a disorder of homeostasis, it is coded as secondary headache attributed to that disorder, examples include: 1) hypoxia and / or hypercapnia, i.e., high altitude, diving and sleep apnea, 2) dialysis, 3) arterial hypertension, i.e., hypertension with or without hypertensive encephalopathy, preeclampsia/eclampsia, pheochromocytoma and autonomic dysreflexia, 4) hypothyroidism, 5) fasting, 6) cardiac cephalgia and 7) Other disorders of homeostasis such as hypercalcemia. Although, varied mechanisms may be involved in these headaches but there general diagnostic criteria applicable in most cases. In this lecture, we will discuss homeostatic headaches in details.

Keywords:

Headache , Systemic , Metabolic , Homeostatic