Headache Episodes

Headache episodes, as opposed to constant headaches, are the majority of all headache disorders, especially those in General Practice.

Most of these episodic headaches are diagnosed (correctly) as migraine or tension-type headache.

You need to know whether the head pains are provoked. You also need to know how long each headache episode typically lasts.

Are the Episodic Headaches Provoked?

Provoked headaches include:

1. Cough Headache
2. Exercise Headache
3. Orgasm Headache, or Sexual Activity Headache

These specific provoking factors should be asked about. In cough headache, minor forms of exertion such as lifting stooping or straining (e.g. doing the toilet) can also provoke the pain. Cough headache is a lot shorter in duration (< 1 minute) compared to exercise headache or sex headache which are usually longer - anything from 5 minutes to 24 hours.

The Episodes of Headache are Unprovoked

1. Duration more than 4 hours per headache
• Episodic Tension-type Headache
• Migraine
2. Duration lasting seconds, and usually recur
• Ice-pick headache
• SUNCT
• Trigeminal Neuralgia
• Occipital Neuralgia
• Supraorbital Neuralgia
3. Duration of minutes, but less than 4 hours
• Cluster Headache
• Paroxysmal Hemicrania
• Hypnic Headache