Stephen D Silberstein MD

Hypnic headache

Hypnic headache is a primary headache disorder characterized by short-lived headaches that occur exclusively during sleep at the same time each night and cause awakening, and may have accompanying migrainous features. Symptoms typically begin after age 50.

Medications and substances causing headache

Recurrent painful ophthalmoplegic neuropathy

The International Classification of Headache Disorders version 3-beta classifies recurrent painful ophthalmoplegic neuropathy as a cranial neuralgia. Although a clinical diagnosis, it may show enhancement of the involved cranial nerve on post-gadolinium MRI. The third cranial nerve is the most frequently involved nerve in recurrent painful ophthalmoplegic neuropathy. Episodes of recurrent painful ophthalmoplegic neuropathy appear spontaneously and then resolve without treatment.

Acute headache: diagnosis

Migraine is the most common diagnosis in the evaluation of acute headache. Diagnosis is made with a systematic approach to the headache, characterizing it in terms of duration, quality, location, and accompanying symptoms.

Headache in children: overview and treatment approaches

Childhood primary headaches are increasingly being recognized as a significant neurologic health problem. According to a study by the AMPP, the migraine prevalence in adolescents is 14%. Early diagnosis and an integrative treatment approach are essential to minimize the impact on a child's quality of life. Differentiating primary headaches from those caused by underlying, perhaps life-threatening pathology is critical to expedient establishment of appropriate treatment and, potentially, cure.

Alternating hemiplegia of childhood

Alternating hemiplegia of childhood manifests with episodes of unusual posturing, hemiplegia, and progressive developmental and behavioral disturbance and seizures, with onset typically in early childhood. It is a rare disorder caused by mutations in the ATP1A3 gene, associated with both familial and sporadic cases.

Tension-type headache

Diffuse, aching head pain without migraine characteristics is the primary symptom of tension-type headache. Sensations of tightness or pressure and muscle pain are also seen. Peripheral and central pain mechanisms both appear to be involved in tension headache, which is the most common type of headache.

Status migrainosus

Status migrainosus consists of headache (with or without aura) in a patient with underlying diagnosis of migraine, similar to their typical headache but with prolonged pain and associated symptoms lasting over 72 hours.