What are cranial neuralgias, facial pain, and other headaches?

Neuralgia means nerve pain (neur= nerve + algia=pain). Cranial neuralgia describes inflammation of one of the 12 nerves that supply the motor and sensation function of the head and neck. Perhaps the most commonly recognized example is trigeminal neuralgia, which affects cranial nerve V (the trigeminal nerve) and can cause intense facial pain.

What causes tension headaches?

While tension headaches are the most frequently occurring type of headache, their cause is not known. The most likely cause is contraction of the muscles that cover the skull. When the muscles covering the skull are stressed, they may become inflamed, go into spasm, and cause pain. Common sites include the base of the skull where the trapezius muscles of the neck insert, the temples where muscles that move the jaw are located, and the forehead.

There is little research to confirm the exact cause of tension headaches. Tension headaches occur because of physical or emotional stress placed on the body. For example, these stressors can cause the muscles surrounding the skull to clench the teeth and go into spasm. Physical stressors include difficult and prolonged manual labor, or sitting at a desk or computer for long periods of time concentrating. Emotional stress also may cause tension headaches by causing the muscles surrounding the skull to contract.

What are the symptoms of tension headaches?

Common presentation of tension headaches includes the following:

• Pain that begins in the back of the head and upper neck and is described as a band-like tightness or pressure. It may spread to encircle the head.
• The most intense pressure may be felt at the temples or over the eyebrows.
• The pain can vary in intensity but usually is not disabling, meaning that the sufferer may continue with daily activities. The pain usually is bilateral (affecting both sides of the head).
• The pain is not associated with an aura (see below), nausea, vomiting, or sensitivity to light and sound.
• The pain occurs sporadically (infrequently and without a pattern) but can occur frequently and even daily in some people.
• The pain allows most people to function normally, despite the headache

• How are tension headaches diagnosed?

  The key to making the diagnosis of any headache is the history given by the patient. The health care professional will ask questions about the headache to try to help make the diagnosis. Those questions may include learning about the quality, quantity, and duration of the pain, and asking about any associated symptoms. The person with a tension headache will usually complain of pain that is mild-to-moderate, located on both sides of the head, described as a tightness that is not throbbing, and not made worse with activity. There will be no associated symptoms like nausea, vomiting, or light sensitivity.