What are the Rare Primary Headache Disorders?

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Is This a Tension Headache or Something Else?. JGI/Jamie Grill/Blend Images/Getty Images

When someone complains of a headache, health care professionals often jump to common etiologies of head pain, like tension-type headaches or migraines. But, what about those rare primary headache disorders? Do you suffer from a headache disorder that has puzzled even your neurologist or headache specialist? Let's take a closer look at primary headache disorders other than migraines, tension-type headaches, and cluster headaches.

Remember, a primary headache occurs on its own or independently. It is NOT the result of another medical condition – which is called a secondary headache

Primary Cough Headache: A primary cough headache is triggered by coughing and is characterized by sudden pain that is located on both sides of the head. This rare headache lasts from 1 second to two hours.

Primary Exercise Headache: Primary exercise headache occurs during or after strenuous physical activity, are throbbing, and last less than 2 days.

Primary Stabbing Headache: This headache causes a single or series of stabbing pains in the region of the trigeminal nerve – a large cranial nerve with branches near the eye, cheek, and jaw. Some people with this headache disorder experience one stabbing headache a day whereas others have multiple headaches. The sharp, stabbing pain is very short-lived, lasting a few seconds.

Primary Headache Associated with Sexual Activity: This head pain is precipitated by sexual activity.

It usually begins as a dull headache that increases in intensity just before or during orgasm.

Primary Thunderclap Headache: This headache is characterized by an explosion of head pain that is severe and resembles that of a subarachnoid hermorrhage. Because this type of headache can indicate a very serious medical condition, it needs to be evaluated emergently.

Hypnic Headache: Hypnic headaches awaken people from their sleep and occur in people over the age of 50. They last for at least 15 minutes and up to 4 hours upon awakening.

Hemicrania continua: This is a painful headache that occurs on one side of the head, is constant.and is associated with at least one autonomic symptom:

  • nasal discharge
  • tearing of the eye
  • miosis  constriction of the pupil of the eye

New Daily Persistent Headache (NDPH): This headache occurs daily and constantly for more than 3 months. It may resemble that of a migraine or tension headaches, or a mixture of both. It's an unusual headache disorder in that it generally occurs in people who did not previously suffer from headaches.

Take Home Message

Some primary headache disorders occur less commonly and can be challenging to diagnose. Fortunately, many of them have good therapies so do not be discouraged if your doctor diagnoses you with one. Instead, focus on learning more about it, so you can be proactive in your headache health.

Sources

Cutrer M. Primary cough headache. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014.

Fuh JL, Kuo KH, & Wang SJ. Primary stabbing headache in a headache clinic. Cephalalgia.2007 Sep;27(9):1005-9.

Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.

Schwedt TJ & Dodick DW. Thunderclap headache. In: UpToDate, Basow DS (Ed), UpToDate, Waltham, MA, 2014.

Silberstein SD, Lipton RB, & Sliwinski M. Classification of daily and near-daily headaches: field trial of revised IHS criteria.Neurology. 1996;47(4):871-875

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