Walsh and Hoyt's Clinical Neuro-Ophthalmology

Headache and Facial Pain

"Headache and facial pain are common complaints and represent a diverse range of etiologies, from benign to lifeand vision-threatening."

"Headache and facial pain are common complaints and represent a diverse range of etiologies, from benign to lifeand vision-threatening. Headache, migraine in particular, has been described in the popular and medical literature for over 3000 years (1). Trepanation, a sign of neurosurgery, has been seen on Neolithic skulls dating from 7000 B.C. (Fig. 26.1). The Ebers papyrus, an ancient Egyptian prescription dating back to 1200 B.C., mentions migraine, neuralgia, and shooting head pains, and is thought to be based on earlier medical documents from 1550 B.C. (2). Indeed, it is estimated that over 90% of individuals have noted at least one headache over their entire life (3). Patients with headache may present initially to a neurologist or ophthalmologist, and are often misdiagnosed initially. Since correct diagnosis facilitates appropriate treatment, it is important for the clinician to be familiar with common causes of head and facial pain. This chapter will focus primarily on those causes of headache and facial pain most relevant to neuro-ophthalmologists."