In some cases, the classic symptoms, may be absent, or other symptoms
may be present; for example, dizziness, hypersensitivity to light and sound,
runny nose and/or eyes, and bloodshot eyes.
3 Treatment. The importance of early medication during an attack
cannot be overemphasized. The patient should be given mild analgesics, aspirin, or
acetaminophen. Additionally, the patient should:
a Lie down in a quiet, darkened room; decrease external
stimulation as much as possible; relax, but do not read.
b Apply a cold cloth or ice pack to the forehead and back of
neck until headache is completely relieved.
Cover both eyes with cloth.
d Immobilize head by placing blankets or towels on each side
of the head.
e If available, drink hot liquids (such as tea) only if there is no
nausea and/or vomiting.
Instruct patient to keep a record of activity or food eaten prior to a migraine,
this may indicate the cause of the headache.
4 Refer patient to a physician if the migraine attack persists longer
than 24 hours, despite treatment. Recurrent migraine headaches will, most likely,
interfere with duty performance.
A more extensive work-up (tests) may be required.
(b) Cluster headache. This type of headache occurs in clusters of
several times a day or week for several weeks, with long intermissions between
clusters. The headache is unilateral, severe, boring, and throbbing. It occurs
consistently on the same side, usually in the orbital region, the temple, or on the side of
the face; it may spread to the neck and shoulder.
1 Etiology. Similar to the migraine headache. The exact cause is
2 Signs and symptoms:
a Severe and frequent attacks of short duration usually in
"cluster or groups"; sometimes as often as 20 or more per week followed by remission
for an indefinite period.