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Primary headache disorders and neuro-ophthalmologic manifestations

Authors Schwartz, Robbins M

Received 15 March 2012

Accepted for publication 16 August 2012

Published 14 September 2012 Volume 2012:4 Pages 49—61

DOI https://doi.org/10.2147/EB.S21841

Review by Single-blind

Peer reviewer comments 3


Daniel P Schwartz, Matthew S Robbins

Department of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY, USA

Abstract: Headache is an extraordinarily common complaint presenting to medical practitioners in all arenas and specialties, particularly primary care physicians, neurologists, and ophthalmologists. A wide variety of headache disorders may manifest with a myriad of neuro-ophthalmologic symptoms, including orbital pain, disturbances of vision, aura, photophobia, lacrimation, conjunctival injection, ptosis, and other manifestations. The differential diagnosis in these patients is broad and includes both secondary, or symptomatic, and primary headache disorders. Awareness of the headache patterns and associated symptoms of these various disorders is essential to achieve the correct diagnosis. This paper reviews the primary headache disorders that prominently feature neuro-ophthalmologic manifestations, including migraine, the trigeminal autonomic cephalalgias, and hemicrania continua. Migraine variants with prominent neuro-ophthalmologic symptoms including aura without headache, basilar-type migraine, retinal migraine, and ophthalmoplegic migraine are also reviewed. This paper focuses particularly on the symptomatology of these primary headache disorders, but also discusses their epidemiology, clinical features, and treatment.

Keywords:
headache, migraine, trigeminal autonomic cephalalgias, neuro-ophthalmologic, aura, photophobia

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