Headache is the most common neurological symptom with which patients attend their primary care physicians. It is also the most common reason for referral to neurology outpatient clinics. Migraine and tension-type headaches are the most common causes of headaches, although patients usually do not seek medical attention for episodic tension-type headaches. Medication overuse is another important cause of chronic daily headaches and is, for the most part, preventable.
This supplement brings together articles on the diagnosis and management of primary headache syndromes, with a focus on migraine. The diagnosis of primary headache disorders is almost entirely based on the history, and this needs to be emphasized. The investigation of headache disorders is to rule out a secondary cause, and neuroimaging is important in this regard although the patient must be made aware of the possibility of picking up incidental findings on head scans. The increased interest in headache disorders in the last two decades is almost certainly due to the advances in understanding of the pathophysiological basis of primary headache disorders, although an increase in the therapeutic options available is also clearly relevant. The trigeminal autonomic cephalalgias are an interesting group of highly disabling headache disorders that are often misdiagnosed and therefore managed incorrectly. Some of the rarer primary headache syndromes present as secondary headache disorders, and the diagnosis is often only made after investigations have been completed.
In addition to the review articles on the topics mentioned above, the supplement also brings together case reports/view point/original articles on primary headache syndromes. I would like to thank all the authors for their contributions and Dr. Sanjeev Thomas for asking me to compile this supplement. This supplement on headache disorders is a joint British–Indian effort and it is my pleasure to present it to the readers of the Annals of Indian Academy of Neurology.