Disability in Headache Disorders

June 11, 2018News

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Jayne must lie flat much of the day to reduce her head pain.


 

Disability Associated with Headache Disorders is Underappreciated

This awareness day is part of Migraine & Headache Awareness Month #MHAM

A few facts:
Migraine headache is the leading cause of disability among neurologic disorders.
Migraine headache is the number 2 cause of disability, second only to low back pain.
Migraine headache is the number 1 cause of disability in the 15-49 age group.

For those that suffer with intracranial hypotension due to spinal CSF leak, also known as “low pressure headache”, disability can vary from mild to profound.

Why is a #spinalCSFleak so disabling?

The most common symptom related to a spinal CSF leak is head pain that is worse after minutes to hours of assuming upright posture. This is because the underlying problem is a loss of cerebrospinal fluid (CSF) volume through a defect (hole or tear) in the spinal dura mater, which is a connective tissue that normally holds this special fluid in around the brain and spinal cord. While horizontal, a patient’s brain-spinal fluid pressure is equal in the head and the spine, but when upright, the fluid pressure is lower in the head and higher at the bottom of the spine. The result is that many patients can function normally while upright for only minutes to hours per day. Relief from head pain and other symptoms comes only from lying flat. Medications are largely ineffective. When the correct diagnosis is made, diagnostic testing and treatments can lead to a cure or improved quality of life for many. The most important determinant of better outcome is the correct diagnosis. But misdiagnosis and delayed diagnosis remain the rule rather than the exception, due to low awareness.

Other common symptoms experienced by those with spinal CSF leak often contribute to disability. These include nausea, vomiting, cognitive changes (brain fog), hearing changes, dizziness, imbalance, fatigue and neck pain, although there are others. Patients with other headache disorders also experience a range of symptoms contributing to the level of impairments in function.

The recognition that headache disorders can be very disabling is important. These are NEUROLOGIC disorders that go far beyond head pain.

#MoreThanJustAHeadache #NotAlone