A 22-years-old man presents with a history of a headache for 6 months which is mainly in the frontal region, occasionally associated with nausea. He has been taking paracetamol 3g per day, Hydroxycodeine 50 mg 3 times a day and Aspirin 300 mg 3 times a day for a headache but only with temporary relief from symptoms no focal signs on neurological examinations. What is the diagnosis?
Cluster headache
Migraine
Depression associated headache
Analgesic abuse headache
Disease Features Analgesic Abuse Headache -Headaches refractory to analgesics -Asthenia, nausea, restlessness, anxiety, irritability, -Difficulty in intellectual concentration, -Depression Migraine -More common in Female -Presents with pulsating throbbing headache with photophobia -Responds to medication Depression Associated Headache -No history of depression -No psychiatric history of patient has been mentioned. Cluster Headache -Retro-orbital pain -Epiphora -Red eye.
Headache And Migraine