Classification of Headache
To fully understand and appreciate the Cayce information headache, a broader analysis of headache classification is helpful. Within this expanded context (both historical and conceptual) the complexity of the Cayce readings make more sense and can be translated into a clinically relevant algorithm for modern practitioners.
A. Modern Classification of Headache
The National Headache Society recognizes two general groups of headache – primary and secondary (National Headache Foundation, 1996). Primary headaches are typically recurrent without known pathology or cause. The three basic categories of primary headache are tension, migraine and cluster. Secondary headaches are associated with a recognized medical condition.
Tension headaches are the most common form of primary headache affecting up to two thirds of the population at some time in their lives. Tension headaches are typically felt on both sides of the head as dull and persistent pain, varying in intensity. These headaches are sometimes described as a “tight band around the head” and may also involve neck pain.
Migraine, or neurovascular headaches, affect about 12 percent of the population with women about two or three times more likely to experience this type of headache. Migraine presents as moderate to severe pain, usually on one side of the head.
Migraine attacks are often include nausea, cold hands, vomiting and sensitivity to light and sound. About twenty percent of migraine episodes are preceded by an “aura” (classic migraine) that may involve visual phenomena, numbness or impaired speech. Migraine is sometimes linked to menstrual cycles (menstrual migraine).
Cluster headaches are much less common and mainly affect men. Cluster headache presents as severe pain around or behind one eye, usually at night. This type of headache can occur daily in groups or “clusters” for days or weeks at a time.
The basic cause of primary headaches is unknown. Treatment is directed at relieving symptoms and preventing episodes. Treatment of secondary headache usually focuses on treating the primary condition and providing symptomatic relief for the headaches.
B. Historical Approaches to Headache Classification
1. Organic and Functional Classification
Historically, many approaches have been used to classify headache. The organic/functional distinction is well represented in the historical medical literature and is probably the forerunner of the modern primary/secondary classification. “In a general consideration of headaches it becomes necessary to make a distinction between headaches due to organic changes and headaches that are purely functional in character.” (Dercum, 1912)
2. Classification by Symptoms and Presentation
Classification by symptoms and presentation is also well represented in the historical literature.
Barton and Yater (1927) provide one of the more extensive discussions of headache classification by symptom diagnosis.
3. Classification by Etiology and Physiology
Carl Nelson, D.C., Marie Eschelman, Douglas Richards, Ph.D., David McMillin, M.A. and Eric Mein, M.D.
Meridian Institute