The full spectrum of headache and facial pain.

Attacks of moderate to severe head pain on fewer than 15 days a month, often one-sided and throbbing, worsened by activity and accompanied by nausea or sensitivity to light and sound. Attacks typically last 4 to 72 hours and leave a day of fatigue behind them.

DiagnosisDiagnosed clinically using ICHD-3 criteria and a careful attack history, supported by a headache diary that records frequency, triggers, and acute medication use. Imaging is reserved for red flags or an atypical pattern rather than used routinely.

TreatmentAn acute plan that works reliably — a triptan, gepant, or non-oral option for early nausea — plus preventive therapy when attacks are frequent or disabling: CGRP monoclonal antibodies, atogepant, candesartan, beta blockers, topiramate, or magnesium and riboflavin.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Headache on 15 or more days a month for at least three months, with at least eight of those days meeting migraine features. Many patients describe a continuous background headache punctuated by full attacks.

DiagnosisConfirmed with a prospective headache diary over four to eight weeks, screening for medication overuse, sleep apnea, cervical contributors, and mood disorders that maintain the chronic pattern.

TreatmentOnabotulinumtoxinA on the full 31-site PREEMPT paradigm every 12 weeks, CGRP-targeted prevention, nerve blocks for flares, and a deliberate limit on acute medication so the pattern can unwind.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Reversible neurologic symptoms — visual zig-zags or blind spots, numbness, tingling, or speech difficulty — that build over five to 60 minutes before or during the headache.

DiagnosisAura is diagnosed on the pattern of gradual spread and resolution. Sudden, negative, or persistent deficits require imaging and vascular assessment to exclude TIA, stroke, or a structural lesion.

TreatmentStandard acute and preventive migraine therapy, with gepants often preferred where vascular risk matters, plus counseling on estrogen-containing contraception and stroke-risk reduction.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Migraine that presents mainly as dizziness, spinning, unsteadiness, or motion sensitivity, sometimes with little or no head pain — frequently mistaken for an inner-ear disorder.

DiagnosisRequires recurrent vestibular episodes lasting minutes to hours alongside a current or past history of migraine, with audiology and vestibular testing used to exclude Meniere's disease and BPPV.

TreatmentMigraine prevention (venlafaxine, nortriptyline, topiramate, or a CGRP antibody) combined with vestibular rehabilitation and trigger stabilization around sleep and hydration.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

A rare migraine subtype with reversible weakness on one side of the body as part of the aura, often with prolonged confusion, aphasia, or fever-like symptoms.

DiagnosisDiagnosis rests on documented motor aura with recovery, imaging to exclude stroke, and consideration of genetic testing for CACNA1A, ATP1A2, and SCN1A variants when there is a family history.

TreatmentPreventives such as verapamil, acetazolamide, or lamotrigine; triptans and ergots are generally avoided, and attack care focuses on antiemetics, hydration, and observation.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Attacks clustered in the two days before through the third day of menstruation, often longer, more severe, and less responsive to usual acute treatment.

DiagnosisEstablished by a diary tracking attacks against the cycle over at least three months to separate pure menstrual migraine from menstrually related migraine.

TreatmentShort-term perimenstrual prevention with frovatriptan, naproxen, or magnesium, hormonal stabilization where appropriate, and continuous prevention when attacks extend beyond the cycle.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Migraine that continues to disable despite adequate trials of multiple preventive classes, often after years of partial responses and side effects.

DiagnosisRe-examines the original diagnosis, verifies that each prior trial reached an adequate dose and duration, and looks for a missed secondary driver such as CSF pressure disorder, venous outflow obstruction, or medication overuse.

TreatmentCombination prevention (for example a CGRP antibody with Botox), interventional care including nerve blocks and infusion bridges, neuromodulation devices, and treatment of the systemic and sleep contributors that keep the pattern alive.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Excruciating strictly one-sided pain around the eye or temple lasting 15 to 180 minutes, with tearing, nasal congestion, drooping eyelid, and restlessness, striking in daily bouts and often at the same hour each night.

DiagnosisDiagnosed on the attack duration, frequency, and cranial autonomic features; MRI with pituitary views is obtained at least once to exclude a secondary cause.

TreatmentHigh-flow oxygen and subcutaneous sumatriptan for attacks, verapamil and galcanezumab for prevention, a steroid or greater occipital nerve block to break the bout quickly, and SPG blockade for refractory cycles.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Shorter, more frequent one-sided attacks — 2 to 30 minutes, often more than five times a day — with the same autonomic features as cluster headache.

DiagnosisConfirmed by a dramatic response to an adequately dosed indomethacin trial, which is both diagnostic and therapeutic.

TreatmentIndomethacin at the lowest effective dose with gastric protection; celecoxib or topiramate when indomethacin cannot be tolerated.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

A continuous one-sided headache present for months or years, with exacerbations carrying autonomic features and a sense of grittiness or foreign body in the eye.

DiagnosisRecognized by strict side-locked continuity and, again, an indomethacin-responsive trial. It is a common missed diagnosis in patients labeled chronic migraine.

TreatmentIndomethacin as first-line, with occipital nerve blocks, Botox, or neuromodulation for patients who cannot stay on it long-term.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Very brief stabbing attacks lasting seconds to a few minutes, recurring many times per day, with conjunctival injection and tearing (SUNCT) or other single autonomic features (SUNA).

DiagnosisDistinguished from trigeminal neuralgia by autonomic accompaniment and lack of a refractory period; MRI is required to look for posterior fossa or pituitary pathology.

TreatmentLamotrigine is first-line, with intravenous lidocaine for severe bouts and occipital nerve blockade or neuromodulation for refractory cases.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Headache that begins within seven days of a head injury and continues beyond three months, often with a migraine-like character layered on neck pain, poor sleep, and difficulty concentrating.

DiagnosisDiagnosed on the temporal link to injury, with imaging when there are focal findings or a worsening course, and screening for CSF leak when the headache is clearly positional.

TreatmentEarly peripheral nerve blocks, migraine-directed prevention such as nortriptyline or a CGRP antibody, and coordinated vestibular, visual, sleep, and cognitive rehabilitation.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Headache referred from injured cervical joints, muscles, and the greater occipital nerve, typically starting in the neck or back of the head and spreading forward.

DiagnosisSupported by restricted cervical movement, reproducible tenderness over the C2-C3 segments, and relief following a diagnostic occipital nerve or trigger point block.

TreatmentOccipital nerve blocks and trigger point injections, targeted physical therapy for the deep cervical flexors, and referral for medial branch blocks when facet pain dominates.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Fragmented sleep, unrefreshing rest, lightheadedness on standing, and exercise intolerance that keep post-traumatic headache going long after the injury.

DiagnosisAssessed with sleep history and testing where apnea is suspected, plus orthostatic vitals or autonomic testing when symptoms suggest dysautonomia.

TreatmentTreatment of the underlying sleep disorder, structured sleep-timing work, salt and fluid loading or compression for orthostatic intolerance, and graded return to aerobic activity.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Structured, symptom-limited reintroduction of school, work, screen time, and sport after concussion, with written accommodations when they are needed.

DiagnosisGuided by symptom-threshold testing and objective vestibular and oculomotor assessment rather than by time since injury alone.

TreatmentStepwise activity progression, workplace and academic letters, and a headache plan that prevents each progression step from triggering a setback.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Sudden, electric-shock facial pain lasting seconds, provoked by light touch, chewing, brushing teeth, or cold air, usually in the cheek or jaw distribution.

DiagnosisClinical pattern plus high-resolution MRI with dedicated trigeminal sequences to demonstrate neurovascular compression at the root entry zone.

TreatmentCarbamazepine or oxcarbazepine first-line, with lamotrigine, gabapentin, or baclofen as alternatives; peripheral branch blocks for breakthrough pain and referral for microvascular decompression, radiosurgery, or rhizotomy when medication fails.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

The same pain pattern caused by an identifiable lesion — multiple sclerosis plaque, vestibular schwannoma, meningioma, or a cavernous malformation.

DiagnosisSuggested by younger age, bilateral pain, or sensory loss on examination; confirmed with contrast MRI and, when demyelination is suspected, spinal imaging and CSF studies.

TreatmentDirected at the underlying lesion alongside the same medication classes, coordinating care with neurosurgery, neuro-oncology, or MS specialists.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

A continuous, poorly localized aching or burning facial pain without the electric quality or triggers of neuralgia, and without an identified structural cause.

DiagnosisA diagnosis of exclusion after dental, sinus, temporomandibular, and neuralgic causes have been ruled out with examination and imaging.

TreatmentTricyclics or duloxetine as the mainstay, with topical agents, trigger point and peripheral blocks, and behavioral pain therapy layered in.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Burning, sensitive, or shock-like pain in a nerve distribution after shingles, dental surgery, sinus surgery, or facial trauma.

DiagnosisBased on the history of the inciting event and a matching area of altered sensation on examination; imaging is used when pain extends beyond the expected territory.

TreatmentGabapentinoids or tricyclics, topical lidocaine or capsaicin, targeted nerve blocks, and vaccination counseling to prevent further zoster episodes.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Elevated spinal fluid pressure producing daily headache, whooshing in the ear, transient visual blurring, double vision, and — if untreated — permanent vision loss.

DiagnosisDilated eye examination for papilledema, formal visual fields, MRI with venography for empty sella and transverse sinus stenosis, and lumbar puncture with a measured opening pressure.

TreatmentAcetazolamide with weight and metabolic management, repeat CSF pressure assessment, and — when vision is threatened — multidisciplinary planning: venous sinus stenting, CSF diversion with neurosurgery, or optic nerve sheath fenestration performed together with neuro-ophthalmology.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Narrowing or compression of the transverse or sigmoid sinus that raises intracranial pressure and produces a heartbeat-synchronous whooshing sound.

DiagnosisCT or MR venography followed by catheter venography with manometry to measure the pressure gradient across the narrowing.

TreatmentMedical pressure management first, with venous sinus stenting for a significant gradient and jugular or diverticular treatment in selected anatomy.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Headache that is markedly worse upright and better lying flat, often with neck pain, hearing change, and cognitive slowing, caused by spinal fluid loss.

DiagnosisBrain MRI with contrast for dural enhancement and brain sagging, then spinal imaging — CT myelography, dynamic or digital subtraction myelography — to localize the leak or fistula.

TreatmentEpidural blood patching, targeted fibrin sealant, transvenous embolization of a CSF-venous fistula, or surgical repair, with caffeine and recumbency as temporary measures only.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Positional headache after lumbar puncture, spinal anesthesia, or epidural placement, typically starting within days and worsening on sitting or standing.

DiagnosisDiagnosed on the procedural history and clear postural pattern; imaging is reserved for atypical features or suspicion of venous thrombosis.

TreatmentConservative care with fluids and caffeine early, sphenopalatine ganglion block for rapid relief, and epidural blood patch when symptoms persist beyond a day or two.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Bilateral pressing or tightening head pain of mild to moderate intensity, without nausea and without worsening on activity — the most common primary headache overall.

DiagnosisA clinical diagnosis that requires excluding migraine features and screening for medication overuse and cervical or jaw contributors.

TreatmentLimited simple analgesics, amitriptyline for frequent episodes, trigger point injections, and physical therapy addressing posture and cervical mechanics.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Sharp, shooting pain in the back of the head radiating toward the crown, with tenderness over the occipital nerve and scalp sensitivity to touch or hair brushing.

DiagnosisConfirmed by reproducible tenderness at the occipital nerve and relief after a diagnostic occipital nerve block; imaging assesses upper cervical pathology.

TreatmentGreater and lesser occipital nerve blocks, gabapentin or a tricyclic, physical therapy, and referral for radiofrequency ablation or stimulation in refractory cases.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Headache that reliably wakes a patient from sleep at the same time each night, lasting 15 minutes to several hours, mainly in adults over 50.

DiagnosisRequires exclusion of sleep apnea, nocturnal hypertension, and raised intracranial pressure before the primary diagnosis is accepted.

TreatmentCaffeine at bedtime, with indomethacin or melatonin as alternatives.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Sudden severe headache triggered by coughing, straining, exercise, or sexual activity, typically brief but alarming.

DiagnosisAlways requires imaging — MRI of the brain and cervical spine with vascular study — to exclude posterior fossa lesions, Chiari malformation, aneurysm, and reversible cerebral vasoconstriction syndrome.

TreatmentIndomethacin before the provoking activity, beta blockers for exertional patterns, and treatment of any secondary cause identified.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

Side-locked headache originating from upper cervical structures, provoked by neck position or movement and often accompanied by reduced range of motion.

DiagnosisSupported by cervical examination, cervical imaging where indicated, and relief from a diagnostic block of the suspected cervical structure.

TreatmentTargeted physical therapy, nerve and trigger point blocks, and referral for medial branch block or radiofrequency ablation when facet joints are the source.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.

A headache with an abrupt, clearly remembered start date that has been continuous ever since, often in someone with no prior headache history.

DiagnosisA diagnosis made only after excluding secondary causes: CSF pressure disorders in both directions, venous thrombosis, infection, and medication overuse.

TreatmentAggressive early treatment — infusion bridges, nerve blocks, and a preventive chosen by phenotype — because the condition responds better the earlier it is addressed.

General information only. Some options are provided by other specialties through referral, and choices vary by patient and with current guidelines.