Primary headache disorders and neuro-ophthalmologic manifestations

imary headache disorders and neuro-ophthalmologic manifestations Review (1274) Total Article Views Authors: Schwartz DP, Robbins MS Published Date September 2012 Volume 2012:4 Pages 49 - 61 DOI: http://dx.doi.org/10.2147/EB.S21841 Received: 15 March 2012 Accepted: 16 August 2012 Published: 14 September 2012 Daniel P Schwartz, Matthew S Robbins Department of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, NY, USA Abstract: Headache is an extraordinarily common complaint presenting to medical practitioners in all arenas and specialties, particularly primary care physicians, neurologists, and ophthalmologists. A wide variety of headache disorders may manifest with a myriad of neuro-ophthalmologic symptoms, including orbital pain, disturbances of vision, aura, photophobia, lacrimation, conjunctival injection, ptosis, and other manifestations. The differential diagnosis in these patients is broad and includes both secondary, or symptomatic, and primary headache disorders. Awareness of the headache patterns and associated symptoms of these various disorders is essential to achieve the correct diagnosis. This paper reviews the primary headache disorders that prominently feature neuro-ophthalmologic manifestations, including migraine, the trigeminal autonomic cephalalgias, and hemicrania continua. Migraine variants with prominent neuro-ophthalmologic symptoms including aura without headache, basilar-type migraine, retinal migraine, and ophthalmoplegic migraine are also reviewed. This paper focuses particularly on the symptomatology of these primary headache disorders, but also discusses their epidemiology, clinical features, and treatment.