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The second headache type related to the neck is cervicogenic headache. This is defined as a headache that occurs in a patient with clinical, laboratory, or imaging evidence of a neck disorder known to cause headache. We offer a panoramic view of nociception, from a central perspective, and discuss various pharmacological options available to treat headache and neck pain. We also debate the role of a new antiepileptic drug, gabapentin, in the management of headache and neck pain. Diagnostic imaging is commonly normal or non-specific, but may identify areas of clinical concern such as C2/3 or C3/4 facet hypertrophy. Physiotherapy may be an effective treatment. Although there are no FDA approved medications for cervicogenic headache, medications such as gabapentin, topiramate, or duloxetine may have a Wade Cooper is the Medical Director of the University of Michigan Headache and Neuropathic Pain Clinic.He is an assistant professor with the departments of Neurology and Anesthesiology at the University of Michigan School of Medicine. He also serves as the fellowship director for the Headache Medicine Fellowship Program. His areas Antiseizure medications like gabapentin (Neurontin) and pregabalin (Lyrica) may provide relief. Your doctor also may prescribe duloxetine (Cymbalta), a type of antidepressant called a selective Cervicogenic headaches are an often-overlooked headache type. These headaches cause pain in the back of the head, the temporal areas, and behind the eyes and are often mistaken for—or co-exist with—tension headaches, migraine headaches and neck pain. Often patients with cervicogenic headaches will have a history of a neck injury such as whiplash, or participate [] Many of the symptoms of cervicogenic headaches overlap with symptoms of migraine or tension-type headache. Because the symptoms are similar, it can be tricky to determine the cause of chronic headaches. Gabapentin is a drug that’s approved to help prevent seizures in people with epilepsy and treat nerve pain from shingles. It’s also sometimes used off-label for migraine prevention. Cervicogenic headaches can be painful and debilitating. However, there are treatments available. Cervicogenic headaches typically arise when the nerves of the upper cervical spine are irritated. The pain from these headaches usually starts in the neck and spreads to one side of the head. It may also cause pain behind one or both eyes. Gabapentin (GBP), originally an antiepileptic drug, is more commonly used in the treatment of pain, including headache disorders. Off-label GBP is used in headache disorders with some success, some failure, and much debate. Cervicogenic headaches are a secondary headache disorder attributable to cervical spine dysfunction resulting in head pain with or without neck pain. Diagnosis of this condition has been complicated by varied clinical presentations, causations, and differing diagnostic criteria. Core Tip: Cervicogenic headache (CEH) was recognized as a unique category of headache.The treatments of CEH remain controversial among different disciplines. The Chinese Association for the Study of Pain asked a multidisciplinary expert group identified the clinically relevant topics in CEH. A systematic review of radiofrequency ablation and pulsed radiofrequency ablation demonstrated “very limited benefit” in the management of cervicogenic headache. 32 A 2016 review focusing solely on cervical zygapophyseal joint pain (as opposed to cervicogenic headache) found some degree of evidence for radiofrequency ablation and nerve What is a cervicogenic headache? A cervicogenic headache is head pain caused by a cervical spine (neck) issue. The pain you feel is referred pain. This happens when you feel pain in a part of your body that’s different from the pain source. Secondary headaches are caused by an identifiable process. Cervicogenic headache, posttraumatic headache, and medication overuse headache are the most common secondary headaches. Red We would like to show you a description here but the site won’t allow us. A cervicogenic headache presents as unilateral pain that starts in the neck and is referred from bony structures or soft tissues of the neck.[1] It is a common chronic and recurrent headache that usually starts after neck movement. It usually accompanied by reduced range of motion of the neck. It could be confused with a migraine, tension headache, or other primary headache syndromes Cervicogenic headache, posttraumatic headache, and medication overuse headache are Gabapentin (Neurontin) is minimally effective at high doses, and adverse effects are common. Most cervicogenic headaches are caused by stress, fatigue, problems sleeping, back and neck injuries, poor posture, and disc injuries. They are usually triggered by sudden neck movements and may be accompanied by dizziness and blurred vision. Cervicogenic headache constitutes 15 to 20% of all chronic and/or recurrent headaches and is categorized as a secondary headache, meaning the condition results from an underlying disease. CGH specifically stems from a neuromusculoskeletal dysfunction of the cervical spine, particularly the upper three cervical segments.¹˒²˒³
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