As part of the review from America, mentioned in our previous blog, the group looked at whether there were any screening questionnaires for Cervicogenic Headache.
They identified one such study. In this study, the researchers looked at the diagnostic criteria for Cervciogenic Headache, and compared how predictive of the condition each component was with respect to other forms of headache (such as Migraine).
Of the various features, the following were found to be associated with Cervicogenic Headache more than 75% of the time, compared to other headache conditions. (E.g. If 100 answer yes to statement 1, 75% will have a Cerviogenic Headache).
Major Symptoms and Signs
1) Pain triggered by neck movements and/or sustained awkward head positioning
2) Pain elicited by external pressure over the GON ( a nerve in the neck) or over C2-3 on the same side as the headache is experienced.
3) Shoulder and arm pain of a rather vague, non-radicular nature on the same side as the headache
4) Pain episodes of varying duration or fluctuating, continuous pain
5) Moderate, non-excruciating pain, usually of a non-throbbing nature
6) Anaesthetic blockades of the GON or C2 nerve root
7) Sustained neck trauma a relatively short time prior to the onset
Less commonly associated features
8) Rarely occurring nausea, vomiting, and XII photo- and phonophobia
9) Ipsilateral oedema and, less frequently, ̄ushing, mostly in the periocular area
11) `Blurred vision' in the eye ipsilateral to the pain
12) Difficulty on swallowing
The criteria are designed to be assessed by a doctor and not self reported by patients, but they may be of interest as we are aware that headaches are a common topic of conversation at Myelopathy Support.
It is worth mentioning that Cervicogenic Headache remains a controversial headache type and many of these symptoms can be experienced in other forms of headache.
(1) Mizer, A., Bachmann, A., Gibson, J., & Donaldson, M. B. (2017). Self-report and subjective history in the diagnosis of painful neck conditions: A systematic review of diagnostic accuracy studies. Musculoskeletal Science & Practice, 31, 30–44. http://doi.org/10.1016/j.msksp.2017.06.002
(2) Antonaci, F., Ghirmai, S., Bono, G., Sandrini, G., & Nappi, G. (2001). Cervicogenic headache: evaluation of the original diagnostic criteria. Cephalalgia : an International Journal of Headache, 21(5), 573–583. http://doi.org/10.1046/j.0333-1024.2001.00207.x
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