Headache and facial pain

Headache and facial pain are very common. Headache accounts for 4.4% of all consultations in general practice, approximately 5% of all medical admissions to hospital and over 25% of neurology outpatient consultations. Tension-type headache is a near-universal part of the human condition, more than 95% of us experiencing it at some point in our lives; at the more severe end of the spectrum, migraine affects 10–20% of the population worldwide, and 1–2% of the population in developed countries have chronic daily headache. Headache is so common that, even though for many people it is no more than an inconvenience, the cumulative burden of migraine alone causes it to rank high in the World Health Organization's league tables of disease-related disability, above all other neurological disorders other than stroke and dementia. As all doctors will encounter patients with headaches and facial pain, they must have a basic working knowledge of the common primary headaches and the important secondary causes, as well as a rational manner of approaching the patient with these conditions that allows a diagnosis to be made quickly and safely. This article provides those resources.