“Living with daily chronic pain is extremely exhausting. But you don't have to accept pain as a part of your life. Finding the "right" doctor is the first step towards an appropriate treatment plan." This is the kind of advice neurologists give to patients complaining about headaches. Children and adults across the globe suffer from headaches; in the US the rate has reached 10 per cent of the population and in Europe 8 to 12 per cent. In Egypt no statistics are available, but it's assumed to be the same as in Mediterranean countries and Europe, where six out of a thousand children suffer from headaches. According to neurologists, the chronic headache is the most common type among adults and adolescents. Migraine is the least common albeit the most severe, associated with inherited problems in certain parts of the brain. Headaches can also be caused by brain tumours and meningitis. Brain haemorrhage starts with a headache and so do problems in the nasal cavity. “Doctors should be aware of these different causes and examine each part of a patient's body as well as getting acquainted with a patient's history in order to prescribe the proper treatment," said Dr Anwar Etribi, professor of neurology and psychiatry at Ain Shams University. He pointed out that Ain Shams University already operated a headache clinic, stressing that doctors should be aware of all possible causes. He added that migraines were considered a serious problem; in most cases they did not respond to drugs and painkillers. But if migraines were not treated they turned into daily chronic headaches. Dr Etribi gave these explanations during a meeting of the Egyptian Society of Neurology, Psychiatry and Neurosurgery that recently took place in Cairo. He added that surgery was only a last resort since it often led to complications. According to Timothy Steiner, professor of public health at the Imperial College, London, who was the guest speaker at the meeting, life-long headaches can also be caused by psychological problems and tension. A patient's quality of life is equally affected. In 2001 the World Health Organisation placed migraine on the list of 20 major illnesses. Doctors have to be trained specifically so they know how to diagnose a patient's headache and prescribe the right treatment. There needs to be a general increase in awareness; if patients knew what caused their headache, they would be more likely to go to the right specialist and receive efficient therapy. Dr Etribi pointed out that last year a device was invented that looks like spectacles to treat head pains known as ‘Cefaly'. It can considerably reduce or replace the consumption of painkillers and their side effects. The device is meant to work on the nerve cells affected by pain. It emits safe and painless electric impulses that act on the very nerves that transmit pain - a bifurcation of nerves known as the trigeminal nerve, often referred to as the biggest sensory nerve in the head and neck. Dr Yousri el-Senoussi, a professor of neurology, noted that headaches could also be symptoms of an illness that hasn't been diagnosed. Headaches where the reason wasn't known amounted to 90 per cent of all cases. Anxiety and depression could also cause serious headaches. He noted that a migraine attack could be accompanied by vomiting. Prevention should be based on avoiding certain foods, lack of sleep and tiredness.
