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These studies suggest that pain on one side of the head can be caused by conditions such as cervicogenic headache, nummular headache, or increased mechanosensitivity of the greater occipital nerve.
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Pain on one side of the head can be a distressing symptom with various underlying causes. This article synthesizes research findings to provide a comprehensive overview of potential conditions associated with unilateral head pain.
Sphenopalatine Neuralgia (SN) is characterized by pain on one side of the head and face, often accompanied by autonomic symptoms such as eyelid and nasal mucosa congestion, runny nose, and tearing. This condition has been debated among specialists, with some considering it a subtype of cluster headache due to overlapping symptoms. However, the distinct autonomic features support its classification as a separate diagnostic entity.
Nummular Headache (NH) presents as localized, round areas of pain on the scalp. A unique case reported pain in two circumscribed areas on the same side of the head, suggesting that NH can manifest in multiple focal points simultaneously. The pain is typically continuous and throbbing, with occasional severe exacerbations. The exact cause remains unclear, but it may involve neuropathy of a cutaneous scalp nerve or nociceptive pain from epicranial tissues.
Cervicogenic Headache (CEH) is a unilateral headache that originates in the neck and spreads forward. It is often associated with reduced neck mobility and may involve ipsilateral shoulder or arm sensations. CEH is distinct in that the pain predominantly affects one side, although severe cases may also involve the contralateral side to a lesser extent.
In patients with side-dominant head and neck pain (SDHNP), increased sensitivity of the greater occipital nerve (GON) has been observed. These patients exhibit lower pressure pain thresholds and higher pain intensity on the dominant side, suggesting a potential role for neural sensitization in their symptoms. This finding highlights the importance of evaluating neural sensitivity in headache patients to inform treatment strategies.
Epicrania Fugax (EF) is characterized by brief, paroxysmal head pain that typically starts in the posterior scalp and radiates forward. However, reverse variants have been reported, where the pain begins in the fronto-parietal region and radiates backward. This condition does not fit neatly into existing headache classifications, indicating the need for further research to understand its mechanisms and treatment.
Unilateral head pain can arise from various conditions, each with distinct characteristics and underlying mechanisms. Sphenopalatine neuralgia, nummular headache, cervicogenic headache, greater occipital nerve sensitivity, and epicrania fugax are all potential causes. Accurate diagnosis and understanding of these conditions are crucial for effective management and relief of symptoms.
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