Drugs & Aging

, Volume 1, Issue 1, pp 48–56 | Cite as

Treatment of the Elderly Patient with Headache or Trigeminal Neuralgia

  • Henry J. Kaminski
  • Robert L. Ruff
Drug Therapy


The elderly as a whole suffer fewer headaches than the young. For the majority headache will represent a minor annoyance to be endured or treated with any available drug in the medicine chest. For some, migraine headaches or tension-type headaches become entwined with every daily activity. With the advent of modern pharmacology, headache can often be treated successfully. Trigeminal neuralgia is a source of particularly high morbidity among the elderly, but may be treated very satisfactorily with carbamazepine or baclofen. Paroxysmal hemicrania is exquisitely sensitive to indomethacin, while cluster headache patients receive relief from oxygen inhalation, corticosteroids or lithium.

Headache may be the signature of the disease which leads to serious morbidity and mortality. The ‘sentinel’ headache of subarachnoid haemorrhage is evaluated by a physician in 15% of patients who will eventually rupture an intracranial aneurysm. Morning headache with nausea and vomiting may represent increased intracranial pressure caused by a tumour, haematoma or abscess. The elderly patient with a new headache needs emergency evaluation for temporal arteritis and rapid corticosteroid treatment if the diagnosis is confirmed, to prevent blindness.

The broad spectrum of headache, at times a benign aggravation, while at others the harbinger of death, makes the careful evaluation of each headache imperative. This article attempts to make the difficult evaluation of head pain a little easier.


Migraine Cluster Headache Baclofen Trigeminal Neuralgia Giant Cell Arteritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Adis International Limited 1991

Authors and Affiliations

  • Henry J. Kaminski
    • 1
  • Robert L. Ruff
    • 1
  1. 1.Department of Neurology, Cleveland Department of Veterans Affairs Medical CenterCase Western Reserve UniversityClevelandUSA

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