Diagnosing Headache in Older People
Headaches become relatively less prevalent in older patients but still more than 50% of people older than 65 years complain about regularly occurring headaches. Most of these headaches are primary headaches, with tension-type headache much more prevalent than migraine headache. The proportion of secondary headaches increases in older patients and remains about 2.2%. Subjects who complain about headaches for the first time after the age of 64 have a clearly elevated risk of having a symptomatic headache (about 15.3%) compared to the general population with 7–8%. There are some changes in the symptoms of primary headache syndromes. In particular, migraine attacks may have other symptoms in older patients with nausea and vomiting less often and a dull and holozephalic pain and isolated auras more often. There are also some headache syndromes that occur almost exclusively in older patients, namely, hypnic headache, giant cell arteritis, and sleep apnea–associated headache. Diagnostic interventions in older patients generally do not differ from those in younger patients.
KeywordsObstructive Sleep Apnea Sleep Apnea Facial Nerve Cluster Headache Trigeminal Neuralgia
The author would like to thank Miss K. Ogston for her help in editing the manuscript.
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