By Anita Manning

Published: Friday, October 5, 2012, 9:18 p.m.
Updated: Monday, October 15, 2012

Katie Biggs' students often know before she does that a migraine is about to strike.

A high-school English teacher and theater coach in Naperville, Ill., Biggs, 42, has had migraine headaches since she was 8 years old, and they've increased in intensity since then.

New research on headache and pain management will be the focus of a symposium, workshop and posters presented by scientists at the annual meeting of the American Neurological Association, held in conjunction with the Association of British Neurologists, starting Friday in Boston.

Migraine is one of about 300 types of headache described in medical manuals, says neurologist Richard Lipton, director of Montefiore Headache Center and professor of neurology at Einstein Medical Center in New York. To diagnose patients and determine which treatments might help, he says, doctors first must rule out underlying causes. These can be serious (brain tumor, stroke, aneurysm) or, less so (hangover or flu).

Once those are ruled out, that leaves what doctors call “primary-headache disorders,” meaning the headache isn't a symptom of some other health issue. The major ones:

Migraine

Almost 30 million Americans are afflicted with this most common form of disabling headache. It tends to run in families, and some patients have them 16 times a month or more, says neurologist Seymour Diamond, executive chairman of the National Headache Foundation. More often, patients have two to four a month. Migraine is linked to hormonal changes; 70 percent of sufferers are women.

After a migraine is triggered, a series of brain activities begins that Diamond describes as a “spreading wave over the cortex,” the nerve tissue covering the outer part of the brain.

Cluster headache

These most painful of headaches occur on one side of the head, often near the eye, and sufferers often have two to 10 attacks a day.

“It's described as a hot poker in the eye, a searing, stabbing, debilitating pain,” Lipton says. About 80 percent to 90 percent of sufferers are male, for reasons unknown, Diamond says. “People get markedly depressed,” he adds. Treatments include triptan medications and high-volume oxygen, steroids and lithium.

Tension headache

These occur when the muscles of the scalp or neck tense in response to stress, anxiety, depression or a head injury. Lipton says tension headaches have pressure on both sides, and are not made worse by physical activity, light or sound, unlike migraines.

Anita Manning is a contributing writer for USA Today.

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