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Primary exertional headache: updates in the literature
Rashmi B Halker1, Bert B Vargas
1Department of Neurology, Mayo Clinic College of Medicine, Scottsdale, AZ 85259, USA. halker.rashmi@mayo.edu
Current Pain and Headache Reports
|April 23, 2013
Summary
Primary exertional headache (PEH) is a rare, short-lasting headache triggered by physical activity. While usually benign and responsive to treatment, initial occurrences require medical evaluation to rule out serious underlying causes.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Primary exertional headache (PEH) is an International Headache Society-recognized diagnosis since 1994.
- PEH is an uncommon, short-lived headache disorder triggered by physical exertion.
- It frequently co-occurs with migraine and shares features with other primary headache types.
Purpose of the Study:
- To provide a comprehensive overview of Primary Exertional Headache (PEH).
- To discuss the diagnostic criteria, differential diagnoses, and management of PEH.
- To highlight the importance of excluding secondary causes upon initial presentation.
Main Methods:
- Literature review of PEH diagnosis, epidemiology, and pathophysiology.
- Comparison of PEH with related headache disorders.
- Discussion of diagnostic workup, including neurological evaluation and imaging.
Main Results:
- PEH is generally considered benign and self-limited.
- Trigger avoidance and indomethacin are effective management strategies.
- Initial presentation necessitates ruling out serious secondary causes like subarachnoid hemorrhage.
Conclusions:
- PEH is a distinct primary headache disorder often linked to exertion.
- Despite being generally benign, thorough evaluation is crucial for initial cases.
- Management focuses on trigger avoidance and pharmacotherapy, with indomethacin being a key treatment.
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