Thermography in the diagnosis of headache

We reviewed thermograms of 993 suitable patients with migraine with and without aura, chronic daily headache, cluster headache, posttraumatic headache, and a variety of other headache types. Eight hundred fifty-five (86.1%) had abnormal thermograms usually characterized by decreased supraorbital thermal emission. Six hundred ninety-four (69.9%) of 993 had migraine without aura of whom 593 (85.4%) had abnormal thermograms. Two hundred two (20.3%) of 993 had migraine with aura, of whom 180 (89.1%) had abnormal thermograms. Thirty of 35 (85.7%) patients with cluster headache, and 28 of 33 (84.8%) with posttraumatic headache had abnormal thermograms. Twenty-four of 29 (82.8%) of patients with various less common headaches and head pain syndromes had abnormal thermography. Previous studies have indicated that about 67 to 84% of patients with migraine have abnormal thermograms. Some reports have indicated fewer have thermal asymmetries in migraine without aura, and even fewer with "mixed or muscle contraction" headaches. Our study indicates a somewhat greater number of headache patients have abnormal thermograms than has generally been reported. We conclude digital infrared thermography is a useful diagnostic test in the management of headaches.