Mechanisms and management of headache.

Headache is the commonest of human maladies, and many books have been devoted to the subject1–3. In this article, the mechanisms of primary headache and its treatment will be considered. Most developments have been in primary headache (Table 1), in particular migraine, so this will be the main focus. Recent reviews of migraine diagnosis5 and management6,7 are available. Diagnostic issues are beyond the scope of this review, though it is worth remarking that the codification of diagnostic criteria for all headache types8, particularly migraine (Table 2), has been a useful step forward.