'Hair wash' or 'head bath' triggering migraine - observations in 94 Indian patients.

Identification of trigger factors is helpful in the diagnosis and management of migraine. Common triggers of migraine are well established but 'hair wash or head bath' as a trigger for migraine has so far not been reported. This prospective study analysed this unusual trigger link in 94 out of 1500 Indian patients who fulfilled the International Headache Society criteria for migraine. In 11 patients, hair wash was the only trigger; in 45 patients hair wash was one of the triggers and in 38 patients hair wash was a trigger concurrently and in combination with another common trigger. The effect of episodic and long-term prophylaxis in preventing this trigger-like headache has been analysed. The underlying pathophysiological basis is not established but it is important for this unusual regional trigger to be identified and incorporated in the management strategy.