ABSTRACT
Since headache is an almost universal experience (80-90 per cent of the population have experienced a headache at some time in the previous 12 months), it is perhaps surprising that headache is not more conspicuous in the list of complaints leading to consultation with the general practitioner. In the USA, it has been calculated that 4.3 annual visits per 100 of the population are due to headache. In a UK survey, headache was the predominant complaint in both 4 per cent of consecutive practice consultations and home visits.8 Analysis of the underlying diagnosis is critically dependent on the criteria used for those diagnoses. In one survey of 200 successive headache patients encountered in general practice, migraine and tension headache accounted for the majority (66.5 per cent) (Table 2)1. This 66.5 per cent of the total is very close to the 58.6 per cent that migraine and tension headache contribute to the headaches seen in neurological practice.4 The major difference between general and neurological practice in terms of causes of headache relates to headache attributable to an infective illness – a rarity in neurological practice, it accounted for 42 per cent of the patients in Milne’s series,8 rising to over 90 per cent for people at home.
