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Side locked headaches


Data were prospectively collected from 975 eligible patients (554 females; 583 Caucasians; age range = 4.5-18.1 years) with headaches. Patients were included only if they were > 4 years old and had suffered headache course for > 6 months and or 5 separate headache attacks. We have adopted previous descriptions of terms for anatomical sites for location [1]. Side locked unilateral headache (SLUH) is defined as a headache that is for all time fixed unilaterally and never changed side. Headache diagnosis was made on the basis of ICHD – II, 2004 [2]. Headache diagnosis included migraine (n=585); tension type headaches (n= 234); other headache types (n=91) and remained unclassified in 65 (7%) patients.


119/975 (12%) of patients experienced recurrent SLUH during a mean headache course of 2.3 years. It was more for unilateral SLUH to localise to the right than the left (60% vs 40%). Topographically, temporal headache was the most frequent, followed by frontal and then parietal. Headaches were SLUH in 11.5% of patients with migraine; 8% with TTH and 23% patients with headache that not yet specified. Brain imaging was normal or showed no significant abnormalities in all scanned patients.


Sinister aetiologies of SLUH were excluded among our patients. Primary headache was the most common headache category among patients with SLUH. Although, migraine constituted 60% of our study series, frequency of SLUH among migraineurs and those with non-migraine headaches did not reach statistical significance (11.5% vs 13%).


Before one could reach a conclusion of sinister aetiologies when faced with a patient with SLUH, primary headaches such as migraine and TTH should be considered.


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  2. International Headache Society: ICHD-II. Cephalalgia 2004., 24(Suppl 1):

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Momoh-Ojewuyi, A., Ayubi, A., Abusamra, R. et al. Side locked headaches. J Headache Pain 14 (Suppl 1), P64 (2013).

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