CERVICOGENIC HEADACHE SYNDROME (CEH)
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| CEH |
Chronic hemicranial pain that is referred to the head from either bony structures or myofascial soft tissues of the upper CSP, OA, C1-3 segments.
What's happening : The C1-C3 nerves relay pain signals to the
nociceptive nucleus of the head and neck, the trigeminocervical nucleus. This connection is thought to be the cause for referred pain to the occiput and/or eyes.
The trigeminocervical nucleus is a region of the upper
cervical spinal cord where sensory nerve fibres in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to interact with sensory fibres from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head.
A functional convergence of sensorimotor fibres in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and might also be responsible for the referral of cervical pain to the head.
Important to differentiate between:
Migraine without aura, Tension-type, and Cervicogenic headache.
In Cervicogenic Headache, patient may present with combination of:
- movement dysfunction in whole of Csp
- muscle function impairment
- upper cervical individual joint dysfunction
Pain and tenderness in sensitive structures in the upper neck, fascia in the head, TMJ,caudalis are believed to interact with sensory fibres from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations between the neck and trigeminal sensory receptive fields of the face and head.
A functional convergence of sensorimotor fibres in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and might also be responsible for the referral of cervical pain to the head.
Important to differentiate between:
Migraine and Cervicogenic headache.
In Cervicogenic Headache, patient may present with combination of:
movement dysfunction in whole of Csp
- muscle function impairment
- upper cervical individual joint dysfunction
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