Headache is a very common problem presenting to primary care physicians and neurologists.
Most headaches are diagnosed based on the history & physical exam w/ no imaging or laboratory examination necessary.
Other types of headaches such as secondary headaches may require further evaluation & referral to a specialist.
A 38-year-old right-handed man had had epilepsy since 2 months of age. There was no relevant family history. Perinatal history was unremarkable. No other risk factors such as central nervous system infection or cerebral trauma were identified. Developmental history did not show major delay. His epilepsy was uncontrolled despite trying valproate, carbamazepine, clobazam, levetiracetam, oxcarbamazepine and perampanel.