Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Cephalalgia. 2023 Mar;43(3):3331024221148657. doi: 10.1177/03331024221148657.
This narrative review aims to provide an update on primary headache associated with sexual activity and primary thunderclap headache.
We conducted a literature search on PubMed with the keywords "headache associated with sexual activity", "sexual headache", "orgasmic cephalalgia", and "coital cephalalgia" in addition to "thunderclap headache" to assess the appropriateness of all published articles in this review.
Primary headache associated with sexual activity is a "primary" headache precipitated by sexual activity, which occurs as sexual excitement increases (progressive at onset), or manifests as an abrupt and intense headache upon orgasm (thunderclap at onset) or combines these above two features. Primary headache associated with sexual activity is diagnosed after a thorough investigation, including appropriate neuroimaging studies, to exclude life-threatening secondary causes such as subarachnoid hemorrhage. According to the criteria of the third edition of the International Classification of Headache Disorders, primary thunderclap headache is also a diagnosis by exclusion. The pathophysiology of primary headache associated with sexual activity and primary thunderclap headache remains incompletely understood. Treatment may not be necessary for all patients since some patients with primary headache associated with sexual activity and primary thunderclap headache have a self-limiting course.
A comprehensive neuroimaging study is needed for distinguishing primary headache associated with sexual activity or primary thunderclap headache from secondary causes. Primary headache associated with sexual activity and primary thunderclap headache are self-limited diseases and the prognoses are good, but some patients with primary headache associated with sexual activity may have a prolonged course.
本综述旨在提供与性行为相关的原发性头痛和原发性霹雳性头痛的最新信息。
我们在 PubMed 上使用了“与性行为相关的头痛”、“性头痛”、“性高潮性头痛”和“性交性头痛”等关键词，并结合“霹雳性头痛”进行了文献检索，以评估本综述中所有已发表文章的适宜性。
与性行为相关的原发性头痛是一种由性行为引发的“原发性”头痛，其发生方式为性兴奋增加（渐进性发作），或表现为性高潮时突然剧烈头痛（霹雳性发作），或兼有上述两种特征。与性行为相关的原发性头痛在经过彻底调查后才被诊断，包括适当的神经影像学研究，以排除危及生命的继发性原因，如蛛网膜下腔出血。根据国际头痛疾病分类第 3 版的标准，原发性霹雳性头痛也是一种排除性诊断。与性行为相关的原发性头痛和原发性霹雳性头痛的病理生理学仍不完全清楚。并非所有患者都需要治疗，因为一些与性行为相关的原发性头痛和原发性霹雳性头痛患者具有自限性病程。
需要进行全面的神经影像学研究，以区分与性行为相关的原发性头痛或原发性霹雳性头痛与继发性病因。与性行为相关的原发性头痛和原发性霹雳性头痛是自限性疾病，预后良好，但一些与性行为相关的原发性头痛患者可能病程较长。
