History questions key to patients with headache:

• Do you have a history of headaches? If yes, is this headache similar?
• Are your headaches associated with specific triggers or do they occur at specific times?
• Does the headache interfere with your usual activities?
• What is the location and character of the headache?
• Does eye movement aggravate the pain?
• Do you have any nausea or vomiting, light or sound sensitivity?
• Does any activity make the headaches worse?
• Have you had any cancer, autoimmune disease, immunosuppression, or seizures?
• Could you be pregnant?
• Have you had weight loss, fever, scalp pain, jaw or tongue pain, or temporary vision loss?

Exam keys in patients with headache:

• Examine lids and orbit for ptosis, proptosis, displacement, and lid retraction.
• Palpate the trochlea.
• Examine pupil for anisocoria and relative afferent pupillary defect.
• Do a motility exam to detect subtle signs of cranial nerve involvement.
• Slit lamp and dilated fundus exam will identify any inflammatory or infectious involvement of the eye or ocular adnexa, and if present, will identify papilledema.