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Letter To The Editor

Prevention of Harrison’s Headache and Cecil’s Cephalgia

Authors: Sanjay Kalra , Atul Dhingra
DOI: https://doi.org/10.37184/lnjpc.2707-3521.7.3
Year: 2024
Volume: 6
Received: Apr 24, 2024
Revised: Jul 05, 2024
Accepted: Jul 15, 2024
Corresponding Auhtor: Sanjay Kalra (brideknl@gmail.com)
All articles are published under the Creative Commons Attribution License


Prevention of Harrison’s Headache and Cecil’s Cephalgia

Dear Editor,

The year was 2003, and a wave of Pottermania had swept the world. An astute physician from Washington, DC, USA, HJ Bennett noted the occurrence of headache in three children aged 8-10 years [1]. He diagnosed the condition as tension headache [2], caused by the effort of reading JK Rowling’s 870-page long book, and termed it as Hogwarts headache. For the uninitiated, Hogwarts is the name of the school of wizardry which occupies center-stage in the Harry Potter saga.

While the epidemic of Hogwarts headaches that Bennett predicted has (mercifully) not materialized, medical students and internists are no strangers to a similar professional hazard. We name this Harrison’s headache or Goldman-Cecil’s cephalgia.

Harrison’s headache or Cecil’s cephalgia is defined as a tension headache that occurs when reading medicine textbooks, such as those named after Harrison and Cecil. The condition occurs in medical students, interns and internists, and is precipitated by examinations, seminars and other educational activities. As per the International Classification of Headache Disorders (ICHD)-3, this is termed as a tension-type headache [3]. Differentials include migraine and cervicogenic headache [4, 5].

Table 1: Prevention of Harrison’s headache/Cecil’s cephalgia.

Primordial prevention

•  Practice reading hygiene while studying heavy textbooks

Primary prevention

•  Stay hydrated

•  Stay well-nourished

•  Read one chapter/one part at a time

•  Consider taking 20-second-long breaks every 20 minutes: blink your eyes 20 times

•  Consider taking breaks for a few minutes at regular intervals

Secondary prevention

•  Be aware of the prodromal sensations of headache

•  Stop reading if headache occurs

Tertiary prevention

•  Paracetamol tablets

•  Reconsider choice of textbooks

Quaternary prevention

•  Rule out conditions such as cervical spondylosis, hypertension, febrile illness

Quinary prevention

•  Share accurate and appropriate information about headache

Prevention is better than cure, they say [6]. While primordial prevention, unfortunately, is not possible for students who have to attain a degree, preventive strategies can be instituted at various levels (Table 1). We propose spreading awareness about these forms of headaches, as well as about their preventative and management strategies, to help future generations of physicians. While various strategies, such as the 20-20-20 rule [7] have been suggested to reduce eye strain, person-centered methods must be implemented to prevent tension-type headaches and optimize the reading experience.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

ACKNOWLEDGEMENTS

We acknowledge the role of Aarav Dhingra and Aarav Kalra in continuing literary education. We commend Aarav Dhingra for diagnosing “Hogwarts sleep” in us.

REFERENCES

  • 1. Bennett H J. Hogwarts headaches-misery for mirggles. N Engl J Med 2003; 349:
    • DOI: https://doi.org/10.1056/NEJM200310303491821
    • 2. Ashina S, Mitsikostas DD, Lee MJ, Yamani N, Wang SJ, Messina R, et Tension-type headache. Nat Rev Dis Primers 2021; 7(1): 24.
      • DOI: https://doi.org/10.1038/s41572-021-00257-2
    • 3. Tension-type Available from: https://ichd-3.org/2- tension-type-headache/
    • 4. Anarte-Lazo E, Carvalho GF, Schwarz A, Luedtke K, Falla D. Differentiating migraine, cervicogenic headache and asymptomatic individuals based on physical examination findings: a systematic review and meta-analysis. BMC Musculoskelet Disord 2021; 22 (755): 1-8.
      • DOI: https://doi.org/10.1186/s12891-021-04595-w
    • 5. Zhu K, Born DW, Dilli E. Secondary headache: current update. Headache 2020; 60(10): 2654-64.
      • DOI: https://doi.org/10.1111/head.13986
    • 6. Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, et al. Lifestyle modifications to help prevent headache at a developmental Front Neurol 2021; 11: 618375.
      • DOI: https://doi.org/10.3389/fneur.2020.618375
    • 7. Johnson S, Rosenfield M. 20-20-20 Rule: Are these numbers justified? Optom Vis Sci 2023; 100(1): 52-6.
      • DOI: https://doi.org/10.1097/OPX.0000000000001971