Headaches and Face Pains as a Manifestation of Munchausen Syndrome
Article first published online: 17 JUN 2002
Headache: The Journal of Head and Face Pain
Volume 39, Issue 1, pages 45–50, January 1999
How to Cite
Solomon, S. and Lipton, R. B. (1999), Headaches and Face Pains as a Manifestation of Munchausen Syndrome. Headache: The Journal of Head and Face Pain, 39: 45–50. doi: 10.1046/j.1526-4610.1999.3901045.x
- Issue published online: 17 JUN 2002
- Article first published online: 17 JUN 2002
- Accepted for publication May 27, 1998.
- factitious disorder;
- Munchausen syndrome;
- somatoform disorder
Virtually every psychological or physical symptom may be feigned in order to assume a sick role; the term Munchausen syndrome is applied when the physical features are predominant. Complaints of headache as a manifestation of this condition are rare. We report such a case and review the literature of similar cases.
A 34-year-old man consulted several headache specialists in different cities. Many different diagnoses were made, consistent with the various histories the patient related. It seems most unlikely that any one individual could experience 14 distinct headache disorders. Dozens of medications were prescribed, and a dozen or more were taken by the patient daily.
People with Munchausen syndrome consciously feign physical symptoms and signs because of the apparently senseless need to assume a sick role. This condition is distinguished from malingering in which the symptoms are consciously feigned for personal gain and from somatoform disorder in which development of symptoms for psychological purposes is unconscious.
Primary headache disorders, once thought to have a psychological basis, are now recognized as biological disorders. Though psychogenic mechanisms have been largely discredited, rarely, as illustrated by the present case, psychological mechanisms are predominant.