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1.
目的:调查慢性头痛患者中睡眠障碍所占比率,同时评估其与精神共患病和慢性头痛的关系.方法:对210例慢性头痛组患者和204例间断头痛组患者先进行年龄、性别和头痛类型的匹配,然后进行睡眠障碍和精神共患病的结构式访谈.结果:210例慢性头痛组患者中,148例为药物过度使用性头痛.与间断头痛组相比,慢性头痛组患者失眠(68.6% vs 39.7%)、白天过度嗜睡(34.8% vs 22.5%),阻塞性睡眠呼吸暂停综合征(46.7% vs 31.9%)的发生率较高.慢性头痛组患者中92例(43.8%)有精神共患病(焦虑和/或抑郁),而间断头痛组仅有55例(27.0%).多元分析显示低教育水平、低龄开始头痛、失眠与慢性头痛独立相关.结论:慢性头痛患者常伴睡眠障碍.失眠可能是头痛慢性化的一个独立危险因素.不论与抑郁或焦虑是否相关,重视睡眠障碍治疗有利于阻止间断头痛慢性化.  相似文献   

2.
陈敏 《新医学》2013,44(2):138-140
目的:观察尼麦角林片联合养血清脑颗粒对慢性紧张性头痛(CTTH)治疗的效果.方法:98例CTTH患者按就诊次序分为观察组和对照组.观察组给予尼麦角林片联合养血清脑颗粒治疗,对照组给予盐酸氟桂利嗪胶囊治疗,均服用4周,治疗后综合评定疗效.治疗前后均行血、尿常规、血生化及心电图常规检查,采用视觉模拟评分法(VAS)评定疼痛程度.结果:治疗前观察组和对照组VAS评分分别为8.09±1.43和8.00±1.40,治疗后观察组和对照组VAS评分分别为3.47±2.23和4.91±2.42,两组治疗前后VAS评分比较差别有统计学意义(P<0.05),两组治疗后VAS评分比较差别亦有统计学意义(P<0.05).观察组总有效率92.10%高于对照组总有效率65.50%,差异有统计学意义(P<0.05).观察组不良反应与对照组比较差异无统计学意义(P>0.05).两组治疗前后血、尿常规,肝功能,肾功能,心电图检查均未见明显异常.结论:尼麦角林片联合养血清脑颗粒治疗CTTH效果较好.  相似文献   

3.
慢性紧张型头痛(CTTH)是临床最常见的慢性头痛症之一.笔者从2004年以来采用香丹复合液局部痛点阻滞治疗CTTH 40例,效果令人满意,现报告于下.  相似文献   

4.
目的:探讨复方雪莲联合帕罗西汀治疗慢性紧张型头痛的临床疗效。方法:80例慢性紧张型头痛随机分为A组(复方雪莲联合帕罗西汀,n=40)和B组(双氯芬酸钠联合帕罗西汀组,n=40);进行临床对照观察,疗程均为4周;评价指标为头痛评分、头痛改善程度、药物不良反应等。结果:对比两组第4周末的观察疗效,差异有统计学意义(P=0.0182)。各组治疗前与治疗后不同时间头痛程度平均水平比较,差异有统计学意义(P<0.0001);治疗前后不同时间点头痛程度两两比较,差异有统计学意义(P<0.001),可以看出2组都随着治疗时间的延长头痛程度逐渐减轻。2组在治疗后不同时间点的头痛程度的差异有统计学意义(P<0.0001)。2组的各项不良反应比较,差异均无统计学意义(P>0.05)。结论:复方雪莲联合帕罗西汀治疗慢性紧张型头痛的临床疗效较好。  相似文献   

5.
慢性每日头痛回顾性分析   总被引:2,自引:1,他引:1  
目的:分析慢性每日头痛(CDH)的临床特征.方法:回顾性研究102例CDH的亚型、原发性头痛的类型,以及药物过量性头痛(MOH)/很可能的MOH患者所用止痛药的种类、撤除止痛药的疗效.结果:CDH亚型中,MOH/很可能的MOH 91例(89.2%);原发性头痛的类型中,偏头痛74例(72.5%).91例MOH/很可能的MOH中,服用含咖啡因的复合止痛剂者83例(91.2%);29例(31.9%)停用止痛药后头痛恢复为原有发作形式,7例(7.7%)未停用止痛药,55例(60.4%)失访.不同性别之间上述特点不全相同.结论:大多数CDH患者有药物过量,停用止痛药是其有效的治疗办法,但是患者依从性差,因此有必要对患者进行CDH相关教育,以提高疗效.  相似文献   

6.
目的:探讨星状神经节阻滞联合头痛宁胶囊治疗慢性紧张性头痛合并失眠的临床疗效。方法:选取2018年2月至2018年12月北京市房山区第一医院疼痛科收治的慢性紧张性头痛合并失眠患者80例作为研究对象,按照随机数字表法分为对照组和观察组,每组40例。对照组单纯实施星状神经节阻滞,观察组联合口服头痛宁胶囊。采用视觉模拟评分法(VAS)和睡眠质量(QS)评分对2组治疗前、后进行疼痛程度和睡眠评分,评估临床治疗效果,同时观察不良反应。结果:对照组和观察组治疗后VAS评分和QS评分均较治疗前降低,差异有统计学意义(P 0. 05),观察组VAS和QS评分明显低于对照组,差异有统计学意义(P 0. 05)。2组均无严重不良反应。结论:星状神经节阻滞联合头痛宁胶囊可有效缓解头痛,改善睡眠,联合治疗疗效优于单一治疗,且未见明显不良反应。  相似文献   

7.
目的:探究补中益气汤加减联合西药治疗气阴虚型慢性头痛的疗效。方法:选择2019年2月~2021年2月100例慢性头痛患者,随机分为两组各50例,对照组仅采取西药治疗,研究组采取补中益气汤加减联合西药治疗,治疗前后应用头痛综合评分量表对两组患者进行评估,并判断临床疗效和安全性。结果:两组治疗后头痛综合评分量表评分均明显降低(P<0.05),而将对照组作为参照,研究组明显更低(P<0.05)。同样将对照组作为参照,研究组总有效率也明显更高(P<0.05)。两组的不良反应比较无明显差异(P>0.05)。结论:补中益气汤加减联合西药治疗气阴虚型慢性头痛,可对患者的头痛症状进行有效改善,使患者的发作次数减少,临床疗效确切,且不良反应轻微。  相似文献   

8.
目的:探讨氟哌噻吨美利曲辛片与头痛宁胶囊在慢性偏头痛治疗中的联用价值。方法:选取我院2016年8月~2018年7月收治的126例慢性偏头痛患者作为研究对象,以随机数字表法分为观察组与对照组各63例。对照组给予头痛宁胶囊治疗,观察组给予氟哌噻吨美利曲辛片+头痛宁胶囊治疗,两组均持续治疗4周。比较两组临床疗效。结果:治疗前,两组偏头痛疼痛程度、每月发作次数、疼痛持续时间以及SAS、SDS评分比较无显著性差异(P0.05);治疗后,观察组偏头痛VAS评分、每月发作次数、疼痛持续时间以及SAS、SDS评分均明显低于对照组(P0.05);两组不良反应发生率比较无显著性差异(P0.05)。结论:氟哌噻吨美利曲辛片联合头痛宁胶囊治疗慢性偏头痛的效果显著,可改善偏头痛发作症状,缓解患者焦虑、抑郁情绪,且具有一定安全性。  相似文献   

9.
目的:研究我国药物过量性头痛(medication overuse headache, MOH)病人临床特点。方法:选取2011年11月至2018年10月期间,以头痛为主诉就诊于解放军总医院神经内科门诊并诊断为MOH的病人418例。收集病人一般人口学特点、头痛临床特征、止痛药物使用情况(类型、频率、持续时间)。结果:284例(67.9%) MOH病人原发性头痛为偏头痛,117例(28.0%)为TTH,17例为混合型或其他头痛类型。女性过度使用止痛药物的时间较男性长(6.0±6.4年:4.5±4.8年,P=0.042)。复方止痛药物是最常用的过度使用药物,共400例(95.7%),其余还包括普通止痛药、阿片类、曲普坦类。结论:偏头痛为MOH最常见的原发性头痛类型。女性过度使用止痛药物的时间较男性长。复方止痛药物是我国MOH病人最常使用的止痛药物。  相似文献   

10.
目的:探讨自拟温阳通络活血方药对慢性心力衰竭的疗效、安全性.方法:58例患者随机分为治疗组30例,对照组28例.2组均采用西医常规治疗,治疗组在西医常规治疗基础上加用温阳通络化气行水方药治疗;疗程30d.观察2组治疗前后临床疗效、左室舒张末内径(LVEDD)、左室射血分数(LVEF)及药物不良反应.结果:治疗组有效率93.3%,高于对照组75%,差异有统计学意义(P<0.05);在LVEDD、LVEF,治疗组均优于对照组(P<0.05);且治疗组发生不良反应少而轻微.结论:温阳通络活血方治疗慢性心力衰竭提高了患者的临床效果.  相似文献   

11.
The aim of this study was to investigate central sensitization (CS) in chronic headaches and compare this phenomenon between chronic migraine (CM) and chronic tension-type headache (CTTH). We recruited 69 patients with chronic headaches and 18 control subjects. Questionnaires of headache history, allodynia and the Hospital Anxiety and Depression scale were administered. We recorded thresholds for pinprick and pressure pain, blink (BR) and nociceptive flexion reflex (NFR) R3 component coupled with wind-up ratios. Thresholds for pressure and pinprick pain, BR and NFR R3 were lower and wind-up ratios higher in patients. No differences of CS parameters between CM and CTTH were observed. CS is persistent and prevalent in patients with various types of chronic headache. CS levels are unrelated to the predominant side of pain, disease duration or depression. Neither is CS related to the headache type, suggesting similar mechanisms of headache chronification and chronicity maintaining and possibly explaining clinical similarity of various forms of chronic headache.  相似文献   

12.
The objective of the study was to assess the efficacy and tolerability of sodium valproate (VPA) on chronic daily headache (CDH) in a prospective, double-blind, randomized, placebo-controlled trial. Seventy patients were included in the study. Twenty-nine had chronic migraine (CM) and 41 had chronic tension-type headache (CTTH). VPA and placebo were applied for 3 months to 40 and 30 patients, respectively. Visual analog scale (VAS) and pain frequency (PF) were used for evaluation. VPA decreased the maximum pain VAS levels (MaxVAS) and PF at the end of the study (P = 0.028 and P = 0.000, respectively), but did not change general pain VAS (GnVAS) levels (P = 0.198). In CM patients, the decreases in MaxVAS, GnVAS and PF parameters were more in VPA treated patients (P = 0.006, P = 0.03, and P = 0.000, respectively). VPA treatment caused more reduction in PF than placebo in the CTTH subgroup (P = 0.000). VPA is effective in the prophylactic treatment of CDH by reducing MaxVAS levels and PF. It was more effective in CM than in CTTH. This study was presented as a poster at “8th Headache Congress Of The European Headache Federation” in Valencia, Spain, between 26–29 April, 2006 and published as an abstract in The Journal of Headache and Pain, Vol 7, Suppl 1 S39 April 2006. An editorial commentary on this article can be found at .  相似文献   

13.
OBJECTIVES: To compare the second edition of the International Classification of Headache Disorders (ICHD-2) and the Silberstein-Lipton (S-L) criteria in the classification of adolescents with chronic daily headache (CDH). METHODS: We reviewed the clinical records and the headache diaries of 170 adolescents (13 to 17 years) seen between 1998 and 2003 at a headache center. Relevant information was transferred to a standardized form that included operational criteria for the ICHD-2. CDH subtypes were classified according the criteria proposed by S-L into transformed migraine (TM) with (TM+) and without medication overuse (TM-), chronic tension-type headache (CTTH), new daily persistent headache (NDPH), and hemicrania continua (HC). RESULTS: From the 69 patients with TM- according the S-L criteria, most (71%) could be classified as chronic migraine (CM), while a minority of patients required a combination of diagnosis, mainly migraine and CTTH (14.4%). Of the patients with TM+, just 39.6% met the criteria for probable CM (PCM) with probable medication overuse (PMO). If instead of 15 migraine days per month, we considered 15 or more days of migraine or probable migraine, 84% of the subjects with TM- and 68.7% of those with TM+ could be classified. Of the 27 subjects classified as NDPH without medication overuse according to the S-L system, the majority (51.2%) were also classified as NDPH according the ICHD-2. Interestingly, three (11.1% of the subjects with NDPH without medication overuse) were classified as CM in the ICHD-2 because these patients had an abrupt onset of 15 or more days of migraine per month. All patients with NDPH with medication overuse according to the S-L criteria required a combination of diagnoses in the ICHD-2. All subjects with CTTH received a single diagnosis in both classification systems. CONCLUSIONS: (i) Among adolescents with TM, the majority (58.1%) could be classified as CM, according to the ICHD-2. These results were driven by TM without medication overuse. (ii) If the ICHD-2 criteria for CM are revised to require 15 days of migraine or probable migraine, the proportion of patients with TM- who meet the criteria for CM increases from 71% to 84%; for TM+, the proportion with probable chronic migraine and PMO increases from 30% to 68%. (iii) About half of the patients with NDPH according to the S-L criteria have too many migraine features to meet ICHD-2 criteria for NDPH.  相似文献   

14.
Mathew NT  Kailasam J  Meadors L 《Headache》2008,48(2):194-200
OBJECTIVE: To evaluate predictors of response to botulinum toxin type A (BoNTA; BOTOX, Allergan Inc., Irvine, CA, USA) in patients with chronic daily headache (CDH). BACKGROUND: Chronic migraine (CM) and chronic tension-type headache (CTTH) form the majority of CDH disorders. Controlled trials indicate that BoNTAis effective in reducing the frequency of headache and number of headache days in patients with CDH disorders. A recent migraine study found that patients with imploding or ocular types of headaches were responders to BoNTA, whereas those with exploding headaches were not. To date, there are no data on factors that might predict response to BoNTA in patients with CDH. METHODS: A total of 71 patients with CM and 11 patients with CTTH were treated with 100 units BoNTA. Every patient received at least 2 sets of injections at intervals of 12-15 weeks; fixed sites, fixed dose, and "follow-the-pain" approaches were used for the injections. A detailed medical history was taken for each patient in addition to recording Migraine Disability Assessment Scale (MIDAS) scores at baseline and every 3 months after each set of injections. Headache frequency was assessed throughout the study from baseline to weeks 24-27. Patients recorded the frequency, severity, and duration of headaches in Headache Diaries. Patients were divided into responders (> or = 50% reduction in both headache frequency and MIDAS scores compared with baseline) and nonresponders (< 50% reduction in either of the above variables). Variables analyzed for predictors of response include headache that is predominantly unilateral or bilateral in location, presence of cutaneous allodynia (scalp allodynia), and presence of pericranial muscle tenderness (also referred to as muscle allodynia). Chi-square analysis was used for parallel-group comparisons (proportion of CM responders vs proportion of CM nonresponders and proportion of CTTH responders vs proportion of CTTH nonresponders). RESULTS: In the CM group, 76.1% (54 /71) of patients were responders to BoNTA, of which 68.5% (37/54) had headache that was predominantly unilateral in location and the remaining 31.5% (17/54) had headache that was predominantly bilateral in location (both P < .01 vs CM nonresponders). Of the 23.9% (17/71) CM nonresponders, 76.5% (13/17) reported predominantly bilateral headache and in the remaining 23.5% (4/17) the headache was unilateral. In the CM responders group, 81.5% (44/54) had clinically detectable scalp allodynia, while pericranial muscle tenderness was present in 61.1% (33/54) (both P < .01 vs CM nonresponders). The presence of scalp allodynia and pericranial muscle tenderness in the CM nonresponders was 11.8% (2/17) and 17.6% (3/17), respectively. In the CTTH group where all patients (100%, 11/11) had bilateral headache, 36.4% (4/11) of patients were responders to BoNTA. All of those CTTH responders (100%, 4/4) had pericranial muscle tenderness (P < .05 vs CTTH nonresponders). None of the CTTH nonresponders had pericranial muscle tenderness. No clinically significant serious adverse events (AEs) were reported. Mild AEs, eg, injection-site pain that persisted for 1-9 days, were reported in 11 patients. One patient had transient brow ptosis. CONCLUSIONS: A greater percentage of patients with CM responded to BoNTA than patients with CTTH. Headaches that were predominantly unilateral in location, presence of scalp allodynia, and pericranial muscle tenderness appear to be predictors of response to BoNTA in CM, whereas in CTTH, pericranial muscle tenderness may be a predictor of response.  相似文献   

15.
The objective of this study was to evaluate the association between low and frequent low back pain and chronic migraine (CM) and chronic tension-type headache (CTTH) in a large, German population-based sample. Headaches were diagnosed according to International Classification of Headache Disorders-2 criteria and categorized according to frequency (episodic 1–14 days/month or chronic ?15 days/month) and headache type (migraine or TTH). We defined frequent low back pain as self-reported low back pain on ?15 days/month. We calculated odds ratios and 95% confidence intervals (CI) using logistic regression analyses, adjusting for sociodemographic covariates. There were 5605 respondents who reported headache in the previous year, of whom 255 (4.5%) had Chronic Headache. Migraine was diagnosed in 2933 respondents, of whom 182 (6.2%) had CM. TTH was diagnosed in 1253 respondents, of whom 50 (4.0%) had CTTH. Among 9944 respondents, 6030 reported low back pain, of whom 1267 (21.0%) reported frequent low back pain. In adjusted models, the odds of having frequent low back pain were between 2.1 (95% CI 1.7-2.6) and 2.7 (95% CI 2.3-3.2) times higher in all episodic headache subtypes when compared to No Headache. The odds of having frequent low back pain were between 13.7 (95% CI 7.4-25.3) and 18.3 (95% CI 11.9-28.0) times higher in all chronic headache subtypes when compared to No Headache. Low and frequent low back pain was associated with CM and CTTH. Multiple explanations may contribute to the association of headache and back pain, including the notion that the neurobiology of chronic headache, independent of primary headache type, not only involves the trigeminal pain pathway, but is also a part of abnormal general pain processing.  相似文献   

16.
With an ad hoc, previously validated clinical record, we analysed the headache characteristics in 245 patients (F, 78.4%, M, 21,6%; mean age, 43.1±12.9 years) affected by chronic daily headache (CDH) attending 9 Italian headache centers. Migraine without aura was the episodic headache preceding CDH in 72.3% of the cases. We divided CDH into 3 categories: chronic tension-type headache (CTTH), chronic coexisting migraine and tension-type headache (CCMTTH), and chronic migraine (CM). CCMTTH accounted for 46.5% of the cases, followed by CM (30.2%) and CTTH (23.3%). Female prevalence was more marked in CCMTTH and CM groups, in which episodic headache started earlier. Migraine without aura was the episodic headache preceding CDH not only in most cases of CCMTTH (83.0%) and CM (91.9%), but also in 25% of CTTH patients.Analgesics misuse (abuse of weak analgesics and/or combination drugs in almost all the cases) prevailed among CCMTTH (61%) and CM (89%) patients with respect to CTTH patients (37%).  相似文献   

17.
Pericranial tenderness is not related to nummular headache   总被引:1,自引:0,他引:1  
The aim of the present study was to investigate whether nummular headache (NH) patients show increased pericranial tenderness in relation to healthy subjects, and to compare pericranial tenderness between both NH and chronic tension-type headache (CTTH) patients. Three tenderness (total, cephalic and neck) scores were objectively and blinded assessed in 10 NH patients, 10 CTTH subjects and 10 healthy matched controls. No significant differences were found in any tenderness score between the symptomatic and non-symptomatic sides in NH, or between right and left sides in either CTTH or control groups. All tenderness scores were significantly greater in CTTH patients compared with both NH patients and controls (P < 0.001), but not significantly different between NH patients and controls. Therefore, NH patients had lower tenderness than patients with CTTH and did not show increased tenderness when compared with healthy subjects. In addition, tenderness in NH patients was quite symmetrical between both the symptomatic and the non-symptomatic sides. The absence of increased pericranial tenderness could be clinically useful in distinguishing NH from CTTH. Current findings expand the evidence supporting the notion that NH is a non-generalized and rather limited disorder, marking the presence of a well-delimited painful zone.  相似文献   

18.
BACKGROUND: Medication overuse headache (MOH) mostly evolves from migraine and episodic tension-type headache (ETTH). Chronic tension-type headache (CTTH) is another headache type that evolves over time from ETTH. It is well known that psychiatric comorbidity is high in MOH patients. AIM: To investigate the frequency of psychiatric comorbidity, and the intensity of depression and anxiety in MOH patients evolving from ETTH and to compare results with CTTH patients and MOH patients evolving from migraine. METHODS: Twenty-eight CTTH (Group C) and 89 MOH patients were included into the study. MOH patients were divided into two groups according to their pre-existing headache types: MOH patients with pre-existing ETTH (Group E, n = 31), and with pre-existing migraine (Group M, n = 58). All patients were interviewed with a psychiatrist and SCID-CV and SCID-II were applied. Beck Anxiety Inventory and Beck Depression Inventory scales were also performed. RESULTS: Eleven patients (39.3%) in Group C, 21 patients (67.7%) in Group E, and 31 patients (53.7%) in Group M were diagnosed to have comorbid psychiatric disorders. The psychiatric comorbidity was found significantly higher in Group E than Group C. In Group E, mood disorders were found significantly higher, but the difference between the two groups with regard to anxiety disorders was insignificant. Mean depression scores were significantly higher in Group E than Group C. The mostly diagnosed type was obsessive-compulsive personality disorder in all the three groups, and was statistically significant in Group M than Group C. CONCLUSION: Psychiatric comorbidity in MOH patients with pre-existing ETTH is common as in those with pre-existing migraine headache and MOH with regard to developing psychiatric disorders should be interpreted as a risk factor in chronic daily headache patients.  相似文献   

19.
Chronic tension-type headache in children and adolescents   总被引:1,自引:0,他引:1  
In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2 : 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as 'just sore' or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.  相似文献   

20.
BACKGROUND: In a previous study, we compared the 1988 International Headache Society (IHS) criteria and the Silberstein-Lipton criteria (S-L) in a subspeciality clinic sample of 638 patients with chronic daily headache (CDH) assessed both clinically and with headache diaries. Both systems allowed for the classification of most patients with CDH. The 1988 IHS classification required multiple diagnoses and was more complex to apply. OBJECTIVES: The aim of this study was to revisit the same database, now comparing the prior classification systems with the new 2004 IHS classification. In contrast with the 1st edition, the 2nd edition includes criteria for chronic migraine (CM), new daily persistent headache (NDPH), and hemicrania continua (HC). METHODS: We reviewed the clinical records and the headache diaries of 638 patients seen between 1980 and 2001 at a headache center. All patients had primary CDH according to the S-L criteria. RESULTS: Using the S-L criteria as a reference, of the 158 patients with transformed migraine (TM) without medication overuse, just 9 (5.6%) met 2004 IHS criteria for CM. Most of the subjects were classified using combinations of migraine and CTTH diagnoses, much like the 1988 IHS classification. Similarly, using the new IHS system, just 41/399 (10.2%) subjects with TM with medication overuse were classified as probable CM with probable medication overuse. Most patients with NDPH without overuse were easily classified using the 2004 criteria (95.8%). Regarding NDPH with medication overuse, the diagnostic groups were much like results for the 1st edition. All patients with chronic tension-type headache (CTTH) and hemicrania continua (HC) according to the S-L system were easily classified using the 2004 IHS criteria. CONCLUSIONS: We conclude that the 2004 IHS criteria facilitate the classification of NDPH without medication overuse and HC. For subjects with TM according to the S-L system, the new IHS criteria are complex to use and require multiple diagnoses. Very few patients with TM in the S-L system could be classified with a single diagnosis in the 2004 IHS classification. In fact, CM was so rare that it would be virtually impossible to conduct clinical trials of this entity using the 2004 IHS criteria. Clinical trials of this entity should therefore be conducted using the S-L criteria. Finally, we propose that in the 3rd edition of the IHS classification, the diagnosis of NDPH be revised so as not to exclude migraine features.  相似文献   

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