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1.
Couch JR 《Current pain and headache reports》2004,8(6):479-483
Chronic daily headache (CDH) is an overarching term that includes multiple types of frequent primary headaches that are not
trigeminal-autonomic cephalgias. The components of typical CDH can be divided into a more severe or “big” headache and a less
severe or “little” headache. The big headaches tend to have features of migraine while the little headaches have features
of tension-type headache (TTH). Whether this represents a spectrum or continuum or whether it is the superimposition of two
unique headache entities is open to debate. For subjects with big and little headache, the concept that the TTH component
is part of a spectrum seems likely. Subjects with only TTH and no migrainous component seem to represent a different entity,
pure chronic TTH. These patients have a daily moderate headache that is poorly responsive to current therapies and appears
to be a different TTH than the migraine tension type of CDH. The TTH component of CDH may represent multiple subdivisions
of TTH. 相似文献
2.
Yokoyama M Suzuki N Yokoyama T Yokoyama A Funazu K Shimizu T Shibata M 《The journal of headache and pain》2012,13(2):137-145
The aim of the study was to investigate associations between headache types and alcohol drinking, alcohol flushing, and hangover.
Alcohol consumption is inhibited by the presence of inactive aldehyde dehydrogenase-2 (ALDH2) whose carriers are susceptible
to alcohol flushing and hangovers. We conducted a cross-sectional study of the 2,577 subjects (men/women: 1,018/1,559) who
reported having ever experienced headaches unrelated to common colds and alcohol hangovers among 5,408 (2,778/2,630) Tokyo
health checkup examinees. We used a questionnaire inquiring about current and past facial flushing after drinking a glass
of beer which identifies the presence of inactive ALDH2 with a sensitivity and specificity of approximately 90%. Based on
ICHD-II criteria migraine was diagnosed in 419 (75/344) subjects, and tension-type headache (TTH) in 613 (249/364). We classified
the headaches of the remaining 1,545 (694/851) of headaches sufferers into the category “other headaches (OH)”. The migraineurs
drank alcohol less frequently than the subjects with TTH among current/past alcohol flushers and than the subjects with OH
regardless of flushing category. No such difference in drinking frequency was observed between TTH and OH. Current/past flushers
drank alcohol less frequently than never flushers, and the likelihood that male migraineurs would avoid alcohol drinking than
men with TTH or OH was stronger among current/past flushers than among never flushers. Flushers and women were more susceptible
to hangover than never flushers and men, respectively, regardless of headache type. Among never flushers, women with migraine
were more susceptible to hangover than women with OH. The difference in alcohol sensitivity may partly explain less alcohol
consumption by migraineurs. 相似文献
3.
BackgroundFew prospective population-based studies have evaluated the bidirectional relationship between headache and affective disorder. The aim of this large-scale population-based follow-up study was to investigate whether tension-type headache (TTH) and migraine had increased risk of developing anxiety and depression after 11 years, and vice-versa.MethodsData from the Trøndelag Health Study (HUNT) conducted in 2006-2008 (baseline) and 2017-2019 (follow-up) were used to evaluate the bidirectional relationship between migraine and TTH and anxiety and depression measured by Hospital Anxiety and depression Scale (HADS). The population at risk at baseline consisted of respectively 18,380 persons with HADS score ≤ 7 and 13,893 without headache, and the prospective data was analyzed by Poisson regression.ResultsIn the multi-adjusted model, individuals with HADS anxiety (HADS-A) and depression scores (HADS-D) of ≥8 at baseline nearly doubled the risk of migraine (Risk rations (RR) between 1.8 and 2.2) at follow-up whereas a 40% increased risk (RR 1.4) was found for TTH. Vice versa, the risk of having HADS-A and HADS-D scores of ≥8 at follow-up were increased for TTH (RR 1.3) and migraine (RR 1.3-1.6) at baseline. Migraine with aura was associated with 81% (RR 1.81, 95% 1.52-2.14) increased risk of HADS-A score of ≥8.ConclusionsIn this large-scale population-based follow-up study we found a bidirectional relationship between anxiety and depression and migraine and TTH. For anxiety, this bidirectional association was slightly more evident for migraine than TTH. 相似文献
4.
Tension-type headache (TTH) is a relatively featureless headache. Many primary and secondary headache disorders can mimic
TTH, particularly in its chronic form, chronic tension-type headache. This review will address both primary and secondary
disorders that can present with headaches phenotypically similar to TTH, and will focus on clinical pearls that help distinguish
these “mimics” from TTH. 相似文献
5.
Examination of anxiety, hostility and psychiatric disorders in patients with migraine and tension-type headache 总被引:1,自引:0,他引:1
The role of psychological factors related to headache has long been a focus of investigation. The aim of this study was to evaluate anxiety, depression, hostility and psychological symptoms in patients with migraine and tension-type headache (TTH) and to compare the results with healthy controls. Seventy-five subjects with migraine and 55 subjects with TTH (according to the criteria of the International Headache Society classification) and a control group including 73 healthy subjects were studied. The Buss-Durkee Hostility Inventory, Brief Symptom Inventory, State-trait Anxiety Inventory, Trait form were administered to the subjects. Compared with healthy controls, the patients with headache had significantly higher scores on measures of anxiety, depression and hostility and lower scores on psychological symptoms. The present results indicate the need to distinguish the unique dimensions of anxiety, depression and hostility that should be assessed in the population with headaches. 相似文献
6.
Recent literature shows an interest in the relationship between psychiatric disorders and headache. This relationship is complex
and multifaceted, with existing studies confirming high rates of comorbidity between psychiatric disorders (especially depression
and anxiety) and migraine and tension-type headache, implicating comorbid psychiatric disorders as risk factors for headache
progression and chronification, and underscoring the need for assessment and treatment of relevant disorders. A smaller amount
of literature has focused on headache that presents exclusively during and secondary to a psychiatric disturbance; this phenomenon
has been termed “headache attributed to psychiatric disorder.” We review recent developments in the relationship between psychiatric
conditions and headache, with a particular focus on headaches attributed to psychiatric disorders, and discuss needed areas
for future research. 相似文献
7.
Ertas M Baykan B Orhan EK Zarifoglu M Karli N Saip S Onal AE Siva A 《The journal of headache and pain》2012,13(2):147-157
Several studies have shown that the prevalence of migraine and tension-type headache (TTH) varied between different geographical
regions. Therefore, there is a need of a nationwide prevalence study for headache in our country, located between Asia and
Europe. This nationwide study was designed to estimate the 1-year prevalence of migraine and TTH and analyse the clinical
features, the impact as well as the demographic and socio-economic characteristics of the participant households in Turkey.
We planned to investigate 6,000 representative households in 21 cities of Turkey; and a total of 5,323 households (response
rate of 89%) aged between 18 and 65 years were examined for headache by 33 trained physicians at home on the basis of the
diagnostic criteria of the second edition of the International Classification of Headache Disorders (ICHD-II). The electronically
registered questionnaire was based on the headache features, the associated symptoms, demographic and socio-economic situation
and history. Of 5,323 participants (48.8% women; mean age 35.9 ± 12 years) 44.6% reported recurrent headaches during the last
1 year and 871 were diagnosed with migraine at a prevalence rate of 16.4% (8.5% in men and 24.6% in women), whereas only 270
were diagnosed with TTH at a prevalence rate of 5.1% (5.7% in men and 4.5% in women). The 1-year prevalence of probable migraine
was 12.4% and probable TTH was 9.5% additionally. The rate of migraine with aura among migraineurs was 21.5%. The prevalence
of migraine was highest among 35–40-year-old women while there were no differences in age groups among men and in TTH overall.
More than 2/3 of migraineurs had ever consulted a physician whereas only 1/3 of patients with TTH had ever consulted a physician.
For women, the migraine prevalence was higher among the ones with a lower income, while among men, it did not show any change
by income. Migraine prevalence was lower in those with a lower educational status compared to those with a high educational
status. Chronic daily headache was present in 3.3% and the prevalence of medication overuse headache was 2.1% in our population.
There was an important impact of migraine with a monthly frequency of 5.9 ± 6, and an attack duration of 35.1 ± 72 h, but
only 4.9% were on prophylactic treatment. The one-year prevalence of migraine estimated as 16.4% was similar or even higher
than world-wide reported migraine prevalence figures and identical to a previous nation-wide study conducted in 1998, whereas
the TTH prevalence was much lower using the same methodology with the ICHD-II criteria. 相似文献
8.
Siniatchkin M Riabus M Hasenbring M 《Cephalalgia : an international journal of headache》1999,19(3):165-173
Psychological factors are important in the chronification and aggravation of headaches. We studied 90 patients suffering from migraine, chronic daily headache (CDH) evolved from migraine, and episodic or chronic tension-type headache (TTH). Emotional, cognitive, and behavioral pain coping were assessed using the Kiel Pain Inventory (KPI), Beck's Depression Inventory, the State-Trait-Anxiety Inventory, and Quality of Life Questionnaire. In addition, the clinical course of headache was analyzed using a validated headache diary. The results were as follows. Firstly, the KPI is reliable internally for the assessment of pain-coping strategy employment among headache patients. Secondly, migraine sufferers were characterized by pronounced psychological abnormalities during the headache phase, demonstrating a less adaptive coping behavior. This was in contrast to the TTH patients, who showed more general distress manifesting in elevated anxiety and lower quality of life. The only factor which appeared to be essential for differentiating between migraine and TTH was the intensity of headache. Thirdly, chronic TTH and CDH evolved from migraine demonstrated more pronounced psychological disabilities and more severe clinical courses of headaches than episodic TTH or nontransformed migraine. The predictor variable for transformation of migraine was impairment of well-being/quality of life, and for transformation of TTH, the frequency of headaches and depression. Finally, analgesic misuse seems to be less important for chronification and transformation of headaches than the degree of psychological disability. This study draws attention to the role of psychological factors in the chronification of TTH and transformation of migraine and provides some recommendations for the behavioral treatment of chronic headaches. 相似文献
9.
Gretchen E. Tietjen MD Jan L. Brandes MD B. Lee Peterlin DO Arnolda Eloff MD Rima M. Dafer MD MPH Michael R. Stein MD Ellen Drexler MD Vincent T. Martin MD Susan Hutchinson MD Sheena K. Aurora MD Ana Recober MD Nabeel A. Herial MD MPH Christine Utley MSN CNP Leah White MPH Sadik A. Khuder MPH PhD 《Headache》2010,50(1):32-41
(Headache 2010;50:32‐41) Objectives.— To assess in a headache clinic population the relationship of childhood abuse and neglect with migraine characteristics, including type, frequency, disability, allodynia, and age of migraine onset. Background.— Childhood maltreatment is highly prevalent and has been associated with recurrent headache. Maltreatment is associated with many of the same risk factors for migraine chronification, including depression and anxiety, female sex, substance abuse, and obesity. Methods.— Electronic surveys were completed by patients seeking treatment in headache clinics at 11 centers across the United States and Canada. Physician‐determined data for all participants included the primary headache diagnoses based on the International Classification of Headache Disorders‐2 criteria, average monthly headache frequency, whether headaches transformed from episodic to chronic, and if headaches were continuous. Analysis includes all persons with migraine with aura, and migraine without aura. Questionnaire collected information on demographics, social history, age at onset of headaches, migraine‐associated allodynic symptoms, headache‐related disability (The Headache Impact Test‐6), current depression (The Patient Health Questionnaire‐9), and current anxiety (The Beck Anxiety Inventory). History and severity of childhood (<18 years) abuse (sexual, emotional, and physical) and neglect (emotional and physical) was gathered using the Childhood Trauma Questionnaire. Results.— A total of 1348 migraineurs (88% women) were included (mean age 41 years). Diagnosis of migraine with aura was recorded in 40% and chronic headache (≥15 days/month) was reported by 34%. Transformation from episodic to chronic was reported by 26%. Prevalence of current depression was 28% and anxiety was 56%. Childhood maltreatment was reported as follows: physical abuse 21%, sexual abuse 25%, emotional abuse 38%, physical neglect 22%, and emotional neglect 38%. In univariate analyses, physical abuse and emotional abuse and neglect were significantly associated with chronic migraine and transformed migraine. Emotional abuse was also associated with continuous daily headache, severe headache‐related disability, and migraine‐associated allodynia. After adjusting for sociodemographic factors and current depression and anxiety, there remained an association between emotional abuse in childhood and both chronic (odds ratio [OR] = 1.77, 95% confidence intervals [CI]: 1.19‐2.62) and transformed migraine (OR = 1.89, 95% CI: 1.25‐2.85). Childhood emotional abuse was also associated with younger median age of headache onset (16 years vs 19 years, P = .0002). Conclusion.— Our findings suggest that physical abuse, emotional abuse, and emotional neglect may be risk factors for development of chronic headache, including transformed migraine. The association of maltreatment and headache frequency appears to be independent of depression and anxiety, which are related to both childhood abuse and chronic daily headache. The finding that emotional abuse was associated with an earlier age of migraine onset may have implications for the role of stress responses in migraine pathophysiology. 相似文献
10.
Brit A Blaauw Grete Dyb Knut Hagen Turid L Holmen Mattias Linde Tore Wentzel-Larsen John-Anker Zwart 《The journal of headache and pain》2014,15(1):38
Background
It is well documented that both anxiety and depression are associated with headache, but there is limited knowledge regarding the relation between recurrent primary headaches and symptoms of anxiety and depression as well as behavioral problems among adolescents. Assessment of co-morbid disorders is important in order to improve the management of adolescents with recurrent headaches. Thus the main purpose of the present study was to assess the relationship of recurrent headache with anxiety and depressive symptoms and behavioral problems in a large population based cross-sectional survey among adolescents in Norway.Methods
A cross-sectional, population-based study was conducted in Norway from 1995 to 1997 (Young-HUNT1). In Young-HUNT1, 4872 adolescents aged 12 to 17 years were interviewed about their headache complaints and completed a comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties.Results
In adjusted multivariate analyses among adolescents aged 12–14 years, recurrent headache was associated with symptoms of anxiety and depression (OR: 2.05, 95% CI: 1.61-2.61, p < 0.001), but not with behavioral problems. A significant association with anxiety and depressive symptoms was evident for all headache categories; i.e. migraine, tension-type headache and non-classifiable headache. Among adolescents aged 15–17 years there was a significant association between recurrent headache and symptoms of anxiety and depression (OR: 1.64, 95% CI: 1.39-1.93, p < 0,001) and attention difficulties (OR: 1.25, 95% CI: 1.09-1.44, p =0.001). For migraine there was a significant association with both anxiety and depressive symptoms and attention difficulties, while tension-type headache was significantly associated only with symptoms of anxiety and depression. Non-classifiable headache was associated with attention difficulties and conduct difficulties, but not with anxiety and depressive symptoms. Headache frequency was significantly associated with increasing symptoms scores for anxiety and depressive symptoms as well as attention difficulties, evident for both age groups.Conclusions
The results from the present study indicate that both anxiety and depressive symptoms and behavioral problems are associated with recurrent headache, and should accordingly be considered a part of the clinical assessment of children and adolescents with headache. Identification of these associated factors and addressing them in interventions may improve headache management. 相似文献11.
Kukava M Dzagnidze A Janelidze M Mirvelashvili E Djibuti M Fritsche G Jensen R Stovner LJ Steiner TJ Katsarava Z 《The journal of headache and pain》2007,8(6):321-324
In a pilot phase of a survey of the prevalence of primary headache disorders in the Republic of Georgia, we validated a Georgian
language questionnaire for migraine (MIG), tension-type headache (TTH), MIG+TTH and trigeminal autonomic cephalalgias (TAC).
A population-based sample of 186 people with headache completed the questionnaire and were blindly examined by one of two
headache experts. The questionnaire diagnoses were: MIG 49, TTH 76, MIG+TTH 45 and TAC 16. The physicians’ diagnoses were:
MIG 59, TTH 77, MIG+TTH 34, TAC 2 and “symptomatic headache” in 14 subjects. Sensitivity and specificity for MIG were 0.75
and 0.96, for TTH 0.79 and 0.86, and for MIG+TTH 0.61 and 0.84 respectively. Of 16 TAC diagnoses, the physicians confirmed
cluster headache in two patients only. The questionnaire can be utilised to investigate the prevalence of MIG and of TTH.
It offers preliminary screening only for TAC, which should be confirmed during a face to face examination.
This is a “Springer Open Choice” article. Unrestricted non-commercial use, distribution, and reproduction in any medium is
permitted, provided the original author and source are credited.
An erratum to this article can be found at 相似文献
12.
The aim of this study was to determine the frequency of misdiagnosis of sinus headache in migraine and other primary headache
types in the children and adolescents with chronic or recurrent headaches. Children with chronic or recurrent headaches (n = 310) were prospectively evaluated. Data collection for each patient included history of previously diagnosed sinusitis
due to headache, and additional sinusitis complaints (such as fever, cough, nasal discharge, postnasal discharge) at the time
of sinusitis diagnosis, and improvement of the headache following treatment of sinusitis. If sinus radiographs existed they
were recorded. The study included 214 patients with complete data. One hundred and sixteen (54.2%) patients have been diagnosed
as sinusitis previously and 25% of them had at least one additional complaint, while 75% of them had none. Sinusitis treatment
had no effect on the headaches in 60.3% of the patients. Sinus graphy had been performed in 52.8%, and 50.4% of them were
normal. The prevalence of sinus headache concomitant with primary headache, and only sinus headache was detected in 7 and
1%, respectively, in our study. Approximately 40% of the patients with migraine and 60% of the patients with tension-type
headache had been misdiagnosed as “sinus headache”. Children with chronic or recurrent headaches are frequently misdiagnosed
as sinus headache and receive unnecessary sinusitis treatment and sinus graphy. 相似文献
13.
Ozge A Bugdayci R Sasmaz T Kaleagasi H Kurt O Karakelle A Tezcan H Siva A 《Cephalalgia : an international journal of headache》2002,22(10):791-798
The objectives of the present study were: (i) to estimate the prevalence of recurrent headaches in schoolchildren (ranging from 2nd to 5th degrees) in Mersin city of Turkey; (ii) to determine the sensitivity, specificity, positive predictive value and positive likelihood ratio of the diagnostic headache characteristics in children with migraine and tension-type headache (TTH) using neurologist's diagnosis as the gold standard. The stratified sample of study was composed of 5562 children. The prevalence of recurrent headache was 49.2% (2739 of 5562) and the prevalence of current headache was 31.3% (859 of 2739). TTH was more common than migraine (24.7% vs. 10.4%). The most sensitive headache characteristic for migraine was 'severity of pain' and the most sensitive definitive symptom was 'duration of headache' in children with TTH. International Headache Society-based symptom definition criteria are highly beneficial in diagnosis of childhood headache, if used together with detailed clinical assessment. 相似文献
14.
Belcastro V Striano P Kasteleijn-Nolst Trenité DG Villa MP Parisi P 《The journal of headache and pain》2011,12(3):289-294
Despite the fact that migraine and epilepsy are among the commoner brain diseases and that comorbidity of these conditions
is well known, only few reports of migralepsy and hemicrania epileptica (HE) have been published according to the current
ICHD-II criteria. Particularly, ICHD-II describes “migraine-triggered seizure” (i.e., migralepsy) among complications of migraine
at “1.5.5” (as a rare event in which a seizure happens during migrainous aura), while hemicrania epileptica (coded at “7.6.1”)
and post-ictal headache (coded at “7.6.2”) are described among headaches attributed to epileptic seizure. However, to date
neither the International Headache Society nor the International League against Epilepsy mention that headache/migraine may
be the sole ictal epileptic manifestation. Based on the current knowledge, migralepsy is highly unlikely to exist as such.
We, therefore, propose to delete this term until clear evidence its existence is provided. Moreover, we herein propose a revision
of terminology and classification criteria to properly represent the migraine/headache relationships. We suggest the term
“ictal epileptic headache” in cases in which headache/migraine is the sole ictal epileptic manifestation. 相似文献
15.
Konstantinidos Vadikolias Ioannis Heliopoulos Grigorios Tripsianis Athanasios Achtaropoulos Elias Homsioglou Nickolaos Artemis Haritomeni Piperidou Ioannis Milonas 《The journal of headache and pain》2002,3(2):87-91
Based on the knowledge that migraine and tension-type headache (TTH) are associated with reduced effectiveness at work and
impairment of function in social roles, we studied the different influences that these primary headaches have on work in a
specialized and homogeneous population. We studied 140 consecutive male patients, aged 18–35 years, attending an outpatient
headache clinic at the Neurology Department of an Army General Hospital. Using International Headache Society (IHS) criteria,
60 patients were diagnosed with migraine and 80 patients with TTH. The impact of headache on work during the preceding 2 months
was assessed using a selfadministered questionnaire, based on MIDAS. Two parameters of work disability were derived: the lost
work days (LWD) and the days with reduced effectiveness while being at work (REWD). Of 142 LWD due to headaches, 95 (66.9%)
were attributable to migraine and 47 (33.1%) to TTH (plt;0.001). Of 490 REWD, 120 (24.4%) were reported by migraineurs and 370 (75.5%) by TTH patients (p<0.001). The number of LWD in migraine was significantly higher (p<0.001) than in TTH group; the number of REWD in TTH group was significantly higher (p<0.001) than in migraine group. Pain intensity was the main factor contributing to disability at work in migraine group (plt;0.001), in contrast with TTH group in which there was no statistical difference (p>0.05) between pain intensity and duration of pain. Patients with migraine were much more likely to report actual lost workdays
because of headache whereas TTH was responsible for the largest proportion of decreased work effectiveness. Assessing headache
severity with an objective method (i.e. questionnaire) may improve headache care and lead to proper treatment decisions. Special
attention must be given to particular populations.
Received: 14 January 2002, Accepted in revised form: 22 April 2002
Correspondence to I. Heliopoulos 相似文献
16.
Individuals with tension-type headache report significant anger, depression, anxiety, and stressors. However, it is not clear to what extent these variables are interrelated. The objective of the present study was to explore the role of anger in headaches, and to examine its relationship to anxiety, depression, and daily life stressors. Participants were 65 young adult women who suffered from recurrent headaches. The sample was obtained in a large-scale screening of young adult women using the Headache Symptoms List to identify those with recurrent headache. Those individuals reporting headaches completed a battery of assessment measures that included the State-Trait Anger Expression Inventory, the Mood and Anxiety Symptoms Questionnaire, and the Hassles Scale. Results revealed a significant relationship between anger suppression and depression (r = 0.40, P<.01), as well as anger expression and anxiety (r = 0.41, P<.01) for those with headache. The use of the Mood and Anxiety Symptoms Questionnaire allowed for the separate analysis of general distress symptoms and symptoms more specific to anxiety and depression. Results indicated that those with headache experience more general, nonspecific distress rather than symptoms indicative of anxiety and depression (P<.01). In addition, the mixed headache group scored high on both general (mean, 28.96) and specific measures of depression (mean, 65.76) and on anger suppression (mean, 20.12), suggesting that they might experience more psychological distress than those with tension-type headache. The present results indicate the need to distinguish the unique dimensions of anxiety and depression that should be assessed in the population with recurrent headache. 相似文献
17.
Pain aggravation by movement and avoidance of movement (kinesiophobia) is often reported by patients during migraine attacks. Yet its specific contribution to migraine diagnosis is undetermined. To characterize the frequency and severity of kinesiophobia during migraine and its role in the diagnosis of primary headaches, we questioned 150 patients (126 women and 24 men, average age 38.5 yrs) with migraine (n = 111) or tension-type headache (TTH) (n = 39) about aggravation of pain by bending forward, brisk head movements (jolt), and avoidance of movement during the attacks. The degree of pain worsening by each stimulus was measured through a visual analog scale and compared to worsening produced by other sensory stimuli such as light, sound, and smell. The discrimination power of kinesiophobia between migraine and TTH was calculated, using the International Classification of Headache Disorders criteria as gold standard. Sensitivity/specificity of studied symptoms was high in differentiating the 2 headache types: bending forward: 98%/85.7%; jolt: 96.3%/81.6%; and immobility during the attacks: 100%/70%. The degree of kinesiophobia was identical to photo- and phonophobia in migraine patients. We conclude that kinesiophobia discriminates between migraine and TTH. Bending forward and jolt may be useful additional questions to ask patients for the differentiation of headache attacks. PERSPECTIVE: This article evaluates the specific role of movement (movement-induced pain aggravation and avoidance of movement) in primary headaches. Kinesophobia is an easy symptom to screen, explained by migraine pathophysiology, and proved to be a sensitive and specific measure to identify migraine attacks when compared to tension-type headache. 相似文献
18.
Wang Y Zhou J Fan X Li X Ran L Tan G Chen L Wang K Liu B 《The journal of headache and pain》2011,12(5):561-567
This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional
study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the
First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used
to collect medical records. Diagnosis of headache was according to the International classification of headache disorders,
2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%)
patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified
(headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster
headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer
than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p < 0.001).TTH patients had more frequent episodes of headaches than migraine patients, and typically headache frequency exceeded
15 days/month (p < 0.001); 22.8% of primary headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the
general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient
headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while
more attention to headache frequency should be given for the TTH ones. 相似文献
19.
Migraine headaches and sleep disturbances in children 总被引:3,自引:0,他引:3
OBJECTIVE: The aim of the present study was to investigate the prevalence of sleep disturbances in children with migraine headaches and to describe individual differences in sleep behaviors based on headache features (eg, frequency, duration, intensity). BACKGROUND: A relationship between migraine headaches and sleep disturbances has been suggested in both children and adults, but there is a lack of research examining the relationship between specific headache features and the range of sleep behaviors in children. METHODS: One hundred eighteen children, aged 2 to 12 years (mean, 9.1; standard deviation, 2.3) were evaluated for headaches at two pediatric neurology departments. Parents completed the Children's Sleep Habits Questionnaire and a standardized questionnaire regarding headache characteristics. RESULTS: Parents reported a high rate of sleep disturbances in children, including sleeping too little (42%), bruxism (29%), child co-sleeping with parents (25%), and snoring (23%). Children with migraine headaches experienced more sleep disturbances compared to published healthy control norms. After controlling for child demographics, we found that the frequency and duration of migraine headaches predicted specific sleep disturbances, including sleep anxiety, parasomnias, and bedtime resistance. CONCLUSIONS: Children with migraine headaches have a high prevalence of sleep disturbances. The direction of the relationship between headaches and sleep is unknown. Regardless, interventions targeting sleep habits may improve headache symptoms, and effective treatment of headaches in children may positively impact sleep. 相似文献
20.
Annamaria Bini Andrea Evangelista Paola Castellini Giorgio Lambru Tullia Ferrante Gian Camillo Manzoni Paola Torelli 《The journal of headache and pain》2009,10(1):3-9
The purpose of this review was to provide a critical evaluation of medical literature on so-called “cardiac cephalgia” or
“cardiac cephalalgia”. The 2004 International Classification of Headache Disorders codes cardiac cephalgia to 10.6 in the
group of secondary headaches attributed to disorder of homoeostasis. This headache is hardly recognizable and is associated
to an ischaemic cardiovascular event, of which it may be the only manifestation in 27% of cases. It usually occurs after exertion.
Sometimes routine examinations, cardiac enzymes, ECG and even exercise stress test prove negative. In such cases, only a coronary
angiogram can provide sufficient evidence for diagnosis. Cardiac cephalgia manifests itself without a specific pattern of
clinical features: indeed, in this headache subtype there is a high variability of clinical manifestations between different
patients and also within the same patient. It “mimics” sometimes a form of migraine either accompanied or not by autonomic
symptoms, sometimes a form of tension-type headache; on other occasions, it exhibits characteristics that can hardly be interpreted
as typical of primary headache. Pain location is highly variable. When the headache occurs as the only manifestation of an
acute coronary event, the clues for suspicion are a) older age at onset, b) no past medical history of headache, c) presence
of risk factors for vascular disorders and d) onset of headache under stress. Knowledge of cardiac cephalgia is scarce, due
to its rare clinical occurrence and to the scant importance given to headache as a symptom concomitantly with an ischaemic
cardiac event. 相似文献