Primary Headache Care Delivery by Nonspecialists in Brazil

Cephalalgia ◽  
1999 ◽  
Vol 19 (5) ◽  
pp. 520-524 ◽  
Author(s):  
MB Vincent ◽  
JJ Freitas de Carvalho
Keyword(s):  
Care Delivery ◽  
Correct Diagnosis ◽  
Preventive Treatment ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Type ◽  
Type Headache ◽  
Headache Patients ◽  
Headache Care ◽  
Made In

Headaches are common disorders usually examined by nonneurologists. In order to assess how primary headache patients (IHS groups 1, 2, and 3) are generally managed by nonspecialists, 414 patients were asked about their previous headache care. Correct diagnosis had previously been made in only 44.9%, 6.7%, and 26.7% of the migraine, tension-type headache, and cluster headache patients, respectively. The patients underwent 501 investigative procedures motivated by the headache, averaging 1.21 examinations per patient, mostly EEGs. Preventive treatment was largely overlooked irrespective of the headache type. It is concluded that scientific improvements in headache care may be ineffective unless educational programs improve headache knowledge in general.

scholarly journals Osmophobia in primary headache patients: associated symptoms and response to preventive treatments

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marianna Delussi ◽  
Anna Laporta ◽  
Ilaria Fraccalvieri ◽  
Marina de Tommaso
Keyword(s):  
Cluster Headache ◽  
Rating Scale ◽  
Preventive Treatment ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Self Rating ◽  
Type Headache ◽  
Headache Center ◽  
Headache Patients

Abstract Background Osmophobia, is common among primary headaches, with prevalence of migraine. The study aimed to evaluate prevalence and clinical characteristics of patients with osmophobia in a cohort of primary headache patients selected at a tertiary headache center. The second aim was to verify the possible predicting role of osmophobia in preventive treatment response in a sub cohort of migraine patients. Methods This was an observational retrospective cohort study based on data collected in a tertiary headache center. We selected patients aged 18–65 years, diagnosed as migraine without aura (MO), migraine with aura (MA) or Chronic Migraine (CM), Tension-Type Headache (TTH); and Cluster Headache (CH). We also selected a sub-cohort of migraine patients who were prescribed preventive treatment, according to Italian Guidelines, visited after 3 months follow up. Patients were considered osmophobic, if reported this symptom in at least the 20% of headache episodes. Other considered variables were: headache frequeny, the migraine disability assessment (MIDAS), Allodynia Symptom Checklist, Self-rating Depression scale, Self-rating Anxiety scale, Pain intensity evaluated by Numerical Rating Scale-NRS- form 0 to 10. Results The 37,9% of patients reported osmophobia (444 patients with osmophobia, 726 without osmophobia). Osmophobia prevailed in patients with the different migraine subtypes, and was absent in patients with episodic tension type headache and cluster headache (chi square 68.7 DF 7 p < 0.0001). Headache patients with osmophobia, presented with longer hedache duration (F 4.91 p 0.027; more severe anxiety (F 7.56 0.007), depression (F 5.3 p 0.019), allodynia (F 6 p 0.014), headache intensity (F 8.67 p 0.003). Tension type headache patients with osmophobia (n° 21), presented with more frequent headache and anxiety. A total of 711 migraine patients was visited after 3 months treatment. The change of main migraine features was similar between patients with and without osmophobia. Conclusions While the present study confirmed prevalence of osmophobia in migraine patients, it also indicated its presence among chronic tension type headache cases, marking those with chronic headache and anxiety. Osmophobia was associated to symptoms of central sensitization, as allodynia. It was not relevant to predict migraine evolution after first line preventive approach.

scholarly journals Prevalence and impact of headache in undergraduate students in Southern Brazil

2010 ◽  
Vol 68 (6) ◽  
pp. 873-877 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Alisson Roberto Teles ◽  
Maíra Cristina Velho ◽  
Viviane Maria Vedana ◽  
Roberta Castilhos da Silva ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Significant Difference ◽  
Headache Episode ◽  
Headache Type ◽  
Probable Migraine ◽  
Type Headache ◽  
The University

OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001). In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

The need for preventive therapy in primary headaches

2011 ◽  
pp. 46-49
Author(s):  
Mario Fernando Prieto Peres ◽  
Daniel Krempel Amado ◽  
André Leite Gonçalves ◽  
Reinaldo Ribeiro ◽  
Jorge Roberto Pagura ◽  
...  
Keyword(s):  
Preventive Treatment ◽  
Primary Headache ◽  
Preventive Therapy ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Correct Treatment ◽  
Treatment Type ◽  
Geographical Regions ◽  
Probable Migraine ◽  
Type Headache

Introduction: Primary headaches are common conditions. In Brazil, the prevalence of migraine is 15.2%, tension-type headache 13% and chronic daily headache (CDH) 6.9%. Although frequent disorders a proportion of patients are undertreated. Patients patterns of headache care can trend toward acute medication only and those in need of prevention may not receive it. Objective: To estimate the rates of preventive treatment in primary headache sufferers. Methods: A telephone interview containing questions about headache and socio-demographic characteristics was applied to 3,848 people from 27 States of Brazil, in its five geographical regions. We considered MIDAS > 10 points as a marker for the need of preventive treatment. Patients were asked if they were taking any medication on a daily basis or any treatment to prevent headaches from happening. Subjects were divided into: 1. Those who responded positively for the question regarding preventive treatment regardless of the treatment type. 2. Those who responded positively for the question, but only medications or treatments studied for migraine prevention, labeled as "Correct treatment" 3. Those who responded positively for the question, but only medications or treatments from the prevention consensus (Brazilian Headache Society), labeled as "Consensus treatment" Results: In total, 12.8% of primary headache sufferers had MIDAS higher than 10, meeting criteria for prophylactic treatment, but only 8.4% of them reported it, 3.9% were using a right preventive treatment. The percentage of patients in need for prevention was 24.7% in migraine, 15.6 % in probable migraine, 5 % for tension-type headache (TTH) and 4% for probable TTH. Only 2.6% of migraineurs, 7.5% of probable migraine patients, 4.3% of tension-type headache and 0% of probable TTH received proper preventive treatment Conclusion: Primary headaches are common, debilitating conditions but a substantial proportion of those who might need prevention do not receive it. Patient education, public health initiatives in order to deliver migraine and other primary headaches treatment for the general population should be considered not only in Brazil, but worldwide.

Changing Headache from Preschool Age to Puberty. A Controlled Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 294-303 ◽  
Author(s):  
R Virtanen ◽  
M Aromaa ◽  
P Rautava ◽  
L Metsähonkala ◽  
P Anttila ◽  
...  
Keyword(s):  
Primary Headache ◽  
Tension Type Headache ◽  
Preschool Age ◽  
Controlled Study ◽  
Abdominal Symptoms ◽  
Common Location ◽  
Headache Type ◽  
Type Headache ◽  
Pain Localization

The characteristics of disturbing primary headache and the occurrence of headache types were studied by sending a questionnaire to 1132 Finnish families of 6-year-old children. Children with headache in the preceding 6 months and their controls were clinically examined at the ages of 6 and 13. During the follow-up, half of the headaches, classified as migraine at age 6 years, were unchanged and 32% turned into tension-type headache. In children with tension-type headache, the situation was unchanged in 35%, and in 38% of children the headache type had changed to migraine. At preschool age the most common location of headache was bilateral and supraorbital, and at puberty bilateral and temporal. During the follow-up, symptoms concurrent with headache, such as odour phobia, dizziness and balance disturbances became more typical, whereas restlessness, flushing and abdominal symptoms became less marked. The early manifestation of both migraine and tension-type headache predict equally often migraine in puberty with marked changes in concurrent symptoms and pain localization.

scholarly journals PROFILE OF PRIMARY HEADACHE PATIENTS IN NEUROLOGICAL POLYCLINIC

2021 ◽  
Vol 2 (1) ◽  
pp. 1-4
Author(s):  
Yulia Damayanti ◽  
Eko Arisetijono Marhaendraputro ◽  
Widodo Mardi Santoso ◽  
Dessika Rahmawati
Keyword(s):  
Primary Headache ◽  
Tension Type Headache ◽  
Analysis Technique ◽  
Social Quality Of Life ◽  
Type Headache ◽  
Observational Descriptive Study ◽  
Life Work ◽  
Headache Patients ◽  
Research Show

Headache is the most common neurological disorder among all the symptoms of general health problems. Headaches are the most frequently complained of after back pain, which brings someone to the doctor and harms personal, family, social, quality of life, work, and finances. This study aims to find out the characteristics of primary headache patients in the neurological polyclinic, RSUD dr. Saiful Anwar Malang. The design of this research was an observational descriptive study of the filled headache questionnaire was to determine the characteristics of headache patients who visited the neurological polyclinic at dr. Saiful Anwar Malang with complaints of primary headache. The procedure of this research is to provide a questionnaire. The data analysis technique used is that the research variables will be presented in the frequency distribution table. The results of this research show that primary headache was more common in women as many as 19 people (61%) compared to male 12 people (39%). Most of the primary headache patients who came to the neurological clinic of Saiful Anwar Hospital were 30-60 years old. Tension-Type Headache (TTH) in this study had the highest percentage of 58%. In this study, cluster headache two patients all attacked women.

scholarly journals Body Mass Index and Primary Headache: A Hospital-Based Study in China

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Qingqing Huang ◽  
Huiqing Yu ◽  
Ningning Zhang ◽  
Bingling Guo ◽  
Changyan Feng ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Chronic Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Chief Complaint ◽  
Secondary Headache ◽  
Episodic Headache ◽  
Type Headache ◽  
Headache Patients

Objective. Primary headache and obesity are highly prevalent disorders in the general population. Although many studies have reported an association between the two, there is still no overall comprehension about this relationship. To gain a more accurate understanding in this regard, we analyzed data from a 2011 cross-sectional study in Chongqing, China. Methods. Patients with a chief complaint of headache were administered a headache questionnaire and diagnosed by neurology doctors in accordance with the International Classification of Headache Disorders 2nd Edition (ICHD-II) criteria. Patients aged < 18 years or diagnosed with secondary headache were excluded. Results. Of 1327 patients who cited headache as the chief complaint, 16 were excluded for missing data, while 396 were diagnosed with chronic headache (177 chronic migraine [CM], 186 chronic tension-type headache [CTTH], and 33 other chronic headache) and 915 with episodic headache (369 episodic migraine [EM], 319 episodic tension-type headache [ETTH], and 227 other episodic headache). Chronic headache patients had a higher number of headache days per month, longer duration of headache history, and greater tendency to overuse analgesics than episodic headache patients. The CM and ETTH patients were more apt to be overweight and had a significantly greater body mass index (BMI; p < 0.05) than the EM and CTTH patients. Overweight (odds ratio [OR] = 3.64; 95% confidence interval (CI), 1.19–8.81) and obesity (OR = 28.63; 95% CI, 2.96–276.6) were independently associated with CM but not with other headaches, and this association was not influenced by other factors such as medication overuse. Conclusions. The relationship between headache and overweight/obesity varies depending on the type of primary headache. CM patients are more likely to have a higher body mass index than EM patients, while ETTH patients are more likely to be overweight/obese than CTTH patients.

scholarly journals Primary headache diagnosis among chronic daily headache patients

2003 ◽  
Vol 61 (2B) ◽  
pp. 364-367 ◽  
Author(s):  
Abouch Valenty Krymchantowski
Keyword(s):  
Chronic Daily Headache ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Hemicrania Continua ◽  
Headache Diagnosis ◽  
Daily Headache ◽  
Type Headache ◽  
Persistent Headache ◽  
Headache Patients

Chronic daily headache (CDH) refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996). Five hundred seventy four patients (88.1%) had episodic migraine as primary headache before turning into daily presentation, 52 (8%) had chronic tension-type headache, 14 (2.2%) had hemicrania continua and 11 patients (1.7%) had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.

Clinical Features of Probable Medication-Overuse Headache: A Retrospective Study in Japan

Cephalalgia ◽  
2007 ◽  
Vol 27 (9) ◽  
pp. 1020-1023 ◽  
Author(s):  
N Imai ◽  
E Kitamura ◽  
T Konishi ◽  
Y Suzuki ◽  
M Serizawa ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Migraine ◽  
Clinical Picture ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Type ◽  
Combination Analgesics ◽  
Type Headache

This study examined the clinical picture of probable medication-overuse headache (MOH) and the presence of any features peculiar to Japan. In a retrospective study of 47 patients, type of primary headache, type of medicine overused, method and result of withdrawal were investigated. Among the 47 patients, 80.9% had migraine only, and 85.1% overused combination medications. While 36 patients (76.6%) succeeded in withdrawal, five patients (10.6%) failed. One patient (2.1%) had not improved by 2 months after withdrawal and was diagnosed with chronic migraine and chronic tension-type headache without MOH. The remaining five patients (10.6%) dropped out. All dropout patients were recommended abrupt inpatient withdrawal, but chose abrupt outpatient withdrawal. As features peculiar to Japan, many patients with probable MOH overused combination analgesics, particularly females.

Psychiatric co-morbidity among patients with primary headache

2020 ◽  
Vol 30 (2) ◽  
pp. 32-35
Author(s):  
Sifat E Syed ◽  
MSI Mullick ◽  
MA Hannan
Keyword(s):  
Psychiatric Disorder ◽  
Sampling Technique ◽  
Primary Headache ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Outpatient Departments ◽  
Type Headache ◽  
Headache Patients

Headache is the commonest complaint in neurology outpatient departments (OPD) and the co- existence of psychiatric disorders with headache is an established fact. This study was aimed to estimate the proportion of adult headache patients suffering from psychiatric co-morbidity and to see the possible association between headache pattern and psychiatric disorders.This cross sectional study was done among 51 sample of neurology OPD of BSMMU. International Classification of Headache Disorders (ICHD-3) was used to determine the types of headache and Mini International Neuropsychiatric Interview (MINI) was used to diagnose psychiatric disorder. Purposive sampling technique was used and data was collected using face-to-face interview from January, 2015 to June, 2015. New and old cases of primary headache of both sexes who were 15-65 years old were taken as samples. The results found that tension type headache was the commonest type of headache and total 62.7% of headache patients suffered from psychiatric disorder. Among them, 39.2% had depressive disorder and 17.6% had anxiety disorders. Logistic regression revealed that higher duration and frequency of headache was a predictor of having psychiatric comorbidity (OR= 1.7). This small study shows the need of larger research in this issue and also points out the importance of psychiatric intervention for headache patients. Bang J Psychiatry December 2016; 30(2): 32-35

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