Frequency of diagnoses in a specialized headache clinic in Buenos Aires

2019 ◽  
pp. 66-69
Author(s):  
Vanessa Nagel ◽  
Sol Cavanagh ◽  
Marina Olivier ◽  
Natalia Larripa ◽  
Maria T Gutierrez ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Buenos Aires ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Craniofacial Pain ◽  
Headache Clinic ◽  
Type Headache

Objective: Headache is one of the most frequent reason for consultations in neurology. The global prevalence among adults with migraine is approximately 10% with migraine, 40% for tension-type headache (TTH) and 3% for chronic daily headache. The purpose of this study is to analyze the prevalence of the diagnoses of headache and craniofacial pain among patients evaluated in a specialized headache clinic of Buenos Aires during 2017. Methods: Retrospective, descriptive study. We reviewed the electronic medical records of patients who consulted for headaches or craniofacial pain from January 1st to December 31st, 2017. Diagnoses were made according to the criteria of the International Classification of Headache Disorders (ICHD-3). Results: We reviewed 3254 electronic medical records and documented 3941 diagnoses: headache (93.03%), craniofacial pain (3.62%) and unclassifiable (3.35%). The average age was 43.14 years. 80.7% were women. Primary headaches were the most frequent diagnoses (78.54%). Migraine represented the main diagnosis (87.42%). Episodic migraine without aura was the most prevalent diagnosis (48%). Tension- type headache (TTH) was found in 8.74% of cases of primary headaches and Trigeminal autonomic cephalalgias (TACs) in 2.89%. Medication-overuse headache (MOH) represented 77.93% of the secondary headaches, and most of them also met chronic migraine criteria fulfilled criteria of chronic migraine. Primary trigeminal neuralgia represented 50% of craniofacial pain and 27% were secondary trigeminal neuralgia, mostly postherpetic or posterior to dental procedures. Regardin to the frecuency, 33.58% of the patients had chronic headache. Conclusion: In our section, migraine is the most frequent diagnosis followed by medication-overuse headache. The percentage of chronic headache is higher than the prevalence in the general population, probably because it is a tertiary center.

scholarly journals СОЦІАЛЬНО-ДЕМОГРАФІЧНІ ТА КЛІНІЧНІ ХАРАКТЕРИСТИКИ ПАЦІЄНТІВ З АБУЗУСНИМ ГОЛОВНИМ БОЛЕМ В ПОЄДНАНІ З ХРОНІЧНИМ ГОЛОВНИМ БОЛЕМ НАПРУГИ

2021 ◽  
Vol 25 (3-4) ◽  
pp. 3-7
Author(s):  
М.Ю. Дельва ◽  
І.І. Дельва ◽  
В.А. Пінчук ◽  
Г.Я. Силенко ◽  
А.М. Кривчун
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Abdominal Obesity ◽  
Medication Overuse Headache ◽  
Depression Scale ◽  
Female Gender ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Exact Test ◽  
Type Headache

Introduction. A study of medication overuse headache (MOH) can define the risk group for MOH in patients with primary headaches. The aim of the research is to study the socio-demographic, clinical and pharmacotherapeutic characteristics of patients with MOH and chronic tension-type headache (CTTH). Material and methods. We examined 28 patients with MOH in combination with CTTH and 34 patients with CTTH. MOH and CTTH were diagnosed according to the International Classification of Headache Disorders 3rd revision. Anxiety and depressive signs were assessed by the Hospital Anxiety and Depression Scale; abdominal obesity was determined using waist circumference. Quantitative values were presented as the median and the interquartile range. Quantitative samples were analyzed according to Mann-Whitney U-test, qualitative samples - according to Fisher's exact test. Differences at p <0.05 were considered significant. Results. Patients with MOH and CTTH had the following characteristics: female gender - 79%, age - 41.0 (33.0-49.5) years, familyless state - 54%, higher education - 25%, employment - 46%, smoking - 43%, anxiety signs - 71%, depressive signs - 75%, cervicalgia - 36%, lower back pain - 61%, arterial hypertension - 21%, diabetes mellitus - 7%, abdominal obesity - 46%, mild traumatic brain injury - 43%, headache intensity - 5.0 (4.0-6.3) points on a visual analog scale, duration of headache attacks - 7.0 (5.0-8.3) hours, age of CTTH onset - 31,5 (23,0-41,0) years, duration of CTTH - 9.0 (6,8-10,3) years, duration of MOH – 15.5 (8.3-20.8) months. Patients with MOH and CTTH compared to patients with CTTH were significantly younger, had a history of traumatic brain injury, had significantly more headache days per month. Patients with MOH and CTTH overused combined analgesics (47%), nonsteroidal anti-inflammatory drugs (32%), triptans with analgesics (21%). Abortive medications had been used on 23.0 (18.0-28.5) days a month, in form of 32.0 (27.3 -41.8) doses a month.

Medication overuse headache in 787 patients admitted for inpatient treatment over a period of 32 years

Cephalalgia ◽  
2020 ◽  
Vol 40 (8) ◽  
pp. 808-817 ◽  
Author(s):  
Sabine Salhofer-Polanyi ◽  
Karin Zebenholzer ◽  
Thomas Berndl ◽  
Kastriot Kastrati ◽  
Sandra Raab ◽  
...  
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Opioid Analgesics ◽  
Tension Type Headache ◽  
P Value ◽  
Cumulative Number ◽  
Number Of Patients ◽  
Withdrawal Therapy ◽  
Type Headache ◽  
Over Time

Background Definitions of medication overuse headache have changed over time. Objective To evaluate the clinical characteristics of medication overuse headache patients admitted for inpatient withdrawal therapy over a period of 32 years. Methods We included all patients with medication overuse headache treated from 1 January 1984 to 31 December 2015. We obtained all data from the medical reports and defined three periods, P1 (1984–1993), P2 (1994–2003), and P3 (2004–2015). The p-value adjusted for multiple comparisons was set to 0.005. Results Within 32 years, a total of 787 patients accounted for 904 admissions for MOH. From P1 to P3, the proportion of patients with preexisting migraine increased from 44.3% to 53.3% (chi2 = 9.0, p = 0.01) and that with preexisting tension-type headache decreased from 47.9% to 34.6% (chi2 = 9.3, p < 0.01). The median time since onset of headache and medication overuse headache decreased from 20 to 15 years ( p < 0.001) and from 3 to 2 years ( p < 0.001). The median cumulative number of single doses decreased from 120 to 90 per month ( p = 0.002). Overuse of triptans, non-opioid analgesics, and opioids increased, whereas overuse of ergotamines decreased over time ( p < 0.001 for all tests). The use of prophylactic medication before admission increased from 8.3% to 29.9% (chi2 = 89.5, p < 0.001). Conclusion This retrospective study in a large number of patients with medication overuse headache admitted for inpatient withdrawal therapy over a period of 32 years shows a trend towards changes in the preexisting headache type, a decrease in the time since onset of headache and medication overuse headache, a decrease in the number of drug doses used per month, changes in the type of drugs overused, and an increase in, but still low rate, of prophylactic medication prior to admission.

Chronic Post-Traumatic Headache – A Clinical Analysis in Relation to the International Headache Classification 2nd Edition

Cephalalgia ◽  
2005 ◽  
Vol 25 (2) ◽  
pp. 132-138 ◽  
Author(s):  
L Baandrup ◽  
R Jensen
Keyword(s):  
Multidisciplinary Treatment ◽  
Clinical Analysis ◽  
Tension Type Headache ◽  
Major Influence ◽  
Primary Headaches ◽  
Headache Classification ◽  
Post Traumatic ◽  
International Headache Classification ◽  
Headache Clinic ◽  
Type Headache

The clinical presentation of chronic post-traumatic headache in 53 patients from a highly specialized headache clinic was analysed and classified according to the diagnostic criteria of the primary headaches in The International Headache Classification 2nd Edition, and compared with the 1st Edition. All patients fulfilled the criteria for both editions indicating that the restrictions in the 2nd Edition have no major influence on the prevalence in specialized clinics. We found the phenomenology to be very heterogeneous, but the vast majority (77%) of patients presented with headache resembling chronic tension-type headache, either as the only manifestation or in combination with migraine symptoms. For the first time episodic tension-type headache is described as occurring after head trauma. The prevalence of coexisting analgesic overuse was 42% and the treatment outcome for these patients was just as favourable as in primary headaches, whereas the time-consuming multidisciplinary treatment demonstrated only very modest results.

scholarly journals Medication-Overuse Headache: Results from a Pain Medicine Clinic Cohort

2022 ◽  
Author(s):  
Leon Moskatel
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Pain Clinic ◽  
Secondary Headache ◽  
Pain Medicine ◽  
Medicine Clinic ◽  
Type Headache ◽  
Clinical Records

Background and Objective: Medication-overuse headache (MOH) is a common, disabling, and treatable cause of chronic daily headache. This study evaluates the characteristics of a cohort of patients with MOH seen in a pain medicine clinic. Methods: We conducted a retrospective study of consecutive patients seen by a neurologist in the pain medicine clinic at the University of California, San Diego. Demographics, headache diagnoses, and overused medications were extracted from clinical records from 83 patients ≥ 18 years of age where a diagnosis of MOH was entered into the electronic medical record September 12, 2017-March 30, 2020. Results: Opioids were the most overused medications (42/83, 50.6%) followed by caffeine-containing compounds (20/83, 24.1%), triptans (12/83, 14.5%) and non-steroidal anti-inflammatory drugs (10/83, 12.9%). Chronic migraine was the most common underlying headache syndrome (54/83, 65.1%), followed by secondary headache disorder (13/83, 15.7%) and tension-type headache (8/83, 9.6%). Men were more likely to be overusing opioids (OR 3.3, p = 0.026) while women were more likely to be overusing caffeine-containing compounds (OR 5.4, p = 0.041). Discussion and Conclusions: It is crucial for pain specialists to recognize MOH in the pain clinic setting. Opioid overuse headache is more common among men, likely in part due to migraine being underrecognized in men and therefore men not receiving migraine-specific medications. Caffeine-containing compound overuse is more common among women; these are over-the-counter (OTC) and often do not appear on patients’ medications lists. Pain specialists should specifically ask patients with headache whether they are using OTC caffeine-containing compounds.

Medication Overuse Headache and Chronic Migraine in a Specialized Headache Centre: Field-Testing Proposed New Appendix Criteria

Cephalalgia ◽  
2009 ◽  
Vol 29 (2) ◽  
pp. 214-220 ◽  
Author(s):  
P Zeeberg ◽  
J Olesen ◽  
R Jensen
Keyword(s):  
Chronic Migraine ◽  
Pain Perception ◽  
Medication Overuse ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Field Testing ◽  
Tension Type Headache ◽  
Main Body ◽  
Headache Centre ◽  
Type Headache

The classification subcommittee of the International Headache Society (IHS) has recently suggested revised criteria for medication overuse headache (MOH) and chronic migraine (CM). We field tested these revised criteria by applying them to the headache population at the Danish Headache Centre and compared the results with those using the current criteria. For CM we also tested two alternative criteria, one requiring ≥ 4 migraine days/month and ≥ 15 headache days/month, the second requiring ≥ 15 headache days/month and ≥ 50% migraine days. We included 969 patients with migraine or tension-type headache (TTH) among 1326 patients treated and dismissed in a 2-year period. Two hundred and eighty-five patients (30%) had TTH, 265 (27%) had migraine and 419 (43%) had mixed migraine and TTH. The current criteria for MOH classified 86 patients (9%) as MOH, 98 (10%) as probable MOH and 785 (81%) as not having MOH after a 2-month drug-free period. Using the appendix criteria, 284 patients (29%) were now classified as MOH, no patients as probable MOH and 685 (71%) as not having MOH. For CM only 16 patients (3%) fulfilled the current diagnostic criteria. This increased to 42 patients (7%) when we applied the appendix criteria. Using the less restrictive criteria of ≥ 4 migraine days and ≥ 15 headache days, 88 patients (14%) had CM, whereas the more restrictive criteria of ≥ 15 headache days and ≥ 50% migraine days resulted in 24 patients (4%) with CM. Our data suggest that the IHS has succeeded in choosing new criteria for CM which are neither too strict, nor too loose. For MOH, a shift to the appendix criteria will increase the number of MOH patients, but take into account the possibility of permanent changes in pain perception due to medication overuse and the possibility of a renewed effect of prophylactic drugs due to medication withdrawal. We therefore recommend the implementation of the appendix criteria for both MOH and CM into the main body of the International Classification of Headache Disorders.

Headache in children: Effectiveness of multidisciplinary treatment in a tertiary paediatric headache clinic

Cephalalgia ◽  
2013 ◽  
Vol 33 (15) ◽  
pp. 1218-1228 ◽  
Author(s):  
Ann-Britt L Soee ◽  
Liselotte Skov ◽  
Lene Theil Skovgaard ◽  
Lise L Thomsen
Keyword(s):  
Chronic Headache ◽  
Medication Overuse Headache ◽  
Multidisciplinary Treatment ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Measurement Analysis ◽  
Headache Clinic ◽  
Type Headache

Aim The aim of this article is to evaluate the effectiveness of a specific multidisciplinary treatment programme for children with headache and to describe the concept and settings of the Children’s Headache Clinic in Denmark. Method All new patients were included and evaluations were conducted after six and 12 months. Pharmacological and non-pharmacological treatments were offered by a team of specialists (physicians, headache nurses, a physiotherapist and a psychologist). Patients The subjects comprised 169 children (mean age 11.7 (range 4–17), 91 females, 78 males), 39% of whom suffered from chronic headache (≥15 days/month). All children were diagnosed according to the International Classification of Headache Disorders, second edition; 20% had migraine, 34% tension-type headache, 27% mixed headache, 4% medication-overuse headache, and 15% were diagnosed with other types of headaches. Results Fifty per cent of the children had an improvement in headache frequency above 50% at six months. By the use of repeated measurement analysis, we found a significant decrease in headache frequency in all of the six headache groups, whereas the increase in quality of life (PedsQL™ 4.0) was significant for the group as a whole. Conclusion Though preliminary, the results show a good outcome for multidisciplinary treatment programmes for children who suffer from frequent or chronic headache.

scholarly journals Migraine, tension-type headache and medication-overuse headache in a large population of shift working nurses: a cross-sectional study in Norway

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022403 ◽  
Author(s):  
Bjørn Bjorvatn ◽  
Ståle Pallesen ◽  
Bente E Moen ◽  
Siri Waage ◽  
Espen Saxhaug Kristoffersen
Keyword(s):  
Shift Work ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Work Schedule ◽  
Shift Work Disorder ◽  
Insomnia Disorder ◽  
Type Headache ◽  
Night Shifts

ObjectivesTo investigate associations between different types of headaches and shift work.Design, participants and outcome measuresNurses with different work schedules (day work, two-shift rotation, night work, three-shift rotation) participated in a cohort study with annual surveys that started in 2008/2009. In 2014 (wave 6), a comprehensive headache instrument was included in the survey, in which 1585 nurses participated. Headaches were assessed according to the International Classification of Headache Disorders IIIb. Frequent headache (≥1 day per month), migraine, tension-type headache, chronic headache (headache >14 days per month) and medication-overuse headache (chronic headache + acute headache medication ≥10 days last month) comprised the dependent variables. Adjusted (for sex, age, percentage of full-time equivalent, marital status, children living at home) logistic regression analyses were conducted with work schedule, number of night shifts worked last year, number of quick returns (<11 hours in-between shifts) last year, shift work disorder and insomnia disorder as predictors.ResultsFrequent headache, migraine and chronic headache were associated with shift work disorder (OR 2.04, 95% CI 1.62 to 2.59; 1.60, 1.21 to 2.12; 2.45, 1.25 to 4.80, respectively) and insomnia disorder (OR 1.79, 95% CI 1.43 to 2.23; 1.55, 1.18 to 2.02; 3.03, 1.54 to 5.95, respectively), but not with work schedule, number of night shifts or number of quick returns. Tension-type headache was only associated with >20 night shifts last year (OR 1.41, 95% CI 1.07 to 1.86). Medication-overuse headache was only associated with insomnia disorder (OR 7.62, 95% CI 2.48 to 23.41).ConclusionsWe did not find any association between different types of headaches and work schedule. However, tension-type headache was associated with high number of night shifts. Nurses with sleep disorders (insomnia disorder and shift work disorder) reported higher prevalence of frequent headaches, migraine, chronic headache and medication-overuse headache (only insomnia) compared with nurses not having insomnia disorder and shift work disorder, respectively.

Assessment of International Headache Society Diagnostic Criteria: A Reliability Study

Cephalalgia ◽  
1994 ◽  
Vol 14 (4) ◽  
pp. 280-284 ◽  
Author(s):  
M Leone ◽  
G Filippini ◽  
D D'Amico ◽  
M Farinotti ◽  
G Bussone
Keyword(s):  
Diagnostic Criteria ◽  
Medical Records ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Kappa Statistics ◽  
Reliability Study ◽  
Ihs Criteria ◽  
Craniofacial Pain ◽  
Type Headache

In 1988 the International Headache Society (IHS) introduced new diagnostic criteria for headaches and craniofacial pain. Since headaches can be diagnosed solely on the basis of information provided by the patient, it is essential that the criteria are reproducible and consistent. phenomena to a form designed to reflect the IHS criteria. Interobserver concordance (kappa statistics) in the application of the diagnostic hemicrania; kappa = 0.88 for migraine; kappa = 0.75 for tension-type headache; (ii) “almost perfect” to “substantial” for the second digit migraine without aura; kappa = 0.71 for chronic tension-type headache; kappa = 0.66 for cluster headache-like disorder not fulfilling the eria. These results show that the IHS diagnostic criteria are satisfactorily applicable to high quality medical records abstracted by experienced.

The first prevalence study of primary headaches in adults in a post-conflict area of Serbia

Cephalalgia ◽  
2021 ◽  
pp. 033310242110060
Author(s):  
Nenad Milošević ◽  
Jasna Zidverc Trajković ◽  
Milija Mijajlović ◽  
Jovana Milošević ◽  
Ana Podgorac ◽  
...  
Keyword(s):  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Primary Headache Disorders ◽  
Conflict Area ◽  
Post Conflict ◽  
Type Headache

Aim The aim of the present study was to establish annual prevalence of primary headaches, migraine, and tension-type headache among adults in a post-conflict area of Serbia. Methods The data for this cross-sectional study was obtained via face-to-face interviews using questionnaires specifically designed for this purpose, in line with the available guidelines. The study sample included adults aged 18–65 years whose native language is Serbian with residence in six predominantly Serbian communities in Kosovo and Metohija. Relevant diagnoses were established according to the diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. Results The study included 1062 adults. Analyses indicated 47.7% prevalence of primary headaches. The 1-year prevalence of migraine (with aura and without aura) and tension-type headache was established at 15.2% (3.3% and 11.9%), and 32.2%, respectively. One-year prevalence of chronic headache was calculated at 3.5%, while the prevalence of medication overuse headache was slightly lower at 2.9%. Primary headaches were more prevalent among women, participants residing south of the river Ibar, married or cohabiting individuals, as well as among interviewees (persons) who reported feeling unsafe in Kosovo and Metohija. This is the first study of the prevalence of primary headache disorders in Serbia. The obtained data is comparable to the data available for other countries, especially those in the Balkan region.

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