Predisposing, precipitating and relieving factors in different categories of headache.

Abstract

SYNOPSISSix hundred headache patients were questioned systematically about factors which precipitated, aggravated or relieved headache, their personal well‐being, symptoms of muscular contraction, and other features thought to be associated with headache (migraine in the immediate family, ice cream headache, icepick‐like pains, symptoms of orthostatic hypotension, travel sickness, and allergies). These items were analysed in relation to the clinical diagnosis (classical migraine, common migraine, tension‐vascular, tension or cluster headache), to two sets of migrainous features (symptoms of common migraine and neurological disturbances during headache), as well as the time course of headache (episodic, constant dull with more severe episodes, or constant). Differences between cluster and noncluster headache in age and sex distribution, precipitating and relieving factors, and family history of migraine supported the view that cluster headache is a distinct entity. The results of other analyses emphasized the continuum between migraine, tension‐vascular and tension headache. Indications of neurovascular involvement both during and between headache episodes were most apparent toward the migraine end of the headache spectrum, whereas psychological factors and symptoms of muscular contraction were associated more frequently with constant than with episodically‐recurring headache.