Common Type Of Headache Research Articles

Clinical characteristics of 2378 patients presenting with headache disorders to headache clinics in Japan: A clinic-based multicenter study

BackgroundThere are reports from single-center studies on patients visiting headache clinics; however, few multicenter studies have been conducted in Japan. This study aims to address this gap by conducting a multicenter analysis of the clinical characteristics, headache types, severity, and psychiatric comorbidities of patients attending headache clinics. MethodsWe prospectively evaluated the clinical characteristics of 2378 patients with headache disorders visiting three headache clinics. Baseline demographics, such as the visual analog scale (VAS), and psychiatric assessments, such as the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), were evaluated. Headache types were classified as migraine, tension-type headache (TTH), trigeminal autonomic cephalalgias (TACs), other primary headache disorders (OPHDs), and secondary headache. Parameters were compared between headache types using the Kruskal–Wallis test or analysis of covariance, as appropriate. ResultsThe most common headache type was migraine (78.8 %), followed by TTH (12.2 %), secondary headache (5.5 %), OPHDs (2.1 %), and TACs (1.6 %). Patients with migraine were significantly younger at first consultation (median age 32.0) than those with other headache types (TTH; 47.0, TACs; 39.0, OPHDs; 49.5, and secondary headache; 47.0). Patients with TACs exhibited the highest severity and psychiatric symptoms, with VAS (median 90.0), GAD-7 (7.0), and PHQ-9 (7.5) scores significantly higher than those of other headache type (migraine; 70.0, 5.0, 5.0, TTH; 50.0, 4.0, 4.0, OPHDs; 65.0, 4.0, 3.5, and secondary headache; 60.0, 3.0, 3.5: p<0.001, p=0.019, p<0.001). ConclusionMost patients visiting headache clinics had migraine; patients with TACs showed significantly higher headache severity and psychiatric symptoms than those with other headache types.

KCNG4 Genetic Variant Linked to Migraine Prevents Expression of KCNB1.

Migraines are a common type of headache affecting around 15% of the population. The signalling pathways leading to migraines have not been fully understood, but neuronal voltage-gated ion channels, such as KCNG4, have been linked to this pathology. KCNG4 (Kv6.4) is a silent member of the superfamily of voltage-gated potassium (Kv) channels, which expresses in heterotetramers with members of the KCNB (Kv2) family. The genetic variant Kv6.4-L360P has previously been linked to migraines, but their mode of action remains unknown. Here, we characterized the molecular characteristics of Kv6.4-L360P when co-expressed with Kv2.1. We found that Kv6.4-L360P almost completely abolishes Kv2 currents, and we propose that this mechanism in the trigeminal system, linked to the initiation of migraine, leads to the pathology.

Effectiveness of manual therapy combined with dry needling in the treatment of cervicogenic headache: A systematic review and meta-analysis

Background &amp; Objective: Headache is a common symptom and disease. Cervicogenic headache (CH) is a common type of headache that can be effectively treated with both manual therapy (MT) and dry needling (DN). However, the results of MT plus DN (MDN) for CH remain controversial. We performed a meta-analysis to evaluate the efficacy of MDN for CH. Methods: A systematic search from database inception to June 1, 2023 on clinical outcome of MDN and MT in the treatment of CH was conducted. Four databases were searched, including Pubmed (Medline), Web of Science, Embase, and Cochrane Library related randomized controlled trials (RCTs). Main outcomes included numeric pain rating scale (NPRS) in the post-treatment, the first month and the third month, extension and flexion in the post-treatment, headache frequency in the first month and the third month, neck disability index (NDI) in the first month and the third month. Results: Three studies involving 263 patients out of 68 studies were conducted. The pooled data showed that there was significant differences in NPRS in the post-treatment, the first month and the third month, extension in the post-treatment, flexion in the post-treatment between MDN group and MT group, but there was no statistically significant difference in the headache frequency in the first month and the third month, NDI in the first month and the third month. Conclusion: Current evidence suggests that MDN may be superior to MT in improving NPRS, extension, and flexion.

Correlation between benign joint hypermobility syndrome and headache in children and adolescents

BackgroundBenign Joint Hypermobility Syndrome (BJHS) is a most common hereditary connective tissue disorders in children and adolescents. This study aimed to investigate the prevalence and subtypes of headache in children with BJHS.MethodsThis observational-analytical study was conducted in a case-control setting on school children aged 7 to 16 years in 2021–2023 in Isfahan, Iran. Students were examined for BJHS using Beighton criteria by a pediatric rheumatologist. Headache disorder was diagnosed according to the Child Headache-Attributed Restriction, Disability, and Social Handicap and Impaired Participation (HARDSHIP) questionnaires for child and adolescent and International Classification of Headache Disorders (ICHD-III).ResultsA total of 4,832 student (mean age 10.3 ± 3.1 years), 798 patients with BJHS and 912 healthy children were evaluated. The probability of headache in children aged 7–11 with hypermobility was 3.7 times lower than in children aged 12–16 with hypermobility (P = 0.001). The occurrence of headache in children with BJHS was more than the control group (P = 0.001), and the probability of headache in children with BJHS was 3.7 times higher than in healthy children (P = 0.001). Migraine was the most common headache type reported of total cases. The probability of migraine in children with BJHS was 4.5 times higher than healthy children ( P = 0.001).ConclusionThis study showed a significant correlation between BJHS and headache (especially migraine) in children and adolescents.

Epidemiology and clinical characteristics of headache among COVID-19 patients in Lebanon: a retrospective cohort study

BackgroundWith the spread and rise in the number of infections of COVID-19 globally, patients experienced neurologic manifestations such as headache and dizziness, along with other serious medical conditions such as stroke and seizures. Many reported cases highlighted headache to be one of the most common COVID-19-related neurological symptoms. With the evolution of the pandemic, broad studies are needed to better understand the mechanism of headache with COVID-19. The aim of this study is to recognize the epidemiology, characteristic and progression of headache among patients with COVID-19 in Lebanon.MethodsA retrospective cohort study was done to assess 439 patients for headache during the course of COVID-19. The Statistical Package for Social Sciences (SPSS) version 26 was used for descriptive analysis.ResultsA confirmed COVID-19 Infection by PCR test was confirmed among 86% of the participants. Tension-like headache was the most common type of headache experienced by participants during COVID-19. Pain was mainly diffuse (48.7%), and compressing in nature (77.0%). Moreover, about 29% required a physician consultation and 7.7% had emergency visits. Partial relief by analgesics was reported in 54.9%, and mainly by paracetamol (64.6%). Those who reported having a history of primary headache before contracting COVID-19 were 46.7%. Among them, 36.7% patients reported a change in the type of headache and about 49.6% reported increased severity.ConclusionHeadache accompanied with COVID-19 is a common symptom during the early stages of illness. COVID-19 related headache was characterized as mainly involving the whole head region, pressuring, and partially relieved by analgesics. Thus, headache should raise early concern for the probability of being infected by COVID-19.

Role of Nasya Karma in Ardhavabhedaka - A Review

Migraine is a disorder characterised by recurrent moderate to severe headaches that interfere with work, social activities, and family life. This is a big health concern among people aged 20 to 50. Migraine is the second most common type of headache. There are numerous varieties of Shiro Rogas reported by Acharyas in Ayurvedic scriptures. The clinical characteristics of Ardhavabhedaka among them are strikingly similar to those of migraine. Similar to how analgesics, which have negative effects on other organs, are typically taken for migraine. Therefore, an Ayurvedic method to treating this ailment is presented in this article. Nasya is kind of Panchkarama treatment for body cleansing a used in Ayurvedic medicine. Administration of drug by the route of nasal cavity is termed as Nasya. It purifies and opens the head's pathways, which enhances Prana's oxygenation process and positively affects how the brain functions. Acharya Charaka mentioned “चतुःस्नेहोत्तमा मात्रा शिरःकायविरेचनम्” as treatment modality of Ardhavabhedaka. Brihat Dashmoola Taila mentioned in Bhaishjya Ratnavali as Abhyanga, Pana and Nasya in Shirorogadhikara chapter with special indication to Ardhavabhedaka.

Examining the Impact of Puberty on Primary Headache Disorders in Female Schoolchildren: A Cross-Sectional Study.

Introduction and aim Headaches are one of the most prevalent childhood disorders. Primary and secondary headaches are the two types of headaches affecting kids and teenagers. The three most typical primary headache forms are tension-type headaches (TTH), migraine, and cluster headaches. This study sought to determine the relationship between puberty and types of headaches. Methods This cross-sectional study was conducted from May 18 to July 31, among female schoolchildren aged between eight and 15 years in the Eastern Province of Saudi Arabia. Respondents were recruited through face-to-face interviews. A self-administered questionnaire was utilized, mainly consisting of demographic data and questions related to diagnosing and managing the impact of puberty in girls on the prevalence of primary headache disorder. Results In total, 481 female schoolchildren were interviewed, mostly between 13 and 15 years old (65.9%). Last year prevalence of headaches was 65.5%, with a significant difference among those who lived in Dhahran (p=0.001) and those with a family history of headaches (p<0.001). The most common type of headache was frequent TTH (16.4%) and chronic TTH (16%). Chronic TTH (p<0.001), frequent TTH (p<0.001), and migraine without aura (p=0.005) were significantly more common among the older age groups. Conclusion There was a high prevalence of headaches among female schoolchildren, with frequent TTH and chronicTTH being the most common. Furthermore, increasing age was associated with an increasing risk for chronic TTH, frequent TTH, and migraine headaches without aura. More epidemiological studies are necessary to determine the underlying causes of headaches among schoolchildren.

Characteristics and effects of headaches on quality of life in individuals with epilepsy in Çorum province of Turkey

Aims: Varying headache prevalence rates have been reported in individuals with epilepsy in the literature. This study was investigate the frequency and types of headaches in individuals with epilepsy, and the impact of headaches on the clinical features and quality of life in this patient group.&#x0D; Methods: 150 individuals with epilepsy, 83 female and 67 male, were included in the study sample by random sampling method. Headaches were primarily defined as pre-ictal, ictal, and post-ictal headaches according to the temporal relationship with seizures. Headaches that were not temporally related to seizures were defined as inter-ictal headaches. Types and features of participants’ headaches were evaluated using the headache questionnaire consisting of 35 questions. Individuals’ quality of life was evaluated using the Quality of Life in Epilepsy Inventory (QOLIE-10).&#x0D; Results: Of the 150 participants included in the study, 73.33% had generalized, 20% focal, and 6.66% combined generalized focal epilepsy, and 41.33% had accompanying headache complaints. Of the participants with headaches, 35.48% were male and 64.51% were female. Inter-ictal headache, which was detected in 72.58% participants, was the most common type of headache. Tension and migrainous type headaches were more common among participants with inter-ictal headache, whereas migrainous type headaches were more common among participants with pre- and post-ictal headaches. There were statistically significant differences in the scores obtained from all three subscales of QOLIE-10 inventory between the participants with and without headache. Accordingly, quality of life was worse in the headache group than in the headache-free group (p

AYURVEDIC MANAGEMENT OF TENSION TYPE HEADACHE (VATAJ SHIRAHSHOOLA): A CASE STUDY

Purpose: Tension Type Headache is the common type of headache, it may last for few days to few weeks, generally seen in patients with stress and psychological conditions. Patient came in OPD with complaints of pain &amp; feeling of tight band around head, pain in eyes, pain in back of head &amp; neck, pain rises in evening, as sign &amp; symptoms and cause of Tension Type Headache resembles with Vataj Shirahshoola. In the era of stress &amp; tension recurrency is commonly seen. The present case highlights the ayurvedic management in reducing the episodes of headache &amp; recurrency with Panchakarma procedure and dietary and lifestyle adoption. Method: The present case study deals with 32-year-old female patient having complaints of pain &amp; feeling of tight band around head, pain in eyes, pain in back of head &amp; neck, pain rises in evening, symptoms increase with stress. She was clinically diagnosed with Vataj Shirahshoola (Tension Type Headache). Patient was treated with Nasya Karma along with Shamana Chikitsa and advised for dietary and lifestyle adoption. Result: Panchakarma along with Shamana &amp; Ahar-Vihar adoption showed significant results in the patient. Conclusion: Tension Type Headache can be managed with Ayurvedic Chikitsa (Panchakarma + Shamana). With Nidan Parivarjana &amp; Ahar-Viharaj adoption we can reduce the recurrency of episodes

#3718 WHAT ARE THE MOST COMMON HEADACHE PROBLEMS IN PATIENTS RECEIVING DIALYSIS?

Abstract Background and Aims Analysis of the clinical features of headache in patients on the program dialysis. Method The study included 40 males and 40 females with CKD on program dialysis for more than 12 months in 2022, each session lasting 4 hours. The exclusion criteria were patients receiving drugs that can cause headache and with any type of primary headache not associated with the HD procedure, diabetes mellitus, and others. Patients with DH were further compared with patients without DH in terms of BP and blood values such as urea, creatinine, Na+, K+. Results 45% (n = 36) reported DH, which was common in women 60%. Differences between pre- and post-dialysis urea values in patients with DH were statistically significant (p&amp;lt;0.05). Patients with DH showed significantly higher mean SBP and DBP values before dialysis compared with patients without DH (systolic, P&amp;lt;0.001; diastolic, P&amp;lt;0.01). 80% of patients (n = 64) reported the quality of their headaches as being throbbing, whereas (20%, n = 6) had headaches with dull character. Headache intensity was moderate in 73% (n = 58) and severe in 27% (n = 22). The headache duration was reported to last less than 4 hours in 63% (n = 50) and 4 to 36 hours in 37% (n = 30), Table 2. Conclusion We determined that DH is a common type of headache among HD patients, female predominance, begins after several hours of therapy, with progressive intensity and throbbing character, which is not associated with a coexisting primary headache, but may be related to differences in urea levels and BP before and after treatment.

Neurologic Deficits and cerebrospinal fluid (CSF) lymphocytosis (HaNDL): a comprehensive systematic review of 93 patients from 57 studies (P3-12.003)

<h3>Objective:</h3> N/A <h3>Background:</h3> Headache with Neurologic Deficits and cerebrospinal fluid (CSF) lymphocytosis (HaNDL) is a self-limiting syndrome characterized by moderate to severe headache associated with focal neurological deficits such as, motor or sensory deficits, or speech disturbances, occurring in the context of lymphocytosis in the cerebrospinal fluid. Due to being a rare condition, data regarding HaNDL is sparse. Therefore, we conducted this review to analyze data related to 93 patients of HaNDL, to characterize their demographics, wide range of presenting symptoms, treatment options in the acute and chronic phases, EEG, brain imaging and CSF findings. <h3>Design/Methods:</h3> We performed a systematic review of cases reported through PubMed and Google scholar database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. <h3>Results:</h3> The mean age was 28.8 years at onset. 70 patients (75.2%) were adults, while 23 (24.7%) were pediatrics. 30% of patients experienced relapsing episodes of HaNDL symptoms. The most common type of headache reported was unilateral severe throbbing episodic headache. Other associated symptoms included sensory deficit (60%) and motor deficits (54.8%). The least common symptoms were nystagmus and agraphia. Antiviral agents were a common treatment option in the acute phase [n=23 patients (23.6%)], while Flunarizine was the most commonly used agent in the chronic setting [n= 3 patients (3.2%)]. The most common brain MRI findings included nonspecific white matter lesions and meningeal enhancement, whereas the most common EEG findings include diffuse and focal slowing. The mean CSF opening pressure was 240.5 mmH2O. CSF protein was elevated in 59 patients , with a mean value of 114mg/dL. <h3>Conclusions:</h3> HaNDL tends to affect young individuals with a slight male predominance. Unilateral severe throbbing episodic headache with associated hemi-paresthesia and hemiparesis were the most common presenting symptoms based on our review. Early recognition of this syndrome is critical in order to prevent unnecessary treatments such as, antimicrobials. <b>Disclosure:</b> Mr. Asghar has nothing to disclose. Mr. Asghar has nothing to disclose. Mr. Hegde has nothing to disclose. Mr. Delcimmuto has nothing to disclose. Dr. Gharaibeh has nothing to disclose. Dr. Aladamat has nothing to disclose. Dr. Esengul has nothing to disclose. Mohammad Mahmoud Samara, MD has nothing to disclose. Dr. Sheikh has nothing to disclose.

The influence of osteopathic correction on liquorodynamics in patients with tension-type headache

Introduction. Tension-type headache (TTH) is known to be the most common type of headache in all age groups. The guidelines of the European Federation of Neurological Societies, the Italian Guidelines for Primary Headaches and the Italian Consensus Conference on Pain in Neurorehabilitation report that non-pharmacological therapies are valid adjunctive treatments for TTH. Previous studies have shown that the use of general osteopathic treatment in patients with TTH is accompanied by a significant decrease in the severity of pain syndrome and asthenic condition. We did not find any scientific publications devoted to the objectification of the results of osteopathic correction in TTH using magnetic resonance imaging (MRI).The aim of the study was to objectify the results of osteopathic correction by assessing changes in the liquor dynamics of the posterior cranial fossa in patients with tension-type headache.Materials and methods. The study was conducted from December 2020 to December 2021 at the clinic of the Center for New Medical Technologies, Novosibirsk. There were under the observation 10 patients with an established diagnosis of TTH aged from 18 to 55 years, 4 men, and 6 women. All patients before the start of treatment and after the course completion were assessed for their osteopathic status and underwent high-field MRI 3T of the brain with the calculation of the posterior cranial fossa restriction index (CFRI). CFRI reflects the state of liquorodynamics at the level of the skull base and shows the level of freedom in the relationship between fluid spaces and brain tissues. Study participants received a course of osteopathic correction, which included 3–4 procedures with an interval of 5–7 days. The observed patients did not receive any other therapy during the study period.Results. The examined patients were most characterized by regional biomechanical disorders (RBD): head (9); neck, structural component (5); thoracic, visceral component (5); dura mater region (9). In terms of severity, mild RBD prevailed (1 point). After treatment, patients have a decrease of the detection frequency of major regional somatic dysfunctions (SD). Statistically significant differences (p&lt;0,05) were obtained in the SD incidence of head region; neck region, structural component; thoracic, visceral component; dura mater region. A statistically significant (p&lt;0,05) increase in the mean CFRI from 30,22±0,63 to 31,78±0,73 % was found after the treatment.Conclusion. The results of the high-field MRI with the study of CFRI allow to quantitatively assess the changes of the cerebrospinal fluid dynamics in patients with tension-type headache, and it can be used as an objective criterion for the osteopathic correction results and the therapy clinical effectiveness. The study should be continued with a more representative sample.

Transient headache and neurological deficits with cerebrospinal fluid lymphocytosis syndrome: A comprehensive systematic review of 93 patients from 57 studies.

Headache with neurologic deficits and cerebrospinal fluid lymphocytosis, previously also termed pseudomigraine with temporary neurologic symptoms and lymphocytic pleocytosis, is a self-limiting syndrome characterized by moderate to severe headache associated with focal neurological deficits occurring in the context of lymphocytosis in the cerebrospinal fluid. As a consequence of its rarity, data regarding headache with neurologic deficits and cerebrospinal fluid lymphocytosis is sparse. Therefore, we conducted this review to analyze data related to 93 patients of headache with neurologic deficits and cerebrospinal fluid lymphocytosis, to characterize their demographics, clinical manifestations, investigations and treatment options. We performed a systematic review of cases reported through PubMed and Google scholar database, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Keywords used were 'Headache with Neurologic Deficits and cerebrospinal fluid lymphocytosis', 'Headache with neurologic deficits and cerebrospinal fluid lymphocytosis syndrome'. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tool. We analyzed a total of 93 cases of headache with neurologic deficits and cerebrospinal fluid lymphocytosis with a mean age of 28.8 years at onset. Seventy patients (75.2%) were adults, while 23 (24.7%) belonged to the pediatric age group. Comparing these groups, mean age at onset was 32.5 years and 14.3 years, respectively. The average duration of follow-up was 11.08 months. Thirty percent of patients experienced relapsing episodes of headache with neurologic deficits and cerebrospinal fluid lymphocytosis symptoms. The most common type of headache reported was unilateral severe throbbing episodic headache. Other associated symptoms included sensory deficit (60%) and motor deficits (54.8%). The least common symptoms were nystagmus and agraphia, which were reported in one patient each. Antiviral agents were a common treatment option in the acute phase (n = 23 patients [23.6%]), while Flunarizine was the most commonly used agent in the chronic setting (n = 3 patients [3.2%]). While most of the patients had normal brain magnetic resonance imaging, 20 patients had magnetic resonance imaging abnormalities, including (but not limited to) non-specific white matter lesions (eight patients) and meningeal enhancement (six patients). The most common electroencephalographic findings included diffuse and focal slowing. The mean cerebrospinal fluid opening-pressure was 240.5 mmH2O. Cerebrospinal fluid protein was elevated in 59 (63.4%) patients, with a mean value of 114 mg/dL. Two patients in our cohort were found to have cerebrospinal fluid oligoclonal bands. Headache with neurologic deficits and cerebrospinal fluid lymphocytosis tends to affect young individuals with a slight male predominance. Unilateral severe throbbing episodic headache with associated hemi-paresthesia and hemiparesis were the most common symptoms based on our review. Elevated cerebrospinal fluid opening-pressure can be seen in headache with neurologic deficits and cerebrospinal fluid lymphocytosis syndrome. Early recognition of the syndrome is paramount. Antivirals were found to be among the most widely used treatments in the acute setting. Magnetic resonance imaging of the brain is mostly normal. Diffuse and focal slowing were among the most common electroencephalographic findings. Cerebral flow abnormalities on perfusion scans are not uncommon in headache with neurologic deficits and cerebrospinal fluid lymphocytosis. Prospective studies with a larger sample size are needed to validate our findings and guide the clinical care of these patients.

Vajinismusta başağrısı, anksiyete ve depresyon

Abstract&#x0D; Objective: Vaginismus is one of the most common problems among patients who apply to the sexual health outpatient clinic. It is known that sexual problems are more common in migraine and tension-type headache patients. Furthermore, the frequency of depression and anxiety is higher in both vaginismus and chronic headache patients. This study was conducted in 2021 and examined the headache characteristics, depression and anxiety in vaginismus patients.&#x0D; Material and methods: In this prospective study, 87 patients diagnosed with vaginismus in the sexual health outpatient clinic were interviewed. Fifty patients who agreed to participate in the study were questioned regarding headache, and Beck depression and Beck anxiety scales were applied.&#x0D; Results: Headache was present in 46% (n:23) of 50 vaginismus patients. Anxiety scores of patients with headaches were higher than those without headaches (p=0.032). The most common type of headache was migraine without aura (60.9%), followed by tension-type headache (30.4%). Beck depression scores of the low-income group were higher than the high-income group (p=0.006). There was no significant correlation between monthly headache frequency, total headache duration, Beck depression score, and Beck anxiety score.&#x0D; Conclusions: Headache is a common neurological symptom in vaginismus patients, and the frequency of migraine is higher than tension-type headaches. Anxiety values are higher in vaginismus patients experiencing a headache. Therefore, headache and anxiety should be considered in the follow-up and treatment of vaginismus patients.

Primary headache types in adult epilepsy patients

BackgroundHeadache is among the most common comorbidities in epilepsy. This study examined the distribution of different primary headache disorders in a large cohort of patients with diagnosed epilepsy. Headache types were analysed with regard to gender, type of epilepsy and antiepileptic drugs (AEDs).MethodsIn this prospective single-centre study, 500 patients with epilepsy (250 female, mean age: 45.52 ± 17.26 years) were evaluated with regards to primary headache types using a validated German headache questionnaire categorizing for migraine (MIG), tension-type headache (TTH) or trigeminal autonomic cephalalgias (TAC), their combinations and unclassifiable headache. Data regarding type of epilepsy, seizure-associated headache, AED treatment and seizure freedom were collected.ResultsOf 500 patients with epilepsy, 163 (32.6%) patients (108 female and 55 male) reported suffering from headaches at least 1 day per month. MIG (without aura, with aura) and TTH were the most frequent headache type (MIG 33.1%, TTH 33.1%). Female epilepsy patients reported headaches significantly more often than male patients (x2 = 8.20, p = 0.0042). In contrast, the type of epilepsy did not significantly affect headache distribution. Of 163 patients with headache, 66 (40.5%) patients reported seizure-associated headache and AEDs were used by 157 patients. Of importance, patients with AED monotherapy suffered from MIG less often when compared to patients on polytherapy (x2 = 4.79, p = 0.028).ConclusionMIG and TTH are the most common headache types in epilepsy patients and headache is more frequent among female epilepsy patients. Monotherapy in AEDs might have a beneficial effect on the frequency of headache compared to polytherapy.

Prevalence of headache disorders in patients living with epilepsy in rural region in western part of India

Background and aimsHeadache disorders cause significant distress in patients living with epilepsy (PWE) and are underreported. This study aimed to evaluate the prevalence of various forms of headache in PWE. MethodologyTwo hundred and three PWE were evaluated for the presence and type of headache as per the International Classification of Headache Disorders (ICHD)-3 classification criteria. The severity was graded using the Headache Under Response to Treatment (HURT)–3. A subgroup analysis of headache and epilepsy was done. The World Health Organization-5 (WHO-5) questionnaire was used to assess mental well-being. The Mini International Neuropsychiatric Interview (MINI) questionnaire was used to study the psychiatric comorbidities, which were classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV classification. ResultsThe prevalence of headaches in PWE was 45% [60% females]. Female gender and younger age were significantly associated with migraine (p values of 0.03 and 0.05, respectively). Migraine was the most common type of headache (71%), followed by tension-type headache (TTH) (23%) in PWE. The headache was inter-ictal in 80% of PWE. In PWE with migraine, both juvenile myoclonic epilepsy (JME) and frontal lobe epilepsy (FLE) had a 28% prevalence. In PWE with TTH, FLE was more common (43%). The prevalence of migralepsy in PWE was 4% [n = 4; 2 each of occipital lobe epilepsy (OLE) and idiopathic generalized epilepsy (IGE)]. A psychiatric illness was more than two times more likely in PWE with headache (n = 34; 37%) as compared to PWE without headache (n = 19; 17%). Patients living with epilepsy with headaches and psychiatric comorbidities had significantly lower mental well-being (p = 0.001). Forty five percent of PWE with headaches required acute management, and 35% required prophylactic management for their headache. ConclusionHeadache is frequently ignored in PWE. It can affect their mental health and quality of life. Evaluation and management of headache in PWE is very important.

A study of the ocular pathology of headache in patients presenting to ophthalmic OPD in a tertiary care center

Aims: Headache is a common presenting complaint of ophthalmic patients, but it is also a symptom of a wide range of systemic problems some of which are life threatening while others benign. This study aimed to detect the common ocular causes of headache in patients visiting the eye outpatient department (OPD). Settings and Design: This was a cross-sectional, observational study of one year duration conducted in a tertiary care center. Materials and Methods: Demographic data and a detailed history was collected from 395 patients complaining of headache and attending the eye OPD, followed by a detailed ocular examination including visual acuity, refraction, intraocular pressure, slit-lamp examination, and fundus. Statistical Analysis: The data was analyzed using the Statistical Package for the Social Sciences (SPSS) software version 21. Frequencies and percentages were calculated. A P value of &lt;0.05 was considered significant. Results: There were 298 females (75.4%) and 97 males (24.5%) with headache. Fifty-six point four percent of the headaches occurred in the 21–40-year age group. Forty-seven percent of headaches were ocular, the most common ocular cause being uncorrected refractive errors (21.3%) followed by computer vision syndrome (19%). Fifty-three percent of headaches had non-ocular pathology, of which 33.5% were primary headaches: overall, the most common type of headache in the study. Red flag signs were noted in 21 cases. Conclusion: This study helped to identify and estimate the frequency of ocular and non-ocular causes of headaches. Also, we identified red flag signs which should be looked out for to avoid missing a life-threatening secondary pathology behind the headache.

Prevalence, frequency, and disability of migraine headaches and tension headaches among the general population in the Eastern Region of Saudi Arabia

A tension-type headache (TTH) is a recurrent headache that is mild to moderate in intensity, unlike migraine (MH), which is accompanied by crippling effects of nausea, vomiting, photophobia, or phonophobia. TTH is more frequent than migraine, but it is less likely to cause severe pain and physical dysfunction. TTHs account for more lost workdays due to their prevalence. The study aimed to evaluate the prevalence, frequency, and disability of MHs and TTHs among the general population in the Eastern Region of Saudi Arabia. A cross-sectional study was employed using a validated questionnaire. The questionnaire implemented the HARDSHIP algorithm to diagnose MH and TTH and questions to correlate their prevalence to socio-demographic data, measurement of the level of disability, headache management, and treatment effectiveness using the chi-square test. The study reviewed 877 subjects (46.6% males vs. 53.4% females). 52.9% of the participants experienced headaches during the previous three months, and 35.6% experienced headaches recently. The most common type of headache was a probable MH (32.1%), followed by a TTH (26.9%), probable TTH (19.5%), and MH (15%). It was reported that some disability was attributed to 47% of MHs and 26% of TTHs. The most commonly used headache medication was paracetamol (53.5%). This study revealed that TTH and MH are common illnesses in Saudi Arabia's Eastern Region. TTH and MH are correlated with significant individual and social burdens, particularly for MH. Headache sufferers mostly manage their headaches using conventional over-the-counter methods.

ASSOCIATION OF COMMON TYPES OF HEADACHES WITH VESTIBULAR IMPAIRMENT AND NECK PAIN IN ELDERLY

Headache(TTH). The headache is associated with vestibular impairment (VI) and neck pain, but this association has not been studied in elder population. Objective: To determine the association of common types of headaches with vestibular impairment and neck pain in elderly. Methods: A cross sectional study was conducted from February 2021 to June 2021 at District Headquarters Hospital Narowal using a non-probability convenience sampling technique on n=140 participants. The inclusion criteria include age above 50 years, able to ambulate independently, complaint history of common type of headache. Headache was assessed clinically based on diagnostic criteria. The head impulse test was used to assess the vestibular function. The neck pain presence was asked through close ended question with binary response. The chi-square (x2) test used for association between the variables. Results: The mean age of the participants was 58.17 ± 7.14 years. The tension type headache was seen in n=76 (54.2%), migraine in n=33 (23.5%) and cervicogenic headache in n=31 (22.1%) patients. Vertigo was seen in n=52 (37%) patients and neck pain in n=82 (58%) patients. A significant association of vestibular impairment with migraine (Chi square value= 7.79, p=0.02) and cervicogenic headache (Chi square value= 6.12, p=0.04). While no significant association with tension type headache (Chi square value= 0.97, p=0.04). All type of headache were significantly associated (p&lt;0.05) with neck pain. Conclusion: The vestibular impairment and neck pain are associated with all type of headache, except tension type headache where vestibular impairments are not associated. There was an association between types of headaches and neck pain. Keywords: Cervicogenic headache, Migraine, Neck pain, Tension type headache, Vestibular impairment (VI).

The effect of manual therapies on tension-type headache in patients who do not respond to drug therapy: a randomized clinical trial

ABSTRACT Backgrounds Tension-Type Headache (TTH) is one of the most common types of headache. In patients with TTH, manual therapy can be used to treat myofascial pain. Objectives This study aimed to evaluate the effect of manual therapy on TTH in patients who did not respond to drug therapy. Methods A total of 24 patients with TTH were randomly enrolled into this prospective trial. The participants were divided into an intervention and a control group. The intervention group received the common medication and manual therapy, while the control group only received the common medication. Headache pain intensity, frequency, and duration, tablet count, and Neck Disability Index (NDI) were measured in both groups before, after, and one week after the intervention. Results There were significant differences between the two groups (treatment, control) regarding pain intensity (3.04, 6.75, P = 0.0001; effect size (ES) = 1.85), headache frequency (2.33, 5, P = 0.004; ES = 1.48) and duration (91.29, 284.74, P = 0.002; ES = 1.48), tablet count (1.83, 4.91, P = 0.01; ES = 1.04), and NDI (7.33, 20.16, P = 0.003; ES = 1.37). Within group differences were recorded in intervention group only for all dependent variables immediately after intervention and one week after the intervention (p < 0.05). Conclusion Manual therapy reduced headache pain intensity, frequency and duration, tablet count, and NDI score in patients with TTH.