Non-migraine Headache Research Articles

Structural and neurochemical markers of brain injury in the migraine diathesis of systemic lupus erythematosus.

To determine whether migraine in systemic lupus erythematosus (SLE) is associated with accentuated brain injury and disease activity. Forty SLE patients (11 without headache, 11 with non-migraine headache, and 18 with migraine) underwent clinical evaluation, magnetic resonance imaging (MRI), and spectroscopy (MRS). Recurrent headache occurred in 75% of SLE patients. MRI abnormalities and reduced N-acetylaspartate were common. However, migraine in SLE was not associated with increased disease activity or severity, neuropsychiatric manifestations, or end-organ involvement compared to patients without migraine (p > 0.05). There were no differences in the prevalence or severity of MRI or MRS abnormalities between SLE patients with migraine, with non-migraine headache, or without headache (p > 0.05). Headache does not identify SLE patients at risk for brain injury, increased disease activity, or increased end-organ involvement. Aggressive immunosuppressive therapy for headache alone is not indicated in SLE.

Stress Factors in Migraine and Other Headaches

Factors associated with migraine and nonmigrainous headache in a group of 3580 children aged 8-9 years were evaluated by mail questionnaire at the Turku University, Finland.

Consultation with the Specialist: Diagnosis and Management of Headache in Children

1. Balbir V. Singh, MD* 2. E. S. Roach, MD* 1. 2. *Division of Pediatric Neurology, Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX. Headache is an age-old problem that affects both children and adults; it is mentioned as far back as 5000 BC in Babylonian and Sumarian writings and later is described by Hippocrates and Galen. In spite of more than 50 epidemiologic studies, there is no consensus on the prevalence of headache. The prevalence of chronic headache varies widely in different studies, probably due to differences in case definition, selection criteria, and demographics of the study populations. Most recent studies suggest rates close to 5% for migraine, 15% for tension-type headache, and about 30% for infrequent nonmigrainous headaches. Nevertheless, most children who suffer migraines never come to medical attention. The International Headache Society’s classification system has replaced the old and somewhat confusing terminology with more descriptive terms (Table 1⇓ ). Migraine is divided into three types: migraine without aura (Table 2⇓ ), migraine with aura (Table 3⇓ ), and complicated migraine. Tension and muscle contraction headache have been replaced by tension-type headache, admitting our ignorance of the pathophysiology of the disorder (Tables 4⇓ and 5⇓ ). Operational diagnostic criteria are used to increase both the sensitivity and the specificity of diagnosis. View this table: Table 1. Etiology of Recurrent Headaches View this table: Table 2. International Headache Society Diagnostic Criteria for Migraine Without Aura View this table: Table 3. International Headache Society Diagnostic Criteria for Migraine With Aura View this table: Table 4. International Headache Society Diagnostic Criteria for Episodic Tension-type Headache View this table: Table 5. International Headache Society Diagnostic Criteria for Chronic Tension-type Headache Migraine is an episodic syndrome characterized by headaches of varying intensity, duration, and frequency. Before puberty, migraine is slightly more common in boys; after puberty, it is two to three times more common in girls. Eighty percent of all migrainous headaches are comprised of migraine without aura. The headache often is unilateral (35%) and throbbing (55%), but it may be diffuse and continuous in more than …

Psychophysiological reactivity in pediatric migraine patients and healthy controls

The hypothesis that physiological responses of migraine patients are symptom-specific was evaluated in 29 children (age range 8–16 years) suffering from migraine and 10 healthy control children. The assessment included two major stress phases and a relaxation period. A standard laboratory stressor (a subtraction task) and parent–child conflict served as stressors. A total of six physiological parameters were measured: pulse amplitude at two extracranial (A. temporalis, A. supraorbitalis) and one peripheral (index finger) sites; finger temperature; heart rate; and skin-conductance level. There were no significant group differences in autonomic arousal. Moreover, extracranial and peripheral vasomotor activity was not different between groups, a finding which might be partially due to the considerable interindividual variability. The implications of the results are discussed taking into account that studying pediatric rather than adult migraine patients allows to minimize the potentially confounding impact of factors such as headache chronicity, medication, and additional nonmigraine headaches.

A behavioral treatment of young migrainous and nonmigrainous headache patients: Prediction of treatment success

We evaluated the outcome of a behavioral treatment package in a clinical setting with a group of young (age: 12-22) headache patients, suffering from migrainous or nonmigrainous. Comparison between the experimental (n = 24) and the waiting-list control group (n = 15) showed a treatment effect on headache frequency and on the headache index. Using a 50% reduction in the headache activity as a criterion for clinical improvement, 52% of the participants in the experimental group had improved clinically at the end of the treatment. The treated participants were found to have maintained significant improvement at 1-year follow-up. The treatment effect was significantly high for nonmigrainous headache patients than for migraineurs. The most important background predictor of outcome was duration of headache history: youngsters with a longer headache history profited less by the treatment than youngsters with a shorter headache history. Family predictors of pre-post improvement were maternal rewarding of illness behavior and mother-child relationship Those youngsters who reported more rewarding and/or a more positive mother-child relationship profited less by the treatment than those who reported less rewarding and/or a less positive mother-child relationship. We conclude that therapists treating young headache patients should be alert to pain-rewarding patterns in the family.

The incidence of chronic headache in children with shunted hydrocephalus.

Report of chronic headache amongst children with shunted hydrocephalus is frequent, and often leads to investigation for raised intra-cranial pressure and shunt malfunction, and much debate has appeared in the literature concerning possible cause. However headache is a common neurological symptom amongst children, and studies of prevalence indicate incidence of frequent non-migrainous headache to be 6.8%, and migrainous headache 4% in the general child population. A relationship between stress and anxiety and headache is recognised, and the hydrocephalic child has many reasons above those of his/her peers to be subject to stress. It is also hypothesised that this group may be more vulnerable than peers to developing a migraine-like condition in the face of adequate shunt function. The clinician dealing with complaint of chronic headache in a hydrocephalic child must therefore be wary of over-investigation in a child with a working shunt, or missing possible shunt malfunction when the only symptom is chronic headache. It was speculated therefore that incidence of non-shunt related chronic headache in this group would be high, and an attempt was made to document incidence of migrainous and non-migrainous headache in the medical notes, and in replies to postal questionnaire sent to a sample of 130 children with shunted hydrocephalus of varying aetiology. Incidence of migrainous headache was documented in the medical notes in 8.5% of cases, with incidence rising to 21.5% using self-report. Incidence of non-migrainous headache was also very high (15.4%) and the overlap between migraine and tension headache, combined with difficulty of diagnosis in children may indicate migraine to be more frequent still. The concept of "Shunt Migraine" is therefore worthy of consideration. Report of chronic headache led to investigation in a large proportion of cases, but symptomatology often continued. Even when shunt malfunction was indicated, shunt revision did not "cure" complaint of headache. Headache was not found to be related to diagnosis associated with hydrocephalus, to presence of seizure disorder, or to the sex of the child, although in common with other studies, there was a strong trend towards girls being statistically more likely to experience headache than boys. There was a relationship however between report of chronic headache, and the sort of school a child was likely to attend; children who attended mainstream school without the support of a Statement of Special Educational Need were more likely to report headache than their peers, and it is hypothesised that these children may be suffering sufficient stress to contribute to maintenance of headache. The importance of the multi-disciplinary team in assessment of children's physical, intellectual and emotional status is stressed, in order that medical interventions have the greatest chance of success.

Headache diary in the diagnosis of childhood migraine.

The usefulness of a headache diary in the diagnosis of migraine and in the clarification of migraine symptoms was studied in 145 children. These children belong to a 1-year age cohort of 5356 children that has been followed since birth. The children were enrolled in the present study according to their headache status in a questionnaire study at the age of 8 to 9 years, at which time 50 children had migraine, 43 had nonmigrainous headache, and 52 did not have recurrent headache. Information on their present headache status was collected with a face-to-face interview at the age of 11 to 13 years and from a headache diary after the interview. The children kept the diary for 2 to 7 months. Altogether, 72 children had migraine according to the International Headache Society criteria for migraine, either in the interview or in the diary. Eight children were diagnosed only according to the diary (11.1%). Thirty-three children had both migraine attacks and nonmigrainous headache episodes according to the diary, even though they were able to report only one type of headache episode in the interview. The duration of headache episodes was underestimated in the interview, compared to the diary, in the children with migraine. Many children recognized new aura symptoms, associated symptoms, and characteristics of pain when they started to pay attention to these when filling in the diary during the follow-up period. The headache diary is useful in clarifying the features of headache attacks and in the diagnosis of headache types in children.

Nonmigrainous headache from food allergy

AllergyVolume 51, Issue 9 p. 657-658 Nonmigrainous headache from food allergy G. F. Stefanini, G. F. Stefanini *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorL. Marsigli, L. Marsigli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. G. Foschi, F. G. Foschi *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. Emiliani, F. Emiliani *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorM. Biselli, M. Biselli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. Caputo, F. Caputo *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorG. H. Leefield, G. H. Leefield *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorE. Castelli, E. Castelli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorG. Gasbarrini, G. Gasbarrini *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this author G. F. Stefanini, G. F. Stefanini *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorL. Marsigli, L. Marsigli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. G. Foschi, F. G. Foschi *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. Emiliani, F. Emiliani *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorM. Biselli, M. Biselli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorF. Caputo, F. Caputo *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorG. H. Leefield, G. H. Leefield *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorE. Castelli, E. Castelli *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this authorG. Gasbarrini, G. Gasbarrini *Patologia Medica I Policlinico S. Orsola Via Massarenti, 9 40138 Bologna ItalySearch for more papers by this author First published: September 1996 https://doi.org/10.1111/j.1398-9995.1996.tb04687.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume51, Issue9September 1996Pages 657-658 RelatedInformation

Non-migrainous headache, neck or shoulder pain, and migraine--differences in association with background factors in a city population.

To study the pattern of association of background factors with reported migraine, non-migrainous headache, and neck or shoulder pain. In a cross-sectional survey the population of the municipality of Tromsø between 20 and 56 years of age was screened for risk factors of different diseases. Everybody attending the screening was given a questionnaire on psychosocial, lifestyle, and health factors. The odds ratios of reporting migraine, non-migrainous headache, and neck or shoulder pain were estimated by logistic regression for several background factors. A population-based study conducted in the municipality of Tromsø, northern Norway. In a survey of risk factors for diseases in 1987/86, all the subjects between 20 and 56 years of age in the municipality of Tromsø were invited. The attenders were given a questionnaire about lifestyle, health, and psychosocial factors. Of the 18105 people who were given a questionnaire, 8537 men and 9162 women (97.7%) answered the questions about "non-migrainous headache", 8533 men and 9117 women (97.5%) answered the questions about neck or shoulder pain, and 8024 men and 7690 women (86.8%) the questions about migraine. "Self estimated health" had the strongest association with all three target conditions although the strength of the association between headache and neck or shoulder pain was far higher than that of migraine. The reporting of headache and neck or shoulder pain was associated with psychosocial factors, in contrast to migraine. The less educated women were prone to both headache and neck or shoulder pain, while there was no association between migraine and length of education. The explored lifestyle factors were not associated with any of the target conditions. Our findings underscore that migraine is reported by people with psychosocial backgrounds other than those of people who report chronic headache and neck or shoulder pain.

Genetic influence in headaches: a Swedish twin study.

The heritability of liability to self-reported migraine and nonmigrainous headaches was examined in two large cohorts from the Swedish Twin Registry consisting of 6448 (the older cohort) and 12,884 (the younger cohort) like-sexed twin pairs. Higher concordance rates were consistently found for lifetime migraine among the monozygotic twins than in the dizygotic twins, as well as for migraine headaches of the recurrent disabling type. In addition, a higher concordance rate was found among the monozygotic twins than in dizygotic twins in a "mixed" group of possible tension-type or mild migraine headaches (or both). The results of structural equation model-fitting analyses showed that genetic effects for migraine headaches were stronger for the females (estimates ranging from 49% to 58%) than for the males (39% to 44%) in the two cohorts. Unique nonshared environmental effects were greatest for the "mixed" group in both sexes (estimates ranging from 60% to 69%). The results are discussed in view of similar large-scale twin studies examining the heritability of liability to migraine.

Migraine and Subsequent Risk of Stroke in the Physicians' Health Study

To evaluate, in a prospective design, whether migraine is an independent risk factor for subsequent stroke. Evaluated as part of the Physicians' Health Study, a randomized, double-blind, placebo-controlled trial of aspirin and beta-carotene in the primary prevention of cardiovascular disease and cancer begun in 1982. The aspirin component of the study was terminated in 1988, with average follow-up of 60.2 months. Conducted by mail among male physicians throughout the United States. A total of 22,071 US male physicians aged 40 to 84 years in 1982 with no prior history of cancer or cardiovascular diseases who were enrolled in the Physicians' Health Study. Participants were randomized to receive 325 mg of aspirin or aspirin placebo every other day and to receive 50 mg of beta-carotene or placebo on alternate days. The primary outcomes of the Physicians' Health Study were cardiovascular disease and cancer. Because stroke was a main outcome, this provided the opportunity to evaluate the association between migraine headaches and stroke. Physicians reporting migraine (n = 1479) had significantly increased risks of subsequent total stroke and ischemic stroke compared with those not reporting migraine. After adjustment for age, aspirin and beta-carotene treatment assignment, and a number of cardiovascular risk factors, the relative risks were 1.84 (95% confidence interval, 1.06 to 3.20) for total stroke and 2.00 (95% confidence interval, 1.10 to 3.64) for ischemic stroke. There were too few hemorrhagic strokes in the study to evaluate this end point. No associations were seen between ordinary nonmigraine headache and subsequent stroke or between migraine and subsequent myocardial infarction or cardiovascular death. These data raise the possibility that vascular events associated with migraine may also have causative importance in stroke but require confirmation in other studies specifically designed to evaluate this question.

Prevalence of Neurological Disorders in Haute-Vienne Department (Limousin Region – France)

The Limousin region had at present one of the largest elderly populations in France and in Europe. To determine the frequency of certain neurological disorders in the elderly, a neuroepidemiological survey was conducted in 1986-1987 on a representative sample of the population in Haute-Vienne (the most population-dense department in the Limousin region). This study used a WHO protocol which was first introduced at the beginning of the 1980s. It had been previously tested in France on a pilot population in 1984. The prevalences of the principal neurological disorders encountered per 100,000 inhabitants were as follows: nonmigraine headache 5,059, migraine 4,270, epilepsy 788, completed stroke 1,445, transient ischemic attacks 657, neuropathy 1,642, Parkinson's disease 328, and dementia 197.

A Population‐Based Survey of the Social and Personal Impact of Headache

To explore the social and personal impact of headache, we contributed questions on serious headache to a population-based telephone survey on health in Kentucky. A total of 647 persons aged 20 and older was assessed for serious headache. Migraine without aura was distinguished from non-migraine headache using a modification of the 1988 IHS criteria. The 12-month period prevalence for all serious headaches was 13.4%; for migraine, it was 8.5%. Demographically, there was a higher proportion of headache sufferers in the low income bracket (< $10,000/year) and a higher proportion of women reporting migraines. Of those with serious headaches, 73.6% stated that headaches adversely affected their lifestyle in at least one way. Migraineurs reported significantly more interference in family relations, work attendance, and work efficiency than non-migraineurs. Women said their family relationships and work productivity were impacted significantly more often than men. Of those reporting disability, 46.8% said they take only non-prescription medications. We conclude there is a significant number of serious headache sufferers in Kentucky who experience social as well as vocational impairment as a result of their illness. Further research is recommended to evaluate the extent of interpersonal and personal disability and to identify barriers to adequate health care for headache sufferers.

Validation of a new instrument for determining migraine prevalence

To provide a reliable instrument for use in large population surveys, we developed a short questionnaire based on existing International Headache Society diagnostic criteria and administered the questionnaire to 50 consecutive patients seeking evaluation at a university-based headache clinic. A single neurologist subsequently examined all patients. Based only on the questionnaires, reviewers scored each patient as having migraine with aura, migraine without aura, or nonmigrainous headache. High predictive validity and low interobserver variability between the examining neurologist and the independent reviewers suggest that the questionnaire may be quite useful as a survey instrument.

Prevalence of headache in a representative sample of the population in a French department (Haute-Vienne-Limousin).

In 1986-1987, a neuroepidemiologic survey was undertaken to study the prevalence of the most frequently encountered neurologic disorders, and in particular headache, in a representative sample of the population in the Haute-Vienne Department (Limousin). A door-to-door survey was made using a protocol developed by the W.H.O. at the beginning of the 1980's. The calculated prevalences (according to Poisson's distribution) per 100,000 inhabitants were 5,059 for nonmigraine headache, and 4,270 for migraine headache. This disorder preferentially affected young adults and essentially involved females. It was the most frequently encountered disorder (50%) during the different surveys of similar methodology.

How Many Different Headaches Do You Have?

Patients with migraine attending a specialist clinic often have more than one type of headache. One hundred and two patients attending the City of London Migraine Clinic for the first time were asked: "What type(s) of headache do you think you have?" A separate diagnosis was made by the doctor, who was blinded to the self-diagnosis. On clinic diagnosis, 27 (26.5%) patients were found to have migraine plus an additional non-migraine headache. When compared with the self-diagnosis, 15 (56%) of these had correctly self-diagnosed two types of headache. Many migraineurs can distinguish migraine from non-migraine headaches when they have both.

Depressive symptoms and headaches in relation to proximity of residence to an alternating-current transmission line right-of-way.

Electric power transmission lines have become objects of public controversy. Hypotheses have linked neurobehavioral effects to the electric and magnetic fields that these lines produce. The authors conducted a telephone interview survey in November 1987 to assess the prevalence of depressive symptoms and headache in relation to proximity of residence to an alternating-current transmission line in the United States. Proximity to the line, defined as residing on a property abutting the right-of-way or being able to see the towers from one's house or yard, was positively associated with a measure of depressive symptoms. The association was not explained by demographic variables associated with depression or by attitudes about power lines or other environmental issues. The estimated prevalence odds ratio was 2.8 (95% confidence interval (CI) 1.6-5.1). The estimate did not change appreciably when the definitions of depressive symptoms or of proximity to the line were altered. Nonmigraine headaches had a weaker association with proximity to the line (odds ratio = 1.5, 95% CI 0.76-2.8), and self-reported migraine headaches exhibited no association (odds ratio = 0.99, 95% CI 0.29-3.4). Additional studies of psychological and behavioral measures should be conducted in relation to electric and magnetic fields, with a strong emphasis on improved exposure assessment.

Non-migraine headache across the menstrual cycle in women with and without premenstrual syndrome.

Fluctuation of estrogen levels across the menstrual cycle influences migraine headache. In this study, 53 women documented prospectively the incidence and severity of headache daily for an average of three menstrual cycles. Seven of the women met the criteria established by the International Headache Society for migraine with or without aura, while the remaining 46 women failed to do so. Chi-square analysis revealed that, overall, the incidence of non-migraine headache was dependent on day of the cycle (chi 2 [1,66] = 247.7, p < 0.001), with more headaches occurring during the perimenstrual phase. The 46 women without migraine were further classified according to NIMH criteria into PMS (n = 26) and non-PMS groups (n = 20). An association between headache and menstrual cycle phase was noted for both groups (p < 0.001), although the incidence of severe headache was greater for the PMS women, during both the perimenstrual and intermenstrual phases. Both groups experienced an increase in severe headaches during the perimenstrual phase. The PMS women peaked on the day prior to menstruation, while the non-PMS women peaked on the first day of menstruation. There did not appear to be an overall difference in the reporting of mild headache across the cycle between women with or without PMS.(ABSTRACT TRUNCATED AT 250 WORDS)

A nationwide survey of migraine in France: prevalence and clinical features in adults. GRIM.

In November 1990 a nationwide survey of migraine was conducted in France on a representative sample of residents aged 15 years and older. The diagnosis of migraine was based on the International Headache Society (IHS) classification. In a previous study, we validated a diagnostic algorithm which classifies headache sufferers as IHS migraine, "borderline" migraine, possible migraine and non-migrainous headache. The overall prevalence of migraine patients with the IHS criteria in the present study was 8.1%; another 4% were classified as "borderline" migraine, which we in fact considered as definite migraine. Age, gender and occupation were found to be risk factors for migraine. Neither frequency and duration of attacks nor length of time of disease differed with gender. Expressed intensity of attacks, however, was greater in females.

Increased prevalence of migraine and chest pain in patients with primary Raynaud disease.

To investigate the prevalence of headaches and recurrent chest pain in patients with primary Raynaud disease. Postal survey. Raynaud disease clinic at the Lahey Clinic Medical Center, a tertiary care hospital. A consecutive series of 120 patients with primary Raynaud disease who had been observed for at least 2 years, 97 of whom received and 93 of whom completed the questionnaire, and a control group of 93 age- and sex-matched hospital employees without Raynaud phenomenon. Migraine was diagnosed in 57 (61%) patients with primary Raynaud disease and in 21 (23%) of the control group (odds ratio, 5.4; 95% CI, 2.8 to 10.3). Migraine with aura and migraine without aura were more common in patients with Raynaud disease than in the control subjects (27% compared with 5%; P less than 0.001 and 34% compared with 17%; P = 0.008, respectively). Nonmigrainous headaches were more common in the control group (51% compared with 25%; P = 0.003). Chest pains were reported by 44 (47%) of the patients with Raynaud disease and by 15 (16%) of the control group (odds ratio, 4.4; CI, 2.4 to 9.3). Chest pains were more frequently reported by patients with Raynaud disease who had migraine (34 of 57, 60%) than by patients without migraine (10 of 36, 28%; P = 0.003). An increased prevalence of migraine was found in patients with primary Raynaud disease. Chest pain, often diagnosed as musculoskeletal or nonspecific, was common in patients with primary Raynaud phenomenon, especially in patients who had coexisting migraine.