Daily Chronic Headache: Classification And Clinical Features. Observation On 250 Patients

The objective of this study was to evaluate both the presence and intensity of depressive symptoms in patients with episodic migraine (EM) and transformed migraine (TM) or chronic migraine, comparing them with a control group. Beck Depression Inventory (BDI) was used for this purpose. The median of BDI score of the control group was significantly lower than the EM and TM groups (p<0.0005). Either the EM or the TM did not show any significant difference in relation to the median of BDI scores (p=0.12). The TM group showed a higher frequency of severe depression when analyzed qualitatively by dependence analysis. Symptoms of severe depression by means of qualitative analysis may strengthen a co-morbidity between depression and transformed migraine. This association might be considered rather a factor of TM perpetuation than a risk factor for the transformation of EM into TM.

Section: Discussionmentioning

confidence: 99%

Depression and migraine

Galego

Cipullo

Cordeiro

et al. 2004

“…EM and TM most commonly occur in women 2,[5][6][7][11][12][13][14] . Our results support these findings; they also showed that in the TM group, the women percentage (95%) was higher than the one in EM group (82.5%).…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, these patients developed mild interictal headaches, evolving to chronic daily headache (CDH) 3 . Several studies reported that TM is the most common type of headaches, followed by chronic tension-type headache [4][5][6][7] . In 1994, Silberstein et al 8 proposed some criteria for TM diagnosis ( Table 1).…”

mentioning

confidence: 99%

Clinical features of episodic migraine and transformed migraine: a comparative study

Galego

Cipullo

Cordeiro

et al. 2002

-Transformed migraine (TM) is one of the most frequent types of chronic daily headache. Eighty patients: 40 with episodic migraine (EM) and 40 with TM with ages ranging from 18 to 60 years old were studied. Females were the majority. At first examination, the mean age was similar in both groups. The initial age of migraine attacks was significantly smaller in the TM group. Time history of episodic attacks was similar in both groups. In the EM group, the headache was predominantly located on only one side of the head; whereas in the TM group, on more than one side. There was variation in the character of pain and intensity in the TM group. Nocturnal awakening with headache, aura and family history did not show significant association with EM or TM. The TM was distinguished from the EM in relation to the frequency, location and pain intensity of the headache. Patients with early migraine headache onset may exhibit a further risk of developing TM.KEY WORDS: transformed migraine, chronic daily headache. Estudo comparativo entre as características clínicas da migrânea episódica e a migrânea transformadaRESUMO -A migrânea transformada (MT) é apontada como a forma mais frequente de cefaléia crônica diária. Foram estudados 80 pacientes: 40 com ME e 40 com MT entre 18 e 60 anos de idade. As mulheres foram maioria. A idade média na primeira consulta foi semelhante nos 2 grupos. A idade de início das crises migranosas foi significantemente menor no grupo MT. O tempo de história de crises episódicas nos dois grupos foi semelhante. No grupo ME predominou um só local da cefaléia enquanto no MT, mais de um. Houve variação no caráter e intensidade da dor na MT. Despertar noturno com cefaléia, aura e história familiar, não apresentaram associação significante com ME ou MT. A MT se distinguiu da ME quanto à frequência, localização e intensidade dolorosa da cefaléia. O início precoce das crises de migrânea pode sugerir um fator de risco para o desenvolvimento da MT. PALAVRAS-CHAVE: migrânea transformada, cefaléia crônica diária.

“…1987 and subsequently in 1991 10,11 , also found most of their patients with CDH having transformed from episodic migraine. The first studied group of patients had 250 subjects and revealed, as primary headache diagnosis, migraine in 178 (71,2%) and tension-type headache in 72 (28,8%) patients.…”

Section: Total Casesmentioning

confidence: 94%

“…Specific categories of chronic daily headache according to the criteria proposed by Silberstein et al 10 .…”

Section: Total Casesmentioning

confidence: 99%

Primary headache diagnosis among chronic daily headache patients

Krymchantowski

2003

-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 (1994Silberstein et al ( , revised 1996. Five hundred seventy four patients (88.1%) had episodic migraine as primary headache before turning into daily presentation, 52 (8%) had chronic tensiontype 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.KEY WORDS: chronic daily headache, primary diagnosis, transformed migraine.Diagnóstico da cefaléia primária em pacientes com cefaléia crônica diária Diagnóstico da cefaléia primária em pacientes com cefaléia crônica diária Diagnóstico da cefaléia primária em pacientes com cefaléia crônica diária Diagnóstico da cefaléia primária em pacientes com cefaléia crônica diária Diagnóstico da cefaléia primária em pacientes com cefaléia crônica diária RESUMO -Cefaléias crônicas diárias (CCD) representam um grupo de cefaléias diárias ou quase diárias, não paroxísticas, com características peculiares que são altamente prevalentes em populações de clínicas neurológicas e não incomuns em populações aleatórias de não pacientes. Muitos dos pacientes com CCD apresentavam, como cefaléia primária, a migrânea episódica a qual, com o tempo, revelou freqüência progressiva, mudança de apresentação clínica e perda de características típicas. Outros pacientes tinham cefaléia do tipo tensional crônica, cefaléia persistente diária de início súbito ou hemicrania continua antes da evolução para a apresentação diária. O objetivo deste estudo é determinar o diagnóstico primário da cefaléia de pacientes com CCD em atendimento em um centro terciário. Durante um período de 5 anos, 651 pacientes consecutivos com CCD foram estudados prospectivamente. Os critérios d...