Chronic daily headaches: clinical profile in Indian patients
Chronic daily headaches: clinical profile in Indian patients
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DOI：
10.1046/j.1468-2982.2003.00514.x
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发表时间：
2003-06-01
期刊：
影响因子：
4.9
通讯作者：
Chakravarty, A
中科院分区：
文献类型：
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作者：
Chakravarty, A
慢性每日头痛（CDH）在印度仍然是一个相对未被探索的疾病。误解很常见，经常进行不必要的调查和不适当的治疗。镇痛剂的过度使用很少被认识到。本报告似乎是印度的第一份此类报告。 CDH 被定义为头痛发生时间超过 15 天，持续 3 个月以上（不包括继发性原因）。两年多（1998-1999）共观察到 849 例（占所有原发性头痛的 49.6%）。 205 名受试者（男性 34 名；女性 171 名）获得了超过 1 年的随访数据。分布情况如下：（一）慢性紧张型头痛（CTH）33例（16.1%）； (ii) 慢性/转化性偏头痛 (TM)，169 (82.4%)； (iii)、新的持续性 CDH，3 (1.5%)。 TM 病例 169 例（男：女 1：4.7；年龄 26-58 岁）。所有人都有既往发作性偏头痛史。转变是渐进的（89.4%）或急剧的（10.6%）。转变的可能因素包括心理压力（44.4%）、镇痛药过度使用（28.4%）、麦角过度使用（4.1%）。激素替代疗法似乎与三名女性受试者有关。镇痛过度使用仅限于每天摄入 600 至 2400 毫克阿司匹林当量（平均 735 毫克）。麦角过度使用的麦角胺剂量为每天 1 至 3 毫克，每周超过或等于 3 天。通过药物治疗，大约 70% 的 TM 和 40% CTH 患者的病情得到显着改善。其中约 80% 在停药后复发。 CDH在印度并不罕见。需要及早识别镇痛剂/麦角的过度使用。与西方报道的相比，CDH 涉及的镇痛药的平均剂量似乎要少得多。
Chronic daily headache (CDH) remains a relatively unexplored entity in India. Misconceptions are common, unnecessary investigations often done and inappropriate therapy prescribed. Analgesic overuse is seldom recognized. The present report appears to be the first of its kind from India. CDH has been defined as headaches occurring more than 15 days per month for more than 3 months (secondary causes excluded). Over 2 years (1998-1999) 849 cases (49.6% of all primary headaches) were seen. More than 1 year's follow-up data were available in 205 subjects (M 34; F 171). The distribution of these was as follows: (i), chronic tension-type headache (CTH), 33 (16.1%); (ii), chronic/transformed migraine (TM), 169 (82.4%); (iii), new persistent CDH, 3 (1.5%). There were 169 cases of TM (M : F 1 : 4.7; age 26-58 years). History of past episodic migraine was present in all. Transformation had been gradual (89.4%) or acute (10.6%). Possible factors in transformation included psychological stress (44.4%), analgesic overuse (28.4%), ergot overuse (4.1%). HRT seemed to be implicated in three female subjects. Analgesic overuse was limited between intake of 600 and 2400 mg of aspirin equivalent per day (mean 735 mg). Ergot overuse varied between 1 and 3 mg/day of ergotamine for greater than or equal to 3 days/week. With medical therapy approximately 70% TM and 40% CTH patients noted significant improvement. About 80% of these relapsed on therapy withdrawal. CDH in India is not uncommon. Analgesic/ergot overuse needs to be recognized early. The average dose of analgesic implicated in CDH seems much less compared with that reported in the West.