Classification and clinical features of headache disorders in Pakistan: a retrospective review of clinical data.
Classification and clinical features of headache disorders in Pakistan: a retrospective review of clinical data.
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DOI：
10.1371/journal.pone.0005827
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发表时间：
2009-06-08
期刊：
影响因子：
3.7
通讯作者：
Sonawalla AB
中科院分区：
文献类型：
--
作者：
Murtaza M;Kisat M;Daniel H;Sonawalla AB
与原发性头痛疾病相关的发病率是一个主要的公共卫生问题，总体患病率为46%。紧张型头痛和偏头痛是两个最常见的原因。然而，在发展中国家，头痛作为一种发病原因尚未得到充分研究。关于这些疾病在南亚的患病率和分类的文献很少。本研究的目的是描述在巴基斯坦寻求医疗建议的头痛患者的分类和临床特征。回顾了255例在三级医院头痛门诊就诊的连续患者的病历。记录人口统计学资料、发病和疾病持续时间、头痛模式、相关特征和家族史。采用头痛疾病国际分类第2版。66%的患者为女性，其中81%的患者年龄在16至49岁之间。偏头痛是最常见的疾病（206例患者），其次是紧张型头痛（58例患者），药物过度使用头痛（6例患者）和丛集性头痛（4例患者）。99例患者出现慢性每日头痛。紧张型头痛患者比偏头痛患者头痛发作更频繁（p<0.001）。女性头痛相关性偏头痛患者每次头痛发作的持续时间更长（p = 0.015）。 报告有一级家族史的偏头痛患者的中位就诊年龄和发病年龄较低（分别为p=0.003和p<0.001）。 在巴基斯坦，因头痛寻求医疗建议的患者通常处于最有生产力的年龄。偏头痛和紧张型头痛是头痛最常见的临床表现。有一级家族史的患者偏头痛发作较早。月经相关性偏头痛影响的女性头痛发作的持续时间比其他患者长，它值得特殊的治疗考虑。需要进行后续研究，以描述巴基斯坦头痛的流行病学和负担。
Morbidity associated with primary headache disorders is a major public health problem with an overall prevalence of 46%. Tension-type headache and migraine are the two most prevalent causes. However, headache has not been sufficiently studied as a cause of morbidity in the developing world. Literature on prevalence and classification of these disorders in South Asia is scarce. The aim of this study is to describe the classification and clinical features of headache patients who seek medical advice in Pakistan. Medical records of 255 consecutive patients who presented to a headache clinic at a tertiary care hospital were reviewed. Demographic details, onset and lifetime duration of illness, pattern of headache, associated features and family history were recorded. International Classification of Headache Disorders version 2 was applied. 66% of all patients were women and 81% of them were between 16 and 49 years of age. Migraine was the most common disorder (206 patients) followed by tension-type headache (58 patients), medication-overuse headache (6 patients) and cluster headache (4 patients). Chronic daily headache was seen in 99 patients. Patients with tension-type headache suffered from more frequent episodes of headache than patients with migraine (p<0.001). Duration of each headache episode was higher in women with menstrually related migraine (p = 0.015). Median age at presentation and at onset was lower in patients with migraine who reported a first-degree family history of the disease (p = 0.003 and p<0.001 respectively). Patients who seek medical advice for headache in Pakistan are usually in their most productive ages. Migraine and tension-type headache are the most common clinical presentations of headache. Onset of migraine is earlier in patients with first-degree family history. Menstrually related migraine affects women with headache episodes of longer duration than other patients and it warrants special therapeutic consideration. Follow-up studies to describe epidemiology and burden of headache in Pakistan are needed.
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