IJCRR - 8(19), October, 2016
PREVALENCE OF CHRONIC DAILY HEADACHE (CDH) IN PEOPLE OF AGE GROUP 18-80 YEARS IN MAX SUPERSPECIALTY HOSPITAL, SAKET, NEW DELHI " INDIA - A PROSPECTIVE STUDY
Author: Maqsood Ahmad Dar, Baseerat Ali, Rajasheikar Redid, Rommel Roshan Tickoo, Owais Hamid Dar
Introduction: Chronic daily headache defined as headache occurring on 15 or more days in a month for at least three months affects around 4% of the general population causes significant distress with substantial impact on the quality of life of an individual and huge economic cost to the society through occupational disability and healthcare consultations.
Objectives of the Study: To study the prevalence of chronic daily headaches in people of age group 18-80 years in Max Super Specialty Hospital and to identify risk factors associated with CDH (stressful life events, obesity, and medicine overuse.)
Material and Methods: It was a prospective study conducted in Max Super Specialty Hospital, Saket, and New Delhi between Aug 2014 to May 2015. Patients coming with complaints of headache in age group of 18-80 yrs and fulfilling the inclusion criteria and exclusion criteria were enrolled in the study. Sample size was calculated by using n-Master (2.0) software and 176 subjects were enrolled. History of the patient including the precipitating factors and drug history was taken. MIDAS and HIT score was used to know the severity of headache; medical conditions were noted by taking brief interviews. Data was analyzed by using chi square test, Pearson’s correlation coefficient.
Result: Of the 4500 subjects presented to our hospital with complaints of headache, 176 fulfilled the criteria of chronic daily headache (CDH) with a prevalence of about 4.5%.In our study we observed that 103 (58.5%) had migraine without aura, 30.6(20.5%) migraine with aura, 33(18.8%) tension type headache (TTH), 2 (1.1%) hemicranias continua and 2(1.1%) mixed-migraine and TTH.We observed that out of 176 patients in age group of 18-80 years ,maximum number of patients were in age group of 30-39 yrs- 67 patients(38.1%) and the least common age group was >70yrs where only 1 patient had chronic daily headache(CDH). It was observed that out of 176 patients 123 (69.9%) were females and 53 (30.1%) were males and type of headache was statistically significantly (p=0.00) associated with gender.
Conclusion: We conclude that Migraine without aura was the most common type (58.5%) and least common type being mixed chronic migraine and tension type headache and Hemicrania continua 1.1%. We found chronic daily headache was more prevalent in females as compared to males, 123 (69.9%) were females and 53 (30.1%) were males. The most common age group affected was 30-39 years and was more common in married. We observed that most of the patients (61.9%) had BMI between 18.5 and 25.After analyzing risk factors it was observed that history of drug intake was present in 154 subjects, most common being Acetaminophen, Naproxen, Triptans, Ergotamine the rest were using preventive. In our study prevalence of medication overuse headache (MOH) among 176 patients of chronic daily headache is (108/176) 61.36% whereas prevalence of MOH in subjects coming to our hospital with headache is 2.4% (108/4500). Stress was the most common precipitating factor of chronic daily headache (CDH), stress was present in 146 patients (85.9%) others being lack of sleep, hunger, working on computer, noise, menstruation, sunlight, travel.
Recommendations: Chronic daily headache is under estimated due to lack of awareness; screening of patients should be done on primary and secondary care centers to estimate the actual burden of disease. Stress, anxiety should be handled as early as possible to prevent transformation of episodic headache to chronic daily headache.
Keywords: Hemicranias continua, Chronic daily headache, Tension type headache, Medication overuse headache
Maqsood Ahmad Dar, Baseerat Ali, Rajasheikar Redid, Rommel Roshan Tickoo, Owais Hamid Dar. PREVALENCE OF CHRONIC DAILY HEADACHE (CDH) IN PEOPLE OF AGE GROUP 18-80 YEARS IN MAX SUPERSPECIALTY HOSPITAL, SAKET, NEW DELHI " INDIA - A PROSPECTIVE STUDY International Journal of Current Research and Review. 8(19), October, 25-35
1. Ahmed F, Parthasarathy R , Khalil M. Annals of Indian Academy of Neurology: 2012; Volume 15, Issue 5 [p. 40-50]
2. Castillo J, Muñoz P, Guitera V, Pascual J. Kaplan Award 1998: Epidemiology of chronic daily headache in the general population. Headache. 1999; 39:190–6.
3.Bigal ME, Lipton RB :what predicts the change from episodic to chronic migraine. Curr Opin Neurology. 2009; 22:269
4. International Headache Society 2013, International classification of headache disorders 3rd edition cephalalgia.2013;33(9) 629-808
5. Coeytaux RR, Linville JC.Chronic daily headache in a primary care population: prevalence and headache impact test scores. 2007; 47(1):7-12.
6.Wiendels NJ, Knuistingh Neven A, Rosendaal FR, Spinhoven P, Zitman FG, Assendelft WJ, Ferrari MD. Chronic frequent headache in the general population: prevalence and associated factors. Cephalalgia. 2006 ;26(12):1434-42.
7. Queiroz LP, Peres MFP, Kowacs F, Piovesan EJ, Ciciarelli MC, Souza JA &Zukerman E. Chronic daily headache in Brazil: a nationwide population-based study. Cephalalgia 2008; 28:1264–1269.
8.Castillo J, Munoz P, Guitera V, Pascual J Epidemiology of chronic daily headache in the general population. Headache .1999; 39:190-196
9.Lanteri-Minet M, Auray JP, El HA, Dartigues JF, Duru G, Henry P, Lucas C, Pradalier A, Chazot G, Gaudin AF Prevalence and description of chronic daily headache in the general population in France. Pain,2003; 102:143-149.
10. Mitsikostas DD, Tsaklakidou D, Athanasiadis N, Thomas A. The prevalence of headache in Greece: correlations to latitude and climatological factors. Headache.1996; 36:168-173
11. Pascual J, Colas R, Castillo. Epidemiology of chronic daily headache. Curr Pain Headache Rep. 2001; 5:529-536
12. Scher AI, Stewart WF, Liberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache. 1998; 38:497-506
13. Seyed Saadat SM, Hosseininezhad M, Bakhshayesh B, Hoseini M, Naghipour M. Epidemiology and clinical characteristics of chronic daily headache in a clinic-based cohort of Iranian population.Neurol Sci. 2014;35(4):565-70.
14. Zebenholzer K , Andree C , Lechner A, Broessner G , Lampl C , Luthringshausen G , Wuschitz A, Maria-S, Obmann, Berek K, and Wöber C. Prevalence, management and burden of episodic and chronic headaches:A Cross-Sectional Multicentre Study in Eight Austrian Headache Centres. Journal of Headache and Pain, 2015;10.1186
15. AS Dabhi, M Vadivelan, J Modia.A study of sixty cases of chronic daily headache. Original article- JIACM. 2013; 14(2):119-2 .
16. Verma A, Transformed migraine: Study of 420 consecutive patients from central India. Annals of Neurosciences.2007;Volume 14, issue 2.
17. Bhatia MS and Gupta R. Migraine:Clinical pattern and psychiatry comorbidity.Indsustrial Psychiatry Journal,2012; 21(1): 18–21.
18.Scher AI, Midgette LA, Lipton RB: Risk factors for headache chronification. Headache. 2008;48:16-25.
19. Scher AI, WF Stewart, JA Ricci, RB Lipton. Factors associated with the onset and remission of chronic daily headache in a population-based study.Pain. 2003;106(1-2):81-9
20. Crisp AH, Kalucy RS, McGuinness B, Ralph PC, Harris G. Some clinical, social and psychological characteristics of migraine subjects in the general population. Postgrad Med J.1977;53:691–7
21. Waters WE, O'Connor PP. Prevalence of migraine. J Neurosurg Psychiatry. 1957;38:613–6.
22. Jette N, Petten S, Williams J, Becker W, Wiebe S. Comorbidity of migraine and psychiatric disorders-A national population-based study. Headache. 2008;48:501–16.
23. Schurks M, Rist PM, Bigal ME, Buring JE, Lipton RB, Kurth T. Migraine and cardiovascular disease: Systematic review and meta-analysis. BMJ. 2009; 339:b3914.
24. Silberstein S. Migraine and Pregnancy. Journal SOGC. Sept. 2000, visited on www.headache-help.org
25. Lipton RB. Tracing transformation: Chonic migraine classification, progression, and epidemiology. Neurology. 2009;72:S3–7.
26. Mehuys E, Paemeleire K, Van Hees T, Christiaens T, Van Bortel LM, Van Tongelen I, De Bolle L, Remon JP, Boussery K. Self-medication of regular headache: a community pharmacy-based survey. European Journal of Neurol.2012; (8) 1093-9.
27. Relja G, Granato A, Maria Antonello R, Zorzon M. Headache induced by chronic substance use: Analysis of medication overused and minimum dose required to induce headache. Headache. 2004; 44:148–53.
28. Vlajinac H, Šipeti? S, Džolji? E, Maksimovi? J, Marinkovi? J, Kosti? V.Some lifestyle habits of female Belgrade university students with migraine and non-migraine primary headache. J Headache Pain.2003; 4:67-71
29. Martin VT, Behbehani MM. Toward a rational understanding of migraine trigger factors. Med Clinic North America.2001; 85:911-941
30. Andress-Rothrock D, King W, Rothrock J. An analysis of migraine triggers in a clinic-based population. Headache.2010 ;50(8):1366-70.
31. Albers L, Ziebarth S, Von Kries R.Modifiable risk factors for primary headache. A systematic review. 2014; 952-60.
32. Santos IS, Griep RH, Alves MG, Goulart AC, Lotufo PA, Barreto SM, Chor D, Benseñor IM.Job stress is associated with migraine in current workers:the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Eur J Pain. 2014;18(9):1290-7
33. Becker WJ. Migraine and Oral Contraceptives. Canadian Journal of Neurological Sciences. 1997;24: p16-21
34. Fettes Ivey. Migraine and the Menopause. Journal SOGC ;2000 visited on www.headache-help.org
35. Loder, Elizabeth. Headache and Oral Contraceptive Use. Seminars in Headache Management. Sex Hormones and Headache. 1998; Vol. 3 Number 2 June p9-12
36. Loder, Elizabeth. Migraine and Menstruation. Journal SOGC. 2000; Vol. 22 number 7, p512-517
37. Spierings EL, Donoghue S, Mian A, Wöber C. Headache. Sufficiency and necessity in migraine: how do we figure out if triggers are absolute or partial and, if partial, additive or potentiating? Curr Pain Headache Rep. 2014; 455.
38. Turner DP, Smitherman TA, Penzien DB, Porter JA, Martin VT, Houle TT. Nighttime snacking, stress, and migraine activity. J Clin Neurosci. 2014; 21638-43.
39. Zivadinov R, Willheim K, Sepic-Grahovac D, Jurjevic A, Bucuk M, Brnabic-Razmilic O, Relja G, Zorzon M. Migraine and tension-type headache in Croatia: a population-based survey of precipitating factors. Cephalalgia..2003;23(5):336-43.
40. Spierings EL, Ranke AH, Honkoop PC. Precipitating and aggravating factors of migraine versus tension-type headacheHeadache. 2001;41(6):554-8.