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Mohammad Mohsin Rana¹, Muhammad Saleem Akhtar¹, Zafar Latif Awan², Danish Gani³, Asma Malik¹ and Muhammad Bilal¹

ABSTRACT

Objective: This study was designed to assess the incidence of chronic headache and its sub-varieties in our local patients, to highlight the importance of exact diagnosis in proper categories and to sensitize both general population and the medical community to recognize its importance for early diagnosis and interventions.

Study Design: Observational cross section study

Place and Duration of Study: This study was conducted at the Department of Medicine, Rai Medical College Teaching Hospital, Sargodha from January to September, 2022.

Materials and Methods: Medical OPD, 13-75 years, both gender with complain of primary headache for more than 3 months. After ensuring the presence of chronic primary headache based on the standard parameters, participating physicians secured informed consent and applied inclusion/exclusion criteria and evaluated them to assign to Migraine, TTH or CH subtype.

Results: After fulfilling inclusion and exclusion criteria 200 patients were enrolled for this study with 63 (31.5%) Male and 137(68.5%) females. 9.5% (n19) were adolescent (13-18), 83.5% (n 167) were adults (18-59 and 7% were in late adults years (above 60). 60 patients (30%) were unmarried and 140 patients (70%) were married. When analyzed 102 (51%) were assigned to Migraine, 79 (39.5%) were assigned to TTH and 19 (9.5%) were assigned CH diagnosis. 45% of our patients presented early within 6 months, 25% presented within 6-12 months, 20% presented with 1-5 years history and only 9% had a history longer than 5 years.

Conclusion: Headache especially chronic is most likely to present in primary care setting. Disability index and severity index didn’t show any typical pattern, TTH turned out to be more disabling. It is concluded that exact diagnosis into the subtypes has important therapeutic implications. Predisposing/ precipitating and/or perpetuating factors have important implication in the management for specific subgroups. Addressing modifiable factors like adequate hydration, menstrual regularity, sleep hygiene, alcohol and substance abuse, excessive caffeine and/or lack of exercise needs attention tailored to each subtype. TTH benefits most from anxiolytics and antidepressants. Prophylaxis medicine along with diet, mood and sleep improvement has important role in Migraine. The non-responders needs a revisit to the diagnosis, noncompliance or overuse. Medication overuse headache must be watched for after regular medication.

Key Words: Primary Headache, Migraine, Tension Type Headache, Cluster Headache

Citation of article: Rana MM, Akhtar MS, Awan ZL, Gani D, Malik A, Bilal M. Importance and Implications of Sub-Categorization of Chronic Headache and the Incidence in General Medical OPD of a Teaching Hospital. Med Forum 2023;34(1):69-72.