偏头痛与紧张性头痛相关的前瞻性研究:颈部疼痛在印度是一种常见的负担吗?

Sucharita Anand, S. Pradhan, Nilesh A Wagh, Kanishka Uthansingh, S. Choudhury
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摘要

背景。本研究旨在了解颈部疼痛与不同原发性和混合型头痛疾病的相关性和因果关系。材料和方法。在神经内科就诊一年的头痛原发患者被纳入研究。在预先设计的表格中输入人口统计学特征、头痛的详细病史和颈部疼痛的特征。在焦特布尔全印度医学科学研究所神经内科、勒克瑙桑贾伊甘地医学科学研究生院神经内科、印度布巴内斯瓦尔IMS和SUM医院神经内科的合作下。结果。本研究共纳入601例原发性头痛患者,其中66.4% (n=399)的患者颈部疼痛是头痛的诱发因素或头痛的一部分。女性明显高于男性,占67.6%。在所有患者中,21% (n=84)患有偏头痛,51% (n=203)患有紧张性头痛(TTH), 28% (n=112)患有混合型头痛。虽然一些偏头痛患者有颈部疼痛作为偏头痛的一部分,但颈部疼痛与紧张性头痛和混合型头痛的相关性明显高于偏头痛(p<0.001 vs p=0.35)。在混合性头痛中;慢性TTH (CTTH)伴发作性偏头痛(EM)最为常见(54.5%,n=61),其次是慢性TTH伴慢性偏头痛(CM),占33% (n=37)。结论。偏头痛中颈部疼痛的存在与TTH的相关性增加,而反过来可能不成立。这是一种单纯的联系还是一种因果关系还有待证明。
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A prospective study on association of migraine with tension-headache: Is neck pain a common burden in India?
Background. The present study aimed to know the association and causal relationship of neck pain with different primary and mixed-type headache disorders. Material and methods. The primary patients with headaches attending the Department of Neurology OPD throughout one-year were included in the study. The demographic features, detailed history of headaches, and the characteristics of neck pain were entered in the pre-designed proforma. With the collaboration of the Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow and the Department of Neurology, IMS and SUM Hospital, Bhubaneswar, India. Results. A total of 601 primary headache patients were included in the study, among which a fraction of 66.4% (n=399) had the problem of neck pain either as a pre-disposing event or as a part of the headache. Females were predominately higher than males with a fraction of 67.6%. Among all the patients a fraction of 21% (n=84) had a migraine, 51% (n=203) had a tension-type headache (TTH) and 28% (n=112) had a mixed-type headache. Though several patients with migraine had neck pain as a part of migraine, neck pain was significantly associated with tension and mixed type headache than migraine headache (p<0.001 vs p=0.35). Among the mixed-quality of headaches; chronic TTH (CTTH) with episodic migraine (EM) was most common (54.5%, n=61), followed by CTTH with chronic migraine (CM) at 33% (n=37). Conclusion. The presence of neck pain in migraine headaches showed an increased association with TTH whereas the reverse may not be true. This is yet to prove whether this is a mere association or a causal relationship.
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