Characteristics of headache disorders, according to ICHD-III in an outpatient headache clinic in Sohag Governorate, Egypt

DOI: https://doi.org/10.1186/s41983- 021- 00271- x

Abstract-Summary The primary headache disorders are more common that of secondary headache.

The third edition of the International Classification of Headache Disorders (ICHD-III) is considered as a helpful tool for classification and diagnosis of differ- ent headache disorders.

Primary headache disorders were found in 89% (most of them is episodic in nature 76.2%), secondary headache disorders in about 10%, and painful cranial neuropathy was present in 0.8%.

Primary headache associated with sexual activity was present in 1% of the total

number of headache patients, and episodic cluster headache was found in 0.8%.

Male to female ratio was 1:3, 3:5, and 1:1 in primary headache, secondary head-

ache, and painful cranial neuropathy respectively.

This study estimates the frequency and characterizes different headache disor- ders, according to ICHD-III in an outpatient headache clinic at Sohag Governorate, Egypt.

3.1 Classification

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Introduction The headache can be classified to primary headache disorders which include migraine, tension-type headache (TTH), and cluster headache, and less common secondary type of headache which may be due to intracranial neoplasms, epileptic seizures, or intracranial infections [92, 93].

In Egypt, a population-based study conducted in Fayoum Governorate revealed that the 1-year headache prevalence was 51.4%, and the most common primary headache subtype was episodic tension type headache (24.5%), followed by epi- sodic migraine (17.3%) [94].

A study conducted in Saudi Arabia revealed that tension headache was also the commonest primary headache with a prevalence of 9.5% then migraine with preva- lence 5.0% [95].

The aim of this hospital-based cross-sectional study is to investigate the fre- quency and characteristics of different types of headache in the light of recent head- ache classification namely ICHD-III.

Methods Each patient was subjected to full medical and neurological evaluation including history of precipitating factors for each headache attack, comorbid medical condi- tions, and educational level based on the International Standard Classification of Education (ISCED) [96].

Patients with unclassified headache disorders were excluded from the study to accurately estimate the percentage of primary and secondary headache disorders.

Patients who reported headaches at a frequency of more than 15 days/month over a period of 3 months were classified as chronic headache which include chronic migraine (CM), chronic tension-type headache (CTTH), medication overuse head- ache (MOH), new daily persistent headache (NDPH), chronic paroxysmal hemicra- nia, SUNA, or hemicrania continua (HC).

Results The participants’ age ranged from 11 to 78 years with a mean age of 34.8 ± 13 years. The percent of chronic headache in males was 30.5% while in females was

21.4% with P value 0.03.

Discussion Although some previous studies reported that TTH is the most common type of primary headache all over the world [97], migraine was the most common presenta- tion in our series, and this may be explained by the under-recognition of TTH by patients and health practitioners for its less disability than migraine.

We found that episodic migraine was found in 40.6% of the total number of headache patients, chronic migraine in 10%, episodic TTH in 29.2% of the total number of headache participants, chronic TTH in 4.4%, and episodic cluster head- ache in 0.8% of the total number of headache participants, and this in agreement with previous study which reported that episodic migraine was present in 35.3%, chronic migraine in 3.9%, episodic TTH in 45.3%, chronic TTH in 5.6%, and clus- ter headache in 3.4% [94].

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3 Diagnosis

Acknowledgement A machine generated summary based on the work of Mohamed, Al-Amir Bassiouny. 2021 in The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.

3.2

Medical history

Machine generated keywords: child, premonitory, premonitory symptom, hour, child year, adolescent, pediatric, child adolescent, aura symptom, pediatric popula- tion, aura, phase, associate migraine, young child, young

Primary headaches during lifespan