Clinical Charateristics of Chronic Daily Headache Patients Visit to University Hospital

ABSTRACT

BACKGROUND: Chronic daily headache(CDH) could be included all of the primary headache disorders with daily or near-daily headache lasting more than 4 hours/day for 15 days/month. Several studies have shown that patients with CDH are difficult to classify using the currently published International Headache Society(HIS) system. Recently, some authors recommended that CDH could be subclassified into transformed migraine(TM), chronic tension-type headache(CTTH), new daily persistent headache(NDPH) and hemicrania continua(HC). METHODS: We analysed 100 patients with CDH who were diagnosed in Taegu-Hyosung Catholic University Hospital from February 1996 to May 1998. To describe clinical features of CDH, we used our CDH protocol. RESULTS: (1) Most of the patients were in their 5th-7th decades, and female was predominantly affected(female to male ratio, 7.31). (2) The subclassification of CDH were CTTH in 59 patients, TM in 33 patients, NDPH in 7 patients, and HC in 1 patient. (3) Clinical characteristics of CDH were mostly bilateral location, mild to moderate intensity and dull nature. The mean onset age of CDH was 47.7 years, the onset time of the day was in the afternoon or anytime, the duration was more than 4 hours or 12 hours in 90 patients, and the frequency was near-daily or daily in 80 patients. Common associated symptoms were nausea, dizziness, insomnia, fatigue, photophobia, blurred vision, and scalp tenderness. (4) Daily use of analgesics was reported in 66 patients. CDH was aggravated during premenstrual period in 10 patients. Positive family history was shown in 26 patients. CONCLUSIONS: We present this report because knowledge of clinical characteristics and adequate protocol for CDH in clinical practice is necessary.