Perimenstrual headache: Migraine without aura or premenstrual syndrome symptom?

Abstract

Background/Aim. Definition of menstrual migraine as a specific clinical entity or, maybe, migraine headache with menstrually related occurring, still remains unresolved question. The aim of this study was to investigate if perimenstrual headache in our patients fulfills diagnostic the International Classification of Headache Disorders (ICHD) criteria for migraine without aura or represents a different type of headache which is the symptom of premenstrual syndrome (PMS). Methods. The study included 50 women with headache in perimenstrual period in at least two out of three menstrual cycles, during the last year or longer. Two questionnaires, a questionnaire for headache and a questionnaire for PMS, were used. Results. The majority of all the examined women, 29 of them, had migraine and PMS and 9 women had migraine without PMS. Headache in 38 (76.0%) patients fulfilled diagnostic criteria for menstrual migraine, (26 and 12 women had pure menstrual migraine and menstrually related migraine respectively). Intensity of PMS was not different in a groups of women with different types of headache (p = 0.184): a total number of PMS symptoms was 8.2 ? 4.6 in the group with pure menstrual migraine, 10.8 ? 3.9 in the group with menstrually related migraine and 10.8 ? 6.3 in the group with non-migraine headache. Conclusion. This study shows that headache, occuring in perimenstrual period, is not always migraine, but could fulfill criteria for tension-type headache, as well. Specific characteristics of perimenstrual headache, which could distinguish it as a symptom of PMS, were not found. Expected relation in time of headache onset and menarche was not confirmed.Uvod/Cilj. Jos uvek nije jasno da li menstrualna migrena predstavlja zaseban klinicki entitet ili je rec o migrenskoj glavobolji koja se specificno javlja u menstrualnom periodu. Cilj ovog istrazivanja bio je da se utvrdi da li perimenstrualna glavobolja ispitanih bolesnica ispunjava dijagnosticke kriterijume Medjunarodne klasifikacije glavobolja (MKG) za migrenu bez aure ili predstavlja glavobolju drugih, nemigrenskih osobina koja se javlja kao simptom predmenstrualnog sindroma (PMS). Metode. Istrazivanjem je bilo obuhvaceno 50 zena sa glavoboljom u perimenstrualnom periodu u najmanje dva od tri menstrualna ciklusa tokom poslednjih godinu dana ili duze. Istrazivanje je uradjeno pomocu dva strukturisana upitnika: Upitnika za glavobolju i Upitnika za PMS. Rezultati. Najveci broj ispitivanih zena, njih 29, imalo je migrenu i PMS, dok je migrena bez PMS-a zabelezena kod devet ispitanica. U ispitivanoj grupi, glavobolja kod 38 zena (76,0%) ispunjavala je dijagnosticke kriterijume za menstrualnu migrenu, od cega je 26 zena imalo cistu menstrualnu migrenu, a 12 migrenu povezanu sa menstruacijom. Stepen izrazenosti PMS-a nije se razlikovao medju grupama zena sa razlicitim tipovima glavobolje (p = 0,184): zene sa cistom menstrualnom migrenom imale su prosecno 8,2 ? 4,6, zene sa menstrualno povezanom migrenom 10,8 ? 3,9, a zene sa glavoboljom nemigrenskih osobina 10,8 ? 6,3 simptoma PMS-a. Zakljucak. Ovim istrazivanjem pokazano je da glavobolja koja se javlja u perimenstrualnom periodu nije obavezno migrena, vec se javlja i kao glavobolja tenzionog tipa. Posebne osobine perimenstrualne glavobolje, na osnovu kojih bi ona mogla biti tumacena kao simptom PMS-a, nisu uocene. Ovim istrazivanjem nije potvrdjena ocekivana vremenska povezanost menarhe i pojave prve glavobolje.