Clinical Profile of Primary Headaches and Awareness of Trigger Factors in Migraine Patients

Abstract

Aim: To classify the patients as per the International Classification of Headache disorders 3rd edition Beta version. To study the demographic details and clinical profile. To study the trigger factors in migraine patients. To study the importance of family history is headache patients. Materials & Methods: The study was a cross sectional observational study of 300 patients at outpatient clinic tertiary health care center, over a period of two years. Patients diagnosed with primary headache were studied with help of an exhaustive questionnaire which covered the relevant details. Results: Our study had 158 migraines (MG), 137 Tension Type Headache (TTH) and 5 Trigeminal Autonomic Cephalgia (TAC) patients. Females are more affected, 1:2.9 in TTH and 1:1.5 in MG. Mean age for MG was 33.37 and for TTH were 36.11. Majority (46-48%) were employed, followed by housewives (43-38%) and students (9-13%) among both the groups. TTH patients had frequency of headache more patients than migraine patients. Family history was positive in 36% in MG and 14% in TTH patients. TTH had dull aching, holocranial pain with pericranial tenderness; whereas migraine had throbbing unilateral pain. Aura was seen only in 21% of MG patients; retinal (67%) being most common. Associated symptoms like nausea, phonophobia, photophobia were seen in 80% of MG patients. Trigger factors on history were present in 64%, which increased to 85% on showing detail list. Most common triggers were climatic, followed by travel, stress and sleep related. Females had hormonal, smell and emotional stress as more common TF. Conclusion: Migraine is most common primary headache presenting in clinics. With predominance in females TTH attacks are more frequent than migraine. TTH showed features like dull aching, pressure like and holocranial pain whereas migraine has throbbing and unilateral pain. Pericranial tenderness is more in TTH patients whereas migraine has associated vasomotor symptoms. It is important to have detail list of all Trigger factors for Migraine patients, so that they can avoid them and prevent their attacks, thus reducing analgesic use. Family history has more influence in migraine patients compared to TTH.