Chronic Daily Headache and Medication Overuse Headache in First-Visit Headache Patients in Korea: A Multicenter Clinic-Based Study
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초록
Background and PurposezzChronic daily headache (CDH) is defned as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. Te aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among frst-visit headache patients presenting at neurology outpatient clinics in Korea. MethodszzEleven neurologists enrolled frst-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classifed according to the International Classifcation of Headache Disorder (third edition beta version) by each investigator. ResultszzPrimary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and defnite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). Te frequency of CDH did not difer between secondary and tertiary referral hospitals. ConclusionszzTe frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in frst-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.
Abstract
Background and PurposezzChronic daily headache (CDH) is defned as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. Te aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among frst-visit headache patients presenting at neurology outpatient clinics in Korea. MethodszzEleven neurologists enrolled frst-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classifed according to the International Classifcation of Headache Disorder (third edition beta version) by each investigator. ResultszzPrimary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and defnite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). Te frequency of CDH did not difer between secondary and tertiary referral hospitals. ConclusionszzTe frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in frst-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.
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