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Survey about headaches in patients with obstructive sleep night apneas
Abstracts / Journal of the Neurological Sciences 333 (2013) e481–e518
doi:10.1016/j.jns.2013.07.1732
Abstract — WCN 2013 No: 2846 Topic: 8 — Headache Survey about headaches in patients with obstructive sleep night apneas
OF
D. Di Nicolaa, A. Lerab, M. Cincisc, V. Russob, L. Di Rèd, A. Orsinie, C. Marinif. aUniversità degli Studi dell'Aquila, L'Aquila, Italy; b U.O. Psichiatria, Italy; cU.O. Medicina Interna, Italy; dU.O. Pneumologia, ASL Teramo, Giulianova, Italy; eU.O. Servizi Farmaceutici, ASL Teramo, Teramo, Italy; fMedicina Interna, Università degli Studi dell'Aquila, L'Aquila, Italy Introduction: We enrolled 254 subjects, 173 men and 81 women, mean age of 56.8 + 15.0, suffering from obstructive sleep night apnea syndrome to evaluate the prevalence of headache, at the Department of Pneumology of the Teramo Hospital, in a period of 2 years. Materials and methods: Apneas were graded as mild (AHI between 5 and 10), moderate (AHI between 11 and 20), severe (AHI greater than 20). Headaches were classified according to the ICHD-II criteria. Twenty patients (8.1%) referred a history of primary headache: 3 were affected by migraine (1.2%) and 17 (6.9%) by headache. One hundred and eighty (70.9%) had headache on awakening, with a greater frequency of breathing pauses during sleep, insomnia of central type and episodes of sweating. All underwent an interview with a standardised questionnaire on sleep features. Results: The severity of obstructive sleep night apneas is related to the frequency of morning headache (frequency greater than in patients with insomnia), suggesting the relevant role of the hypercapnia consequential vasomotor phenomena. Discussion: The study group has a high prevalence of morning headache confirming results of previous studies concerning both its high frequency and severity in patients with sleep disorders. The strength of our study is the large sample size assessed, and the detailed information collected on sleep disorders and other risk factors for headache. Conclusions: Our study suggests the need for patients with morning headache to undergo careful screening for sleep disturbances related to breathing disorders, for a correct diagnostic and therapeutic approach.
DP
doi:10.1016/j.jns.2013.07.1731
correct diagnosis and treatment), sinus CT findings are important as well as neurological and rhinological examination.
RO
had 3 sessions of GON (one injection per week for 3 weeks) blockade with 2 ml of 1% lidocaine bilaterally. Severity of headache was evaluated by VAS (Visual Analogue Scale) and number of days with headache per month, number of analgesic use per month and number of triptan use per month were recorded before treatment and 3 months after treatment. Results: When we compare both groups according to gender, age, pre-treatment pain intensity, and frequency, number of analgesic use per month and number of triptan use per month; no significant difference was detected (p N 0.05 for all parameters). When we evaluate Group 1 and 3 for all parameters, a statistically significant decrease was detected 3 months after treatment (p b 0.05 for all parameters). When we evaluate Group 2 according to the frequency of pain, VAS and number of analgesic use per month before treatment and 3 months after treatment, a significant decrease was detected but there was no statistically significant difference in the number of triptan use per month (p b 0.05). Discussion: GON blockade is more effective in patients with chronic migraine and patients with both migraine and chronic tension type headache, but response in TTH is less. Additional placebo-controlled studies that include larger study populations are needed to confirm our results.
e489
Abstract — WCN 2013 No: 2856 Topic: 8 — Headache Sinus headache's relationship with primary headaches; clinical and radiological evaluation
EC
TE
H.L. Gula, O. Karadaşb, S. Fırtınac, A. Meteoğlud, A.K. Erdemoğlue, A. Özgef, L. İnang. aDepartment of Neurology, Kartal Education and Research Hospital, Istanbul, Turkey; bDepartment of Neurology, Erzincan Military Hospital, Erzincan, Turkey; cDepartment of Cardiology, Erzincan Military Hospital, Erzincan, Turkey; dDepartment of Ear Throat and Nose, Erzincan Military Hospital, Erzincan, Turkey; eDepartment of Neurology, Acıbadem Hospital, Ankara, Turkey; fDepartment of Neurology, Mersin University, Mersin, Turkey; gDepartment of Neurology, Ankara Education and Research Hospital, Ankara, Turkey
UN
CO
RR
Introduction: Patients suffering from sinus headache (SH), may be able to meet the criteria for primary headaches (PHs) according to IHS criteria. In this study, we aimed to assess the clinical and radiological findings of sinus headache sufferers that meet the criteria of primary headache. Materials and methods: 39 patients suffering from sinus headache were evaluated clinically and radiologically with paranasal sinus tomography. At CT scans; Lund–Mackay Grading System (LMS) scores, sinus abnormalities and rhinological pathologies were investigated. PHs that also meet the criteria of SH were detected. Results: When findings are analyzed in terms of meeting the criteria of primary headaches (IHS criteria): 18 (46.1%) patients meet the criteria for migraine, 10 patients (25.6%) for tension type headache (TTH), and 2 patients (3.2%) for cluster headache (CH). Evaluation according to LMS scores did not show significant differences between the migraine group, TTH group, CH group and SH that do not meet the criteria for PH group (p N 0.05). All of the patients had radiological rhinological pathology. Groups that meets the criteria of PH had sinus disease more than septal deviation and concha bullosa. Conclusion: Most patients with sinus headaches also meet the criteria for primary headaches. These primary headache patients mostly have radiological sinus disease. In the evaluation of patients with primary headaches associated with sinus pathology (in terms of
doi:10.1016/j.jns.2013.07.1733
Abstract — WCN 2013 No: 2826 Topic: 8 — Headache Contribution of twenty-one epidemiological factors to migraine disability A. Mitrovic, S. Sretenovic, A. Stanic. Migraine Center, University Hospital KBC ‘Zvezdara’, Belgrade, Serbia Background: Migraine headache is one of the most important primary headaches. It is associated with a negative impact, reduction of life quality and disability. Epidemiology and impact of migraine on disability are only partially documented in Serbia. Objective: This study is to determine whether socio-epidemiological parameters have an impact on migraine headache and potentially high scores on the MIDAS questionnaire.
doi:10.1016/j.jns.2013.07.1732
Abstract — WCN 2013 No: 2846 Topic: 8 — Headache Survey about headaches in patients with obstructive sleep night apneas
OF
D. Di Nicolaa, A. Lerab, M. Cincisc, V. Russob, L. Di Rèd, A. Orsinie, C. Marinif. aUniversità degli Studi dell'Aquila, L'Aquila, Italy; b U.O. Psichiatria, Italy; cU.O. Medicina Interna, Italy; dU.O. Pneumologia, ASL Teramo, Giulianova, Italy; eU.O. Servizi Farmaceutici, ASL Teramo, Teramo, Italy; fMedicina Interna, Università degli Studi dell'Aquila, L'Aquila, Italy Introduction: We enrolled 254 subjects, 173 men and 81 women, mean age of 56.8 + 15.0, suffering from obstructive sleep night apnea syndrome to evaluate the prevalence of headache, at the Department of Pneumology of the Teramo Hospital, in a period of 2 years. Materials and methods: Apneas were graded as mild (AHI between 5 and 10), moderate (AHI between 11 and 20), severe (AHI greater than 20). Headaches were classified according to the ICHD-II criteria. Twenty patients (8.1%) referred a history of primary headache: 3 were affected by migraine (1.2%) and 17 (6.9%) by headache. One hundred and eighty (70.9%) had headache on awakening, with a greater frequency of breathing pauses during sleep, insomnia of central type and episodes of sweating. All underwent an interview with a standardised questionnaire on sleep features. Results: The severity of obstructive sleep night apneas is related to the frequency of morning headache (frequency greater than in patients with insomnia), suggesting the relevant role of the hypercapnia consequential vasomotor phenomena. Discussion: The study group has a high prevalence of morning headache confirming results of previous studies concerning both its high frequency and severity in patients with sleep disorders. The strength of our study is the large sample size assessed, and the detailed information collected on sleep disorders and other risk factors for headache. Conclusions: Our study suggests the need for patients with morning headache to undergo careful screening for sleep disturbances related to breathing disorders, for a correct diagnostic and therapeutic approach.
DP
doi:10.1016/j.jns.2013.07.1731
correct diagnosis and treatment), sinus CT findings are important as well as neurological and rhinological examination.
RO
had 3 sessions of GON (one injection per week for 3 weeks) blockade with 2 ml of 1% lidocaine bilaterally. Severity of headache was evaluated by VAS (Visual Analogue Scale) and number of days with headache per month, number of analgesic use per month and number of triptan use per month were recorded before treatment and 3 months after treatment. Results: When we compare both groups according to gender, age, pre-treatment pain intensity, and frequency, number of analgesic use per month and number of triptan use per month; no significant difference was detected (p N 0.05 for all parameters). When we evaluate Group 1 and 3 for all parameters, a statistically significant decrease was detected 3 months after treatment (p b 0.05 for all parameters). When we evaluate Group 2 according to the frequency of pain, VAS and number of analgesic use per month before treatment and 3 months after treatment, a significant decrease was detected but there was no statistically significant difference in the number of triptan use per month (p b 0.05). Discussion: GON blockade is more effective in patients with chronic migraine and patients with both migraine and chronic tension type headache, but response in TTH is less. Additional placebo-controlled studies that include larger study populations are needed to confirm our results.
e489
Abstract — WCN 2013 No: 2856 Topic: 8 — Headache Sinus headache's relationship with primary headaches; clinical and radiological evaluation
EC
TE
H.L. Gula, O. Karadaşb, S. Fırtınac, A. Meteoğlud, A.K. Erdemoğlue, A. Özgef, L. İnang. aDepartment of Neurology, Kartal Education and Research Hospital, Istanbul, Turkey; bDepartment of Neurology, Erzincan Military Hospital, Erzincan, Turkey; cDepartment of Cardiology, Erzincan Military Hospital, Erzincan, Turkey; dDepartment of Ear Throat and Nose, Erzincan Military Hospital, Erzincan, Turkey; eDepartment of Neurology, Acıbadem Hospital, Ankara, Turkey; fDepartment of Neurology, Mersin University, Mersin, Turkey; gDepartment of Neurology, Ankara Education and Research Hospital, Ankara, Turkey
UN
CO
RR
Introduction: Patients suffering from sinus headache (SH), may be able to meet the criteria for primary headaches (PHs) according to IHS criteria. In this study, we aimed to assess the clinical and radiological findings of sinus headache sufferers that meet the criteria of primary headache. Materials and methods: 39 patients suffering from sinus headache were evaluated clinically and radiologically with paranasal sinus tomography. At CT scans; Lund–Mackay Grading System (LMS) scores, sinus abnormalities and rhinological pathologies were investigated. PHs that also meet the criteria of SH were detected. Results: When findings are analyzed in terms of meeting the criteria of primary headaches (IHS criteria): 18 (46.1%) patients meet the criteria for migraine, 10 patients (25.6%) for tension type headache (TTH), and 2 patients (3.2%) for cluster headache (CH). Evaluation according to LMS scores did not show significant differences between the migraine group, TTH group, CH group and SH that do not meet the criteria for PH group (p N 0.05). All of the patients had radiological rhinological pathology. Groups that meets the criteria of PH had sinus disease more than septal deviation and concha bullosa. Conclusion: Most patients with sinus headaches also meet the criteria for primary headaches. These primary headache patients mostly have radiological sinus disease. In the evaluation of patients with primary headaches associated with sinus pathology (in terms of
doi:10.1016/j.jns.2013.07.1733
Abstract — WCN 2013 No: 2826 Topic: 8 — Headache Contribution of twenty-one epidemiological factors to migraine disability A. Mitrovic, S. Sretenovic, A. Stanic. Migraine Center, University Hospital KBC ‘Zvezdara’, Belgrade, Serbia Background: Migraine headache is one of the most important primary headaches. It is associated with a negative impact, reduction of life quality and disability. Epidemiology and impact of migraine on disability are only partially documented in Serbia. Objective: This study is to determine whether socio-epidemiological parameters have an impact on migraine headache and potentially high scores on the MIDAS questionnaire.