Main Article Content
Clinical Profile of Primary Headache disorders in Kano, Northwestern Nigeria
Abstract
Background/Purpose: Primary headache disorder, which is headache with no organic or structural etiology, is an important disorder because of its high prevalence, socioeconomic impact, and adverse effects on quality of life. However, there is paucity of data and dearth of knowledge about clinical characteristics of this common malady in our environment. The aim of the present study was to profile the clinical pattern and clinical characteristics of primary headache in Kano, Northwestern Nigeria.
Methodology: At the Aminu Kano Teaching Hospital (AKTH) and Murtala Muhammad Specialist Hospital (MMSH) Nigeria, patients that presented with headache were screened for primary headaches using the International Headache Society criteria for primary headache between June, 2007 and June, 2011. A proforma was completed for each patient documenting the diagnosis of primary headache, demographic data as well as the patient's clinical characteristics.
Results: Two hundred and sixty (260) out of 406 (65%) that were seen within the study period fulfilled the ISH criteria for primary headache. Their age ranged between 15 and 52 with mean age of 27.2 ±8.2; their mean age at onset of the headache was 20.2± 6.8. The most common primary headache subtypes were migraine and tension type headache. Migraine without aura (MWOA) was commoner than migraine with aura (MWA) (58% and 42% respectively). Associated symptoms, such as nausea (OR=6.5, 95%CI= 2.98-14.48), vomiting (OR=19, 95%CI= 7.38-51.35 and visual impairment (OR=2.6. 95%CI= 1.01-6.94) were significantly more common in MWOA compared to MWA. Conversely, unilateral headache was significantly less common (OR=0.38, 95%CI= 0.14-0.99) in the former. One hundred and seven patients received TTH diagnosis. Episodic tension-type headache TTH (ETTH) was more frequent (85.5%) than chronic tension-type headache (CTTH). After adjusting for confounders, only vomiting, photophobia, phonophobia and family history were independently associated with migraine.
Conclusion: Primary headache constitutes a large proportion of headaches in two neurology clinics in Kano. Migraine and tension type were the most common subtypes. Vomiting, photophobia, phonophobia and family history were associated with migraine in comparison to TTH.
Methodology: At the Aminu Kano Teaching Hospital (AKTH) and Murtala Muhammad Specialist Hospital (MMSH) Nigeria, patients that presented with headache were screened for primary headaches using the International Headache Society criteria for primary headache between June, 2007 and June, 2011. A proforma was completed for each patient documenting the diagnosis of primary headache, demographic data as well as the patient's clinical characteristics.
Results: Two hundred and sixty (260) out of 406 (65%) that were seen within the study period fulfilled the ISH criteria for primary headache. Their age ranged between 15 and 52 with mean age of 27.2 ±8.2; their mean age at onset of the headache was 20.2± 6.8. The most common primary headache subtypes were migraine and tension type headache. Migraine without aura (MWOA) was commoner than migraine with aura (MWA) (58% and 42% respectively). Associated symptoms, such as nausea (OR=6.5, 95%CI= 2.98-14.48), vomiting (OR=19, 95%CI= 7.38-51.35 and visual impairment (OR=2.6. 95%CI= 1.01-6.94) were significantly more common in MWOA compared to MWA. Conversely, unilateral headache was significantly less common (OR=0.38, 95%CI= 0.14-0.99) in the former. One hundred and seven patients received TTH diagnosis. Episodic tension-type headache TTH (ETTH) was more frequent (85.5%) than chronic tension-type headache (CTTH). After adjusting for confounders, only vomiting, photophobia, phonophobia and family history were independently associated with migraine.
Conclusion: Primary headache constitutes a large proportion of headaches in two neurology clinics in Kano. Migraine and tension type were the most common subtypes. Vomiting, photophobia, phonophobia and family history were associated with migraine in comparison to TTH.
