Birinci Basamağa Başvuran Klasik Migrenli ve Kronik Günlük Başağrılı Hastalarda Sosyodemografik ve Semptomatik Faktörlerin Değerlendirilmesi ve Karşılaştırılması

Year 2013, Volume: 13 Issue: 2, 54 - 56, 11.03.2014

Muhteşem Yayla

Abstract

Amaç: Migren erişkinlerde sık görülen ve sağlık sorunlarınaneden olan bir hastalıktır. Kronik günlük baş ağrısı (KGB),en az üç aydır ve ayda 15 günden fazla olan baş ağrılarınıtanımlamak için kullanılır 4. makalede birinci basamağabaşvuran klasik migrenli ve kronik günlük başağrılı hastalarısosyodemografik ve semptomatik açıdan değerlendirmeyi vekarşılaştırmayı amaçladık.

Gereç ve Yöntem: Mart 2012 ve Ağustos 2012 arası Afyon5 Nolu Aile Sağlığı Merkezi’ne başvuran hastalardan dahaönce nöroloji uzmanı tarafından migren tanısı almış hastalarınsosyodemografik ve semptomatik öyküleri alındı.

Bulgular: Çalışmaya 38 hasta katıldı. Kronik günlük baş ağrısıolan 8 hasta vardı (%21). Çalışmamızda migren auralarında,görsel semptomlar ön plandaydı (daha çok zigzag çizgiler).9 hastada (%23,7) aura vardı. Bu oran migrenle ilgili bilinenaura oranı ile uyumlu idi. Hastaların hepsinde bulantı varken,kusma sadece 12(%31,6)’sinde vardı. Fonofobi ve fotofobitüm hastalarda vardı. Hastaların 21’i (%45,7) tek taraflı ağrıtariflerken, 12’si(%26,1) bilateral ağrı, 5(%10,9) kişi de bazentek taraflı bazen de iki taraflı ağrı tarifliyordu. Orta veya ağırağrı yoğunluğunu 38 hasta (%100) tariflerken, 19 hasta (%50)eforla agreve olan ağrıdan bahsediyordu. Risk faktörlerininaraştırılmasında istatistiksel yöntem olarak Ki-kare Testikullanıldı.Risk faktörü olarak kabul edilen, obezite, horlama, uykuapnesi, uyku bozukluğu, cinsiyet,iskelet kas ağrısı, bekar veyaevli olma gibi faktörlerin klasik migrenli hastalarda kronikgünlük başağrısı için istatistiksel olarak anlamlı olmadıklarıgösterilmiştir.

Sonuç: Bu konu ile ilgili daha geniş örneklem gruplarındaparametrik testlerin yapıldığı çalışmalar gerekmektedir

Keywords

Olağan migren, kronik günlük başağrısı, Birinci Basamağa

Evaluation And Comparison Of Sociodemografic And Symptomatic Factors Among Patients Who Have Classic Migraine And Chronic Daily Headache Attended To Primary Care

Abstract

Objective: Migraine is a disease prevelant in adults and it arises medical problems. Chronic daily headache is a term used to describe headaches lasting for over 15 days in a month and lasting for at least 3 months.4 We aimed to evaluate and compare the sociodemografic and symptomatic data of patients presented to primary care who have classic migraine and chronic daily headache.Materials and Methods: Sociodemografic and symptomatic histories of patients who have had migraine diagnosis by a neurology specialist before and who have attended to 5th Family Medicine Center of Afyon between March 2012 and August 2012 were noted down. Findings: 38 patients were enrolled in this study. 33 patients were female (%86,8), 5 were male (13,2). 8 patients had chronic daily headache (%21).Visual symptoms were most frequent in auras, 9 patients (%23,7) had aura and this was correlating with the literature. All patients had nausea, but vomiting was seen in 12 (%31,6) patients. Phonophobia and photophobia was seen in all patients. 21 patients (45,7%) defined unilateral, 12 (26,1%) bilateral pain. 5 (10,9%) patients defined accordingly chancing pain. 38 (100%) patients had moderate or intense pain, 19 (50%) patients had pain aggrevating with exercise. Statistics with Chi-Square test revealed no statistical difference between classical migraine and chronic daily headache according to risc factors like having obesity, norring, sleep apnea, sleep disorder, head and muscle pain, being female or single.Conclusion: Parametric tests in wider samples should be done about this issue in the future.

Keywords

classic migraine, chronic daily headache, Evaluation

References

• Stewart WF,Shechter A,Rasmussen BK.Migraine prevalance.A review of population-based studies. Neurology 1994;44:17-23
• Stewart WF, Simon D, Shechter A, Lipton RB.Population variation in migraine prevalance:a meta-analysis. J Clin Epidemiol 1995; 48:269-280 Headache Classification Subcommitee of the International Headache Society.The International Classification of Headache Disorders,2nd ed. Cephalalgia 2004:24 (suppl 1):1-160
• Işıkay CT.Kronik Günlük Baş Ağrıları (Derleme). Türkiye Klinikleri 2008;1:47-53
• Bussone G.Pathophysiology of migraine.Neurol Sci 2004;25: 239-241
• Fisher L.Assessment of patients presenting with headache . Innovait 2011;0:1-9
• Lance Wl, Goadsby PJ.Mechanism and Management of Headache.7th edition 2005: 41-42
• Scher AI, Stewart WF, Ricci JA, Lipton RB. Factors associated with the onset and remis-sion of chronic daily headache in a population-based study. Pain 2003; 106(1/2):81-89.
• ME Bigal Bigal ME,Lipton RB Lipton RB. What predicts the change from episodic to chronic migraine? Curr Opin Neurol 2009 ; 22 : 269 – 276
• Scher AI, Lipton RB, Stewart WF. Habitual snoring as a risk factor for chronic daily headache. Neurology 2003; 60(8):1366.
• Scher AI, Stewart WF, Lipton RB. Caffeine as a risk factor for chronic daily headache: a population-based study. Neurology 2004; 63(11):2022-2027.
• Scher AI, Lipton RB, Stewart W. Risk factors for chronic daily headache. Curr Pain Headache Rep 2002; 6(6):486- 491.
• Wang SJ, Fuh JL, Lu SR, Juang KD. Chronic daily headache in adolescents. Prevalence, impact, and medication overuse. Neurology 2006; 66:193-197.
• Aaron LA, Buchwald D. A review of the evidence for overlap among unexplained clinical conditions. Ann Intern Med 2001; 134(9 Pt 2):868-881.
• Boardman HF, Thomas E, Millson DS, Croft PR. Psychological, sleep, lifestyle, and comorbid associations with headache. J Head Face Pain 2005; 45:657-669.
• Lu SR, Fuh JL, Chen WT, Juang KD, Wang SJ. Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors. Cephalalgia 2001; 21(10):980-986.
• Scher AI, Stewart WF, Liberman J, Lipton RB. Wolff Award 1998: Prevalence of fre-quent headache in a population sample. Headache: J Head Face Pain 1998; 38:497-506.
• Wang SJ, Fuh JL, Lu SR, et al. Chronic daily headache in Chinese elderly: prevalence, risk factors, and biannual follow-up. Neurology 2000; 2000(54):314-319.
• Hagen K, Vatten L, Stovner LJ, Zwart JA, Krokstad S, Bovim G. Low socio-economic status is associated with increased risk of frequent headache: a prospective study of 22718 adults in Norway. Cephalalgia 2002; 22(8):672- 679.