The Frequency of Primary Headache in MS Patients

Öz

Multiple sclerosis (MS) and primary headaches are the neurological diseases that most affect the quality of life in young adults. In our study, we aimed to investigate the primary headache frequency, types of MS patients, to shed light on appropriate treatment options, to improve the quality of life of patients and to investigate the relationship between headache and disease modifying drug (DMD)The study included 258 patients with definitive Relapsing Remitting Multiple Sclerosis (RRMS) followed up in the MS outpatient clinic of our hospital. Patients were questioned with the 'Headache Form' prepared in line with the headache diagnostic criteria. Headache rates, sociodemographic characteristics of patients, the relationship of headache with attacks and treatment were examined. The data were analysed with IBM SPSS V18.The mean age of 258 MS patients with 153 (59.3%) headache was 38.03 ± 11.23 years (min-max: 18-66 years), 36.20 ± 13.80 years in women (min- max: 18-64 years), 39.08 ± 14.12 (min-max: 19-66 years) in men. 61.60% of the patients were diagnosed with tension headache (GTBA), 35.94% of migraine, 1.81% of neuralgiform pain and 0.65% of cluster headache. Of the 55 migraine patients, 30.9% were higher than the normal population, with migraine with aura (most often visual-aura). Most of the patients with headache were female (79.7%) and younger (p <0.001). Headache was adversely affected after MS diagnosis in 22.9% of 153 patients; There was an increase in headache frequency in 57.1% and severity in 51.6%. There was no relationship between the duration of the disease and the presence of headache (p> 0.05). With the long-term disease-modifying drugs used, 28.23% worsening was observed in the patients' headache, which was not statistically significant (p> 0.05). Primary headache should be taken into consideration in the planning of diagnosis and tests in MS patients, and unnecessary examinations should be avoided. In conclusion, we expect patients to have better quality of life with appropriate diagnosis and treatment of headache in addition to MS treatment.

Multipl Sklerozda Primer Baş Ağrısı Sıklığı:

Öz

Multiple skleroz (MS) ve primer baş ağrıları genç erişkinde yaşam kalitesini en çok etkileyen nörolojik hastalıklardandır. Çalışmamızda MS hastalarının primer baş ağrı sıklığını,tiplerini araştırarak uygun tedavi seçeneklerine ışık tutmayı, hastaların yaşam kalitelerini yükseltmeyi ve baş ağrısının hastalık modifiye edici tedavi ile ilişkisiniaraştırmayı amaçladık.Çalışmaya hastanemiz MS polikliniğinde takip edilen kesin Relapsing Remitting Multiple Skleroz (RRMS) tanılı 258 hasta dahil edildi. Baş ağrısı tanı kriterleri doğrultusunda hazırlanan ‘Baş ağrısı Formu’ ile hastalar sorgulandı. Baş ağrısı oranları, hastaların sosyodemografik özellikleri, baş ağrısının ataklarla, tedaviyle ilişkileri incelendi. Veriler IBM SPSS V18 ile analiz edildi.153(%59,3)’ünde başağrısı saptanan258 MS hastasının ortalama yaşı 38,03±11,23 yıl (min-max: 18-66 yıl), , kadınlarda 36,20±13,80 yıl (min-max: 18-64yıl),erkeklerde 39,08±14,12(min-max:19-66yıl)idi. Hastaların % 61,60’sı gerilim tipi baş ağrısı (GTBA), % 35,94’ü migren,%1,81’inevraljiform ağrı ve %0.65’i küme tipi baş ağrısı tanısı aldı. 55 migren hastasında% 30,9 oranında auralı migren(en sık vizüel-aura)mevcut olup, bu oran MS u olmayan migrenlilerde aura görülme sıklığına göre çok yüksekti.Baş ağrısı olan hastaların çoğu kadın cinsiyette (%79,7) ve daha genç yaştaydı (p<0.001). 153 hastamızın %22,9’sinde MS tanısından sonra baş ağrısı olumsuz yönde etkilenmişti; bunların %57,1’inde başağrısı sıklığında, %51,63’ündeşiddetinde artış mevcuttu. Hastalık süresi ile baş ağrısı varlığı açısından bir ilişki izlenmedi (p>0.05).Kullanılan uzun dönem hastalık modifiye edici ilaçlar ile hastaların başağrısında %28,23 oranında kötüleşme saptanmış olup bu durum istatistiksel olarak anlamlı bulunmamıştır (p>0.05).Primer baş ağrısının MS hastalarında yüksek oranda görüldüğü tanı ve tetkiklerin planlanmasında gözönüne alınmalı, gereksiz incelemelerden kaçınılmalıdır. Sonuçta MS tedavisinin yanında başağrısının uygun tanı ve tedavisi ile hastaların yaşamlarının daha kaliteli hale gelmesini beklemekteyiz.

Anahtar Kelimeler

• multipl skleroz,
• gerilim tipi baş ağrısı
• migren
• hastalık modifiye edici tedavi

Kaynakça

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