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The Frequency of Primary Headache in MS Patients

Yıl 2021, , 131 - 137, 30.03.2021
https://doi.org/10.20515/otd.778605

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.

Kaynakça

  • 1. Zettl UK, Stuve O, Patejdl R. Immune-mediated CNS diseases: a review on nosological classification and clinical features. Autoimmunity reviews. 2012;11:167–73.
  • 2. IHS The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;24 (l): 9–160.
  • 3. Stovner L, Hagen K, Jensen R, et al. (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.
  • 4. Möhrke J, Kropp P, Zettl UK. Headaches in Multiple Sclerosis Patients Might Imply an Inflammatorial Process. PLoS ONE. 2013;8(8):e69570.
  • 5. Levy D. Migraine pain, meningeal inflammation, and mast cells. Curr Pain Headache Rep. 2009;13:237–40.
  • 6.Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nature reviews. Neuroscience. 2011;12:570–84.
  • 7. Villani V, Prosperini L, Ciuffoli A, et al. Primary headache and multiple sclerosis: preliminary results of a prospective study. Neurol Sci. 2008;29(1):146–8.
  • 8. D’Amico D, La Mantia L, Rigamonti A, et al. Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia. 2004;24:980–4.
  • 9. Kister I, Caminero AB, Herbert J, et al. Tension-type headache and migraine in multiple sclerosis. Curr Pain Headache Rep. 2010;14:441–8.
  • 10. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.
  • 11. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13:147–57.
  • 12. Gee JR, Chang J, Dublin AB, et al. The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache. 2005;45:670–7.
  • 13. Nicoletti A, Patti F, Lo Fermo S, et al. Headache and multiple sclerosis: a population-based case-control study in Catania, Sicily. Cephalalgia. 2008;28:1163–9.
  • 14. Putzki N, Pfriem A, Limmroth V, et al. Prevalence of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. Eur J Neurol. 2009;16:262–7.
  • 15. Yetimalar Y, Secil Y, Inceoglu AK, et al. Unusual primary manifestations of multiple sclerosis. N Z Med J. 2008;121:47–59.
  • 16. Boneschi FM, Colombo B, Annovazzi P, et al. Lifetime and actual prevalence of pain and headache in multiple sclerosis. Mult Scler. 2008;14:514–21.
  • 17. Pöllmann W, Erasmus LP, Feneberg W, et al. Interferon beta but not glatiramer acetate therapy aggravates headaches in MS. Neurology. 2002;59:636–9.
  • 18. Akpınar Z, Tokgöz OS, Gümüş H. The Relationship Between Pain and Clinical Features in Multiple Sclerosis. Turkish Journal of Neurology. 2014;20:79-83.
  • 19. Sorgun MH, Yücesan C. Multipl Sklerozda Baş Ağrısı ve Fonksiyonel Sistem Tutulumu. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2011;64:81-5.
  • 20. Diamond S, Bigal ME, Silberstein S, et al. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache. 2007;47:355–63.
  • 21. Kister I, Caminero AB, Monteith TS, et al. Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course. J Headache Pain. 2010;11:417–25.
  • 22. Vacca G, Marano E, Brescia Morra V, et al. Multiple sclerosis and headache co-morbidity. A case-control study. Neurol Sci. 2007;28:133–5.
  • 23. Mantia La, Amico DD, Rigamonti A, et al. Interferon treatment may trigger primary headaches in multiple sclerosis patients. Multiple Sclerosis. 2006;12:476–80.
  • 24.Pöllmann W, Erasmus LP, Feneberg W, et al.The effect of glatiramer acetate treatment on pre-existing headaches in patients with MS. Neurology. 2006;66:275–7.

Multipl Sklerozda Primer Baş Ağrısı Sıklığı:

Yıl 2021, , 131 - 137, 30.03.2021
https://doi.org/10.20515/otd.778605

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.

Destekleyen Kurum

bulunmamaktadır

Kaynakça

  • 1. Zettl UK, Stuve O, Patejdl R. Immune-mediated CNS diseases: a review on nosological classification and clinical features. Autoimmunity reviews. 2012;11:167–73.
  • 2. IHS The International Classification of Headache Disorders: 2nd edition. Cephalalgia 2004;24 (l): 9–160.
  • 3. Stovner L, Hagen K, Jensen R, et al. (2007) The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210.
  • 4. Möhrke J, Kropp P, Zettl UK. Headaches in Multiple Sclerosis Patients Might Imply an Inflammatorial Process. PLoS ONE. 2013;8(8):e69570.
  • 5. Levy D. Migraine pain, meningeal inflammation, and mast cells. Curr Pain Headache Rep. 2009;13:237–40.
  • 6.Akerman S, Holland PR, Goadsby PJ. Diencephalic and brainstem mechanisms in migraine. Nature reviews. Neuroscience. 2011;12:570–84.
  • 7. Villani V, Prosperini L, Ciuffoli A, et al. Primary headache and multiple sclerosis: preliminary results of a prospective study. Neurol Sci. 2008;29(1):146–8.
  • 8. D’Amico D, La Mantia L, Rigamonti A, et al. Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia. 2004;24:980–4.
  • 9. Kister I, Caminero AB, Herbert J, et al. Tension-type headache and migraine in multiple sclerosis. Curr Pain Headache Rep. 2010;14:441–8.
  • 10. Polman CH, Reingold SC, Banwell B, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292-302.
  • 11. Ertas M, Baykan B, Orhan EK, et al. One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults. J Headache Pain. 2012;13:147–57.
  • 12. Gee JR, Chang J, Dublin AB, et al. The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache. 2005;45:670–7.
  • 13. Nicoletti A, Patti F, Lo Fermo S, et al. Headache and multiple sclerosis: a population-based case-control study in Catania, Sicily. Cephalalgia. 2008;28:1163–9.
  • 14. Putzki N, Pfriem A, Limmroth V, et al. Prevalence of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. Eur J Neurol. 2009;16:262–7.
  • 15. Yetimalar Y, Secil Y, Inceoglu AK, et al. Unusual primary manifestations of multiple sclerosis. N Z Med J. 2008;121:47–59.
  • 16. Boneschi FM, Colombo B, Annovazzi P, et al. Lifetime and actual prevalence of pain and headache in multiple sclerosis. Mult Scler. 2008;14:514–21.
  • 17. Pöllmann W, Erasmus LP, Feneberg W, et al. Interferon beta but not glatiramer acetate therapy aggravates headaches in MS. Neurology. 2002;59:636–9.
  • 18. Akpınar Z, Tokgöz OS, Gümüş H. The Relationship Between Pain and Clinical Features in Multiple Sclerosis. Turkish Journal of Neurology. 2014;20:79-83.
  • 19. Sorgun MH, Yücesan C. Multipl Sklerozda Baş Ağrısı ve Fonksiyonel Sistem Tutulumu. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2011;64:81-5.
  • 20. Diamond S, Bigal ME, Silberstein S, et al. Patterns of diagnosis and acute and preventive treatment for migraine in the United States: results from the American Migraine Prevalence and Prevention study. Headache. 2007;47:355–63.
  • 21. Kister I, Caminero AB, Monteith TS, et al. Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course. J Headache Pain. 2010;11:417–25.
  • 22. Vacca G, Marano E, Brescia Morra V, et al. Multiple sclerosis and headache co-morbidity. A case-control study. Neurol Sci. 2007;28:133–5.
  • 23. Mantia La, Amico DD, Rigamonti A, et al. Interferon treatment may trigger primary headaches in multiple sclerosis patients. Multiple Sclerosis. 2006;12:476–80.
  • 24.Pöllmann W, Erasmus LP, Feneberg W, et al.The effect of glatiramer acetate treatment on pre-existing headaches in patients with MS. Neurology. 2006;66:275–7.
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Musa Öztürk 0000-0001-9652-384X

Mesude Tutuncu 0000-0002-1176-3156

Rabia Gökçen Gözübatık Çelik 0000-0002-8186-8703

Selma Topaloğlu Tunç Bu kişi benim 0000-0002-1190-0771

Fulya Başoğlu Koseahmet 0000-0002-9277-6644

Aysun Soysal 0000-0002-1598-5944

Yayımlanma Tarihi 30 Mart 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Öztürk M, Tutuncu M, Gözübatık Çelik RG, Topaloğlu Tunç S, Başoğlu Koseahmet F, Soysal A. Multipl Sklerozda Primer Baş Ağrısı Sıklığı:. Osmangazi Tıp Dergisi. 2021;43(2):131-7.


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