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ORIGINAL ARTICLE
Year : 2011  |  Volume : 53  |  Issue : 2  |  Page : 134-139

Comparison of clinical characteristics of migraine and tension type headache


Department of Psychiatry, University College of Medical Sciences and GTB Hospital, Dilshad Garden, Delhi, India

Correspondence Address:
Ravi Gupta
Sleep and Headache Care, 1061, Kissan Marg, Barkat Nagar, Jaipur - 302 015, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5545.82538

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Context: Migraine and tension type headache (TTH) are two most common types of primary headaches. Though the International Classification of Headache Disorders-2 (ICHD-2) describes the diagnostic criteria, even then in clinical practice, patients may not respect these boundaries resulting in the difficulty in diagnosis of these pains. Materials and Methods: This cross-sectional study involved 50 subjects in each of the two groups - migraine and TTH - after screening for the inclusion and exclusion criteria. Diagnosis was made according to the ICHD-2 criteria. Their clinical history was taken in detail and noted in a semi-structured performa. They were examined for the presence of a number of factors like pericranial tenderness and muscle parafunction. Statistical analysis was done with the help of SPSS v 11.0. To compare the non-parametric issues, chi-square test was run and continuous variables were analyzed using independent sample t test. Results: In general, migraineurs had progressive illness (χ2=9.45; P=0.002) with increasing severity (χ2 =21.86; P<0.001), frequency (χ2 =8.5; P=0.04) and duration of each headache episode (χ2 =4.45; P=0.03) as compared to TTH subjects. Along with the headache, they more commonly suffered orthostatic pre-syncope (χ2 =19.94; P<0.001), palpitations (42%vs.18% among TTH patients; χ2 =6.87; P=0.009), nausea and vomiting (68% vs. 6% in TTH; χ2 =41.22; P<0.001, and 38% vs. none in TTH; χ2 =23.45, P<0.001, respectively), phonophobia (χ2 =44.98; P<0.001), photophobia (χ2 =46.53; P<0.001), and osmophobia (χ2 =15.94; P<0.001). Their pain tended to be aggravated by head bending (χ2 =50.17; P<0.001) and exercise (χ2 =11.41; P<0.001). Analgesics were more likely to relieve pain in migraineurs (χ2 =21.16; P<0.001). In addition, post-headache lethargy was more frequent among the migraineurs (χ2 =22.01; P<0.001). On the other hand, stressful situations used to trigger TTH (χ2 =9.33; P=0.002) and muscle parafunction was more common in TTH patients (46% vs. 20%; χ2 =7.64; P=0.006). All the cranial autonomic symptoms were more common in migraineurs as compared to TTH subjects (conjunctival injection: χ2 =10.74, P=0.001; lacrimation: χ2 =17.82, P<0.001; periorbital swelling: χ2 =23.45, P<0.001; and nasal symptoms: χ2 =6.38, P=0.01). Conclusion: A number of symptoms that are presently not included in the ICHD-2 classification may help in differe-ntiating the migraine from the TTH.



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