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Analysis of Patients Attending Headache
Clinic: An Indian Experience
Y. Ganesh, Y. Nalini, et al.
Posted: March 2005  
CephalalgiaVol. 20, Number 4

Objective:   To analyze the clinical features and diagnoses of the patients who attended the headache clinic from 1997 to 2000.

Materials and Methods:  Some 662 patients were examined and investigated by a team of specialists comprising the physician, ophthalmologist, neurologist, ENT surgeon and psychiatrist. We classified these patients according to the IHS guidelines. The patients underwent routine investigations after history and physical examination. Patients with high index of suspicion for intracranial pathology were subjected to a CT/MRI scan of the brain.

Results:   Five hundred and ten patients were suffering from migraine with a male to female ration of 15:85. More than 99% of these patients had migraine without aura. Only three patients had a visual aura and one patient had paraesthesia. Among 152 nonmigrainous patients, 40 had tension headaches, 20 had cluster headaches, 19 ENT causes and 8 ophthalmic causes. Eight patients who presented with headache were having mild hypothyroidism. Two patients had primary intracranial neoplasm, two secondary malignant deposits, two neurocysticercosis, two tuberculoma of brain and two trigeminal neuralgia. Traumas, stroke, arteriovenous malformations and weightlifting were the other causes (one patient each). Constipation was a predominant symptom in 12 patients and four of them had immediate relief from headache after defecation. The remaining patients could not be categorized into IHS classification.

Conclusions:  The interesting features in this study are a very low incidence of classic migraine, hypothyroidism presenting as headache and headache associated with constipation.