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