A Study of clinical profile of five hundred cases of primary Headaches.

Selvaraj, C (2011) A Study of clinical profile of five hundred cases of primary Headaches. Masters thesis, Madurai Medical College, Madurai.


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Introduction: Headache is one among the most common medical complaints. Various forms of headache, properly called headache disorders, are among the most common disorders of the nervous system. They are pandemic and, in many cases, life-long conditions. Recurrent headache disorders impose a substantial burden on headache sufferers, family and society. Almost 90% headache cases seen in practice are classified as primary headaches, and they are defined as headaches that are not caused by an identifiable underlying structural, vascular or systemic illness. Although the epidemiology of headache disorders is only partly documented, taken together, headache disorders are extraordinarily common. This work of dissertation has been done with an aim at documenting the different types of primary headaches, their clinical presentations and responses to prophylaxis among patients presented to the Neurology Out Patient Department, Govt.Rajaji Hospital, Madurai during an one year period. Aims and Objectives: This study is aimed to 1. To classify and study the incidence of various types of Primary Headache among patients presented at Neurology Outpatient Department, Govt. Rajaji Hospital, Madurai. 2. Study the Clinical Profile of each type of Primary Headache. 3. Study the various patterns of response to prophylaxis in Migraine. CONCLUSIONS: The observations of this study are here with summarised 1. Migraine is the commonest type of headache comprising of about 76%. Migraine without aura [48%] was more common than migraine with aura [32%]. Female preponderance was noticed in all subtypes of migraine, age of onset being in 2nd and 3rd decade for majority of the subgroups of migraine, except for basilar migraine which was common in 1st and 2nd decade. Migraine pain was temporal in location, unilateral, throbbing in character, lasting for 12 to 24 hours in majority of the cases. 2. Chronic migraine, Migraine triggered seizures and Migrainous infarction were the complications of migraine encountered in this study in the order of frequency of occurrence. Transformation to Chronic migraine was more common from episodic forms and in patients with onset of migraine in teens or twenties. Among patients with migraine and seizures, 13 patients were grouped under migraine triggered seizures that differed from the classical description of migralepsy in their duration of headache, with a window period of more than two hours prior to the seizure. This 74 group of patients presented with both migraine with aura and migraine without aura and responded to anti-migrainous prophylaxis alone with a 1 year episode free period. 3. Tension type headache constituted about 20% of cases, Chronic tension type headache was the commonest type (48%), majority of cases occurred in fourth decade with female preponderance. 4. Patients with all types of migraine responded well to Antimigraine prophylactic drugs. Among migraine patients on combination prophylaxis with Propronolol and amitryptiline, 16% responded with disease free interwal of more than 1 year, while it was 12% for patients on propronolol and 10% for patients on amitryptiline. The response rate with disease free interwal in the range of 6 to 12 months was 33%, 27% and 18% for the above respective group of drugs.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Primary Headaches ; clinical profile.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 03 Jul 2017 08:27
Last Modified: 03 Jul 2017 08:27
URI: http://repository-tnmgrmu.ac.in/id/eprint/796

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