J Clin Neurol.  2016 Jul;12(3):316-322. 10.3988/jcn.2016.12.3.316.

Chronic Daily Headache and Medication Overuse Headache in First-Visit Headache Patients in Korea: A Multicenter Clinic-Based Study

• Cha MJ
• Moon HS
• Sohn JH
• Kim BS
• Song TJ
• Kim JM
• Park JW
• Park KY
• Kim SK
• Kim BK
• Cho SJ

• KMID: 2354119
• DOI: http://doi.org/10.3988/jcn.2016.12.3.316

Abstract

BACKGROUND AND PURPOSE
Chronic daily headache (CDH) is defined as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. The aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among first-visit headache patients presenting at neurology outpatient clinics in Korea.
METHODS
Eleven neurologists enrolled first-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classified according to the International Classification of Headache Disorder (third edition beta version) by each investigator.
RESULTS
Primary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and definite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). The frequency of CDH did not differ between secondary and tertiary referral hospitals.
CONCLUSIONS
The frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in first-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.

Keyword

chronic daily headache; epidemiology; medication overuse headache; migraine; tension-type headache; headache

MeSH Terms

Ambulatory Care Facilities
Classification
Diagnosis
Epidemiology
Headache Disorders*
Headache Disorders, Secondary*
Headache*
Humans
Korea*
Migraine Disorders
Neurology
Prescription Drug Overuse*
Research Personnel
Tension-Type Headache
Tertiary Care Centers

Figure

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  Fig. 1 Frequency of chronic daily headache by age at onset and sex.

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  Fig. 2 Proportion of medication overuse headache (MOH) among patients with CDH and other headache disorders. CDH: chronic daily headache, NDPH: new daily persistent headache, TTH: tension-type headache.

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