使用偏头痛残疾评估（MIDAS）问卷评估偏头痛残疾：慢性偏头痛与发作性偏头痛的比较。

Assessment of migraine disability using the migraine disability assessment (MIDAS) questionnaire: a comparison of chronic migraine with episodic migraine.

作者信息

Bigal Marcelo E, Rapoport Alan M, Lipton Richard B, Tepper Stewart J, Sheftell Fred D

机构信息

Department of Neurology, Albert Einstein College of Medicine, Office 334-A, Rousso Building, 1165 Morris Park Avenue, Bronx, NY 10461, USA.

出版信息

Headache. 2003 Apr;43(4):336-42. doi: 10.1046/j.1526-4610.2003.03068.x.

DOI:10.1046/j.1526-4610.2003.03068.x

PMID:12656704

Abstract

BACKGROUND

Chronic migraine is the most common type of chronic daily headache seen in headache tertiary care centers. Most patients with chronic migraine report their ability to function and feeling of well-being as severely impaired.

OBJECTIVE

To measure the headache-related disability of patients with chronic migraine using the Migraine Disability Assessment (MIDAS) Questionnaire, comparing it with that obtained in a control group of patients with episodic migraine.

METHODS

The clinical records of 703 patients with chronic daily headache treated in a headache specialty clinic were reviewed to identify 182 with chronic migraine who were evaluated using the MIDAS at their initial visit. Our control group consisted of 86 patients with episodic migraine.

RESULTS

Of the 182 patients with chronic migraine, 127 (69.8%) were overusing acute-care medication. Patients were predominantly women (72.5%), with a mean age of 38.3 years. The group with episodic migraine consisted of 59 women (68.6%), with a mean age of 36.1 years. No statistically significant demographic differences were observed between the two groups. The group with chronic migraine had more total headache days over 3 months (66.7 versus 15.5, P<.001), missed more days of work or school (5.3 versus 2.3, P =.0007), had more reduced effectiveness days at work or school (11.9 versus 4.6, P =.0001), missed more days of housework (16.5 versus 3.3, P<.0001), and missed more days of family, social, or leisure activities (7.0 versus 5.5, P =.03). The group with chronic migraine was more likely to be in MIDAS grade IV (64.3% versus 43.2%, P =.001), reflecting the great likelihood of severe disability in this group. The average total MIDAS score was 34.9 in the group with chronic migraine versus 19.3 in the group with episodic migraine (P<.001).

CONCLUSION

In subspecialty centers, patients with chronic migraine demonstrate remarkable impairment of their daily activities and are severely burdened by their headache syndrome, reflected by their high MIDAS scores. The chronicity and pervasiveness of migraine thus is associated with increased functional impairment as well as increase in headache frequency.

摘要

背景

慢性偏头痛是头痛三级护理中心最常见的慢性每日头痛类型。大多数慢性偏头痛患者报告其功能和幸福感严重受损。

目的

使用偏头痛残疾评估（MIDAS）问卷测量慢性偏头痛患者与头痛相关的残疾情况，并与发作性偏头痛患者对照组的情况进行比较。

方法

回顾了在头痛专科门诊接受治疗的703例慢性每日头痛患者的临床记录，以确定182例慢性偏头痛患者，他们在初次就诊时使用MIDAS进行评估。我们的对照组由86例发作性偏头痛患者组成。

结果

182例慢性偏头痛患者中，127例（69.8%）过度使用急性护理药物。患者以女性为主（72.5%），平均年龄38.3岁。发作性偏头痛组由59名女性（68.6%）组成，平均年龄36.1岁。两组之间未观察到统计学上显著的人口统计学差异。慢性偏头痛组在3个月内的总头痛天数更多（66.7天对15.5天，P<0.001），错过的工作或学习天数更多（5.3天对2.3天，P = 0.0007），工作或学习效率降低的天数更多（11.9天对4.6天，P = 0.0001），错过的家务天数更多（16.5天对3.3天，P<0.0001），错过的家庭、社交或休闲活动天数更多（7.0天对5.5天，P = 0.03）。慢性偏头痛组更有可能处于MIDAS IV级（64.3%对43.2%，P = 0.001），这反映了该组严重残疾的可能性很大。慢性偏头痛组的平均MIDAS总评分为34.9分，而发作性偏头痛组为19.3分（P<0.001）。