延迟性酒精性头痛的临床特征：一项 1108 名参与者的研究。

Clinical characterization of delayed alcohol-induced headache: A study of 1,108 participants.

机构信息

From the Headache Unit (D.G.-A., A.L.G.-P.), Neurology Department (B.T.), Hospital Clínico Universitario; Medicine Faculty (L.A.-C.), University of Valladolid, Spain; Pain Management Clinic (A.J.), RC Hospital and Clinics, Olivia, MN; Danish Headache Center (H.W.S.), Department of Neurology, Rigshospitalet-Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; and Institute of Biomedical Research of Salamanca (A.L.G.-P.), Salamanca, Spain.

出版信息

Neurology. 2020 Oct 13;95(15):e2161-e2169. doi: 10.1212/WNL.0000000000010607. Epub 2020 Sep 1.

DOI:10.1212/WNL.0000000000010607

PMID:32873689

Abstract

OBJECTIVE

To evaluate the International Classification of Headache Disorders (ICHD) criteria and to characterize the clinical phenotype of delayed alcohol-induced headache (DAIH).

METHODS

We conducted a cross-sectional study of university students who voluntarily consumed alcohol and experienced headache. Participants completed a survey that included demographic and clinical data. We analyzed the phenotype of the headache, validated ICHD phenotype criteria for DAIH, and analyzed whether participants fulfilled criteria for low-CSF-pressure headache or migraine.

RESULTS

A total of 1,108 participants were included (58% female, mean age 23 years, 41% with headache history). Mean alcohol intake was 158 g; spirits were consumed by 60% of the participants; beer was consumed by 41%; and wine was consumed by 18%. The ICHD criteria for DAIH were met in 95% of the participants. Headache duration (mean, 6.7 hours) correlated with total grams of alcohol consumed ( = 0.62, = 0.03). Pain was bilateral in 85% of patients with predominantly frontal topography (43%). Pain quality was mainly pressing (60%) or pulsatile (39%) and was aggravated by physical activity in 83% of participants. ICHD low-CSF pressure-headache criteria were fulfilled in 58% of patients, and migraine criteria were fulfilled by 36%.

CONCLUSIONS

DAIH is a moderate-intensity headache, is typically bilateral, and presents with frontal predominance and a pressing quality. The phenotype of DAIH combines features of both migraine and low-CSF-pressure headaches.

摘要

目的

评估国际头痛疾病分类（ICHD）标准，并描述迟发性酒精性头痛（DAIH）的临床表型。

方法

我们进行了一项横断面研究，纳入了自愿饮酒并出现头痛的大学生。参与者完成了一份包括人口统计学和临床数据的调查问卷。我们分析了头痛的表型，验证了 ICHD 标准中 DAIH 的表型标准，并分析了参与者是否符合低颅压性头痛或偏头痛的标准。

结果

共纳入 1108 名参与者（女性占 58%，平均年龄 23 岁，41%有头痛史）。平均饮酒量为 158 克；60%的参与者饮用烈酒，41%饮用啤酒，18%饮用葡萄酒。95%的参与者符合 ICHD 标准中 DAIH 的标准。头痛持续时间（平均 6.7 小时）与饮酒总量呈正相关（ = 0.62， = 0.03）。85%的患者头痛呈双侧性，主要位于额部（43%）。疼痛性质主要为压迫性（60%）或搏动性（39%），83%的参与者在体力活动后疼痛加重。58%的患者符合 ICHD 低颅压性头痛标准，36%的患者符合偏头痛标准。