Demetgul Ozcan, Duman Taskin, Guntel Murat
Neurology Clinic, Hatay State Hospital, Antakya, Hatay, Turkey.
Neurology Department, Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey.
Neurol India. 2020 Nov-Dec;68(6):1333-1337. doi: 10.4103/0028-3886.304126.
In this study, we aimed to investigate the prevalence of primary headaches in patients with multiple sclerosis (MS), to determine the type of headache according to the criteria of International Headache Society and to investigate the relationship between primary headache type and MS subtype, and the relationship between the localization of plaques in the brain magnetic resonance imaging (MRI) with MS clinic.
In this study, we include the patients diagnosed with MS according to the Mc Donald criteria and functional loss determined with Expanded Disability Status Scale (EDSS). We include the patients who were questioned about headache characteristics in detail and the patients who have MRI previously. MRI evaluations of plaque localization of the patients were classified retrospectively.
Headache in 54.4% of 320 patients participated in the study are available (23.8% tension-type headache (TTH), 30.6% migraine). When we look at the first three initial symptoms of MS patients, the patients who have polysymptomatic symptoms at the beginning are 25.3%, those with motor symptoms are 23.1%, and patients with optical symptoms are 19.7%. The mean EDSS was 2.6 ± 1.9. When we look the lesion localization, at most pericallosal lesions are present. Mean disease duration was 9.9 years in patients with TTH and 4.5 years in patients with migraine. The difference was statistically significant (P < 0.05). The mean EDSS score was 4.7 in patients with TTH and 1.8 in patients with migraine, and the difference was statistically significant (P < 0.001). The average number of lesions in the brain was 22.07 in patients with TTH and 15.79 in patients with migraine. The difference was statistically significant (P < 0.001).
In this study, the frequency of headache in MS patients was found to be greater than the general population and we found a higher incidence of migraine-type headache in these patients. We observed that the tension type of headache is more frequent in MS patients with higher ages, longer disease duration, more plaque numbers, and high EDSS scores.
在本研究中，我们旨在调查多发性硬化症（MS）患者原发性头痛的患病率，根据国际头痛协会的标准确定头痛类型，并研究原发性头痛类型与MS亚型之间的关系，以及脑磁共振成像（MRI）中斑块定位与MS临床症状之间的关系。
在本研究中，我们纳入了根据麦克唐纳标准诊断为MS且用扩展残疾状态量表（EDSS）确定功能丧失情况的患者。我们纳入了详细询问头痛特征的患者以及之前进行过MRI检查的患者。对患者斑块定位的MRI评估进行回顾性分类。
参与研究的320例患者中，54.4%有头痛症状（23.8%为紧张型头痛（TTH），30.6%为偏头痛）。当我们查看MS患者的前三个初始症状时，最初有多种症状的患者占25.3%，有运动症状的患者占23.1%，有视觉症状的患者占19.7%。平均EDSS为2.6±1.9。当查看病变定位时，胼胝体周围病变最多。TTH患者的平均病程为9.9年，偏头痛患者为4.5年。差异具有统计学意义（P<0.05）。TTH患者的平均EDSS评分为4.7，偏头痛患者为1.8，差异具有统计学意义（P<0.001）。TTH患者脑内病变的平均数量为22.07个，偏头痛患者为15.79个。差异具有统计学意义（P<0.001）。
在本研究中，发现MS患者头痛的频率高于一般人群，并且我们发现这些患者中偏头痛型头痛的发病率更高。我们观察到，在年龄较大、病程较长、斑块数量较多且EDSS评分较高的MS患者中，紧张型头痛更为常见。
