印度西部农村地区癫痫患者头痛障碍的患病率。
Prevalence of headache disorders in patients living with epilepsy in rural region in western part of India.
机构信息
Neurology Resident, Department of Neurology, Shree Krishna Hospital and Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India.
Medicine Resident, Department of Medicine, Shree Krishna Hospital and Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India.
出版信息
Epilepsy Behav. 2023 Feb;139:109063. doi: 10.1016/j.yebeh.2022.109063. Epub 2023 Jan 6.
BACKGROUND AND AIMS
Headache disorders cause significant distress in patients living with epilepsy (PWE) and are underreported. This study aimed to evaluate the prevalence of various forms of headache in PWE.
METHODOLOGY
Two hundred and three PWE were evaluated for the presence and type of headache as per the International Classification of Headache Disorders (ICHD)-3 classification criteria. The severity was graded using the Headache Under Response to Treatment (HURT)-3. A subgroup analysis of headache and epilepsy was done. The World Health Organization-5 (WHO-5) questionnaire was used to assess mental well-being. The Mini International Neuropsychiatric Interview (MINI) questionnaire was used to study the psychiatric comorbidities, which were classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV classification.
RESULTS
The prevalence of headaches in PWE was 45% [60% females]. Female gender and younger age were significantly associated with migraine (p values of 0.03 and 0.05, respectively). Migraine was the most common type of headache (71%), followed by tension-type headache (TTH) (23%) in PWE. The headache was inter-ictal in 80% of PWE. In PWE with migraine, both juvenile myoclonic epilepsy (JME) and frontal lobe epilepsy (FLE) had a 28% prevalence. In PWE with TTH, FLE was more common (43%). The prevalence of migralepsy in PWE was 4% [n = 4; 2 each of occipital lobe epilepsy (OLE) and idiopathic generalized epilepsy (IGE)]. A psychiatric illness was more than two times more likely in PWE with headache (n = 34; 37%) as compared to PWE without headache (n = 19; 17%). Patients living with epilepsy with headaches and psychiatric comorbidities had significantly lower mental well-being (p = 0.001). Forty five percent of PWE with headaches required acute management, and 35% required prophylactic management for their headache.
CONCLUSION
Headache is frequently ignored in PWE. It can affect their mental health and quality of life. Evaluation and management of headache in PWE is very important.
背景与目的
头痛障碍会给癫痫患者（PWE）带来严重困扰，但头痛的报告率却较低。本研究旨在评估 PWE 中各种类型头痛的患病率。
方法
根据国际头痛疾病分类（ICHD）-3 分类标准，对 203 例 PWE 进行头痛的存在和类型评估。使用头痛治疗反应不佳量表（HURT）-3 对严重程度进行分级。对头痛和癫痫的亚组进行了分析。使用世界卫生组织-5（WHO-5）问卷评估心理健康。使用迷你国际神经精神访谈（MINI）问卷研究精神共病，根据精神障碍诊断与统计手册（DSM）-IV 分类进行分类。
结果
PWE 头痛的患病率为 45%[女性占 60%]。女性性别和年龄较小与偏头痛显著相关（p 值分别为 0.03 和 0.05）。偏头痛是 PWE 最常见的头痛类型（71%），其次是紧张型头痛（TTH）（23%）。80%的 PWE 头痛为发作间期头痛。在偏头痛 PWE 中，青少年肌阵挛性癫痫（JME）和额叶癫痫（FLE）的患病率均为 28%。在 TTH PWE 中，FLE 更为常见（43%）。PWE 中偏头痛的患病率为 4%[n=4；分别为枕叶癫痫（OLE）和特发性全面性癫痫（IGE）各 2 例]。与无头痛的 PWE（n=19；17%）相比，有头痛的 PWE（n=34；37%）发生精神疾病的可能性高出两倍以上。患有头痛和精神共病的癫痫患者的心理健康状况明显较差（p=0.001）。45%的头痛 PWE 需要急性治疗，35%需要预防性治疗头痛。
结论
头痛在 PWE 中经常被忽视。它会影响他们的心理健康和生活质量。评估和管理 PWE 中的头痛非常重要。
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