| Objective:To compare the symptomatic characteristics of the chronic tension-type headache(CTTH)and chronic migraine(CM).To analyze the clinical predictors of chronic tension headache and chronic migraine.Methods:Information on outpatients admitted to department of neurology who complaint with headache from December 2016 to March 2017 were surveyed;The semi-structured questionnaire of headache which developed by ourselves was adopted.Clinical symptoms,supplementary examination,past history were collected.Diagnosis of chronic tension headache and chronic migraine was performed by the Headache Study Group based on the International Classification of Headache Disorders,3rd edition(beta version),ICHD-3-beta.All the quantitative data follow a normal distribution are expressed as mean 士 standard deviation.The t-test was used for the between-group comparison.The median and the quartile range were used to describe the skewness distribution.The proportion(N)and ratio(%)were used in the count data.The Chi-square test was used for comparing the symptomatic differences between CM and CTTH in the between-group.The correlation of CM,CTTH and headache risk factors was carried out by logistic regression analysis.All data were analyzed by SPSS 20.0 software.Results:(1).A total of 6684 outpatients were collected,among which 584 patients complained headache and 124 patients were diagnosed to CTTH,with an average age of 46.44 ± 11.51 years and 87 patients(70.16%).The average age of the patients in the CTTH group was higher than that in the CM group(P<0.05),and the average age was 43.43 ± 12.11 years.(2).Symptomatic features of CTTH including:CTTH patients with headache are more accompanied by dizziness(20.96%vs.10.96%,OR=2.15,95%CI,1.11-4.18),headache was more often seen in entire head(24.19%vs.5.80%,OR=5.17,95%CI,2.35-11.39),posterior occipital(21.77%vs.12.25%,OR=1.99,95%CI,1.05-3.78),forehead(19.35%vs.7.09%,OR=3.14,95%CI,1.47-6.70),and cupula headache(15.32%vs.7.09%,OR=2.37,95%Cl,1.08-5.18).Oppressive pain(66.12%vs.25.16%,OR=5.81.95%CI,3.45-9.76)and constriction pain(15.32%vs.1.93%,OR=9.16,95%CI,2.64-31.77)were more common in the patients with CTTH.Headache duration lasts for more than 72 hours was more often seen in patients with CTTH(19.35%vs.10.32%,R = 2.08.95%CI,1.05-4.12),and often can not be self-remission(49.19%vs.35.48%,OR = 0.56),95CI,0.35-0.92).Symptoms characteristics of CM including:auditory symptoms were more common in CM group than that of CTTH(25.16%vs.13.70%,OR = 0.47,95%CI,0.25-0.88),Unilateral headache was more common(68.38%vs.14.51%,OR = 0.08,95%CI,0.04-0.14),throbbing pain was more common(74.83%vs.4.83%,OR = 0.02,95%CI,0.01-0.04),intermittent pain was more chef(93.54%vs.81.45%,OR = 3.30,95%CI,1.51-7.24);and family history of headache was more common in CM patients(21.29%vs.8.87%,OR= 0.36,95%CI,0.17-0.74).(3).Multivariate logistic regression analysis showed that dizziness,vertigo,mild headache,and moderate headache were predictors of tension-type headache progress to CTTH.Tension-type headache patients accompany dizziness had a 2.47-fold increase in the risk of developing CTTH than other symptoms(OR=2.47,95%CI,1.22-5.01),The risk of tension-type headache with vertigo developing CTTH was 2.37-fold(OR=2.37,95%CI,1.19-4.73)than other symptoms,The risk of patients with mild tension-type headache transforming to CTTH increased 2.43 times(OR=2.43,95%CI,1.05-5.60),The risk of moderate tension-type headache transforming to CTTH developing 2.03 times(OR=2.03,95%CI,1.04-3.95).The independent prediction factor of migraine progressing to CM include self-remission,accompany auditory symptoms.The risk of headache patients which can self-remission developing to CM can increase 2.34 times(OR=2.34,95%CI,1.37-3.98),The risk of patients with auditory symptoms(tinnitus)transform to CM was 2.64 folds than migraine patients accompany with other symptoms(OR=2.64,95%CI,1.32-5.29),The risk of migraine patients with headache family history developing to CM was 2.82 times higher than other patients(OR=2.82,95%CI,1.30-6.11).Conclusion:(1).Patients with chronic tension-type headache had an elder age than that of patients with chronic migraine.(2).The site of chronic tension-type headache major locate in entire head,posterior occipital,forehead,and cupula head.The characters of headache were oppressive pain and constriction pain.Patients of CTTH accompany with dizziness and sustained more than 72 hours and cannot be self-relief are more common than patients of CM.(3).The site of patients with chronic migraine headache major locate in the side of unilateral temporal.The character of headache throbbing pain.CM patients more accompany with auditory symptoms than that of CTTH patients.CM patients major with intermittent pain and usually accompany with headache family history.(4).Dizziness,vertigo,mild headache,and moderate headache were independent prediction factors for tension-type headache develop to CTTH.(5).Self-mitigation,associated with auditory symptoms and family history of headache are predictor factors for migraine transform to CM. |
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