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Presenting complaints

Most people have occasional headache, and regard it as normal. Headache becomes a problem at some time in the lives of about 40% of people in the UK. The patient with headache presents with bothersome recurrent or unremitting headache which may be associated with other symptoms.

Such headaches:

  • are debilitating and disabling
  • impair quality of life
  • engender fears of serious pathology.

The headache disorders encountered in general practice are:

  • Migraine, which occurs in 12-15% of the UK population, in women more than men in a ratio of 3:1 (ref 140).
  • Tension-type headache, which affects >80% of people from time to time (ref 141) but recurs frequently in a small minority. In 2-3% of adults it is chronic (ref 142), occurring on more days than not.
  • Cluster headache, an intense and frequently recurring but short-lasting headache affecting 1 in 1,000 men and 1 in 6,000 women.
  • Medication-overuse headache, a chronic daily headache occurring in up to 3% of adults, affecting 5 women to each man, and some children. This is a secondary headache, but it occurs only as a complication of a pre-existing primary headache disorder (usually migraine).
  • A large number of other secondary headaches, some serious but which overall account for <1% of presenting patients.

 

References

140. Steiner TJ, Scher AI, Stewart WF et al. The prevalence and disability burden of adult migraine in England and their relationships to age, gender and ethnicity. Cephalalgia 2003; 23: 519-527.

141. Rasmussen BJ, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population - a prevalence study. J Clin Epidemiol 1991; 44: 1147-1157.

142. Schwartz BS, Stewart WF, Simon D, Lipton RB. Epidemiology of tension-type headache. JAMA 1998; 279: 381-383. 143. British Association for the Study of Headache. Guidelines for all doctors in the diagnosis and management of migraine and tension-type headache, 2nd edition (revised). BASH 2003 at http://www.bash.org.uk.

Last edited: 2/2/2004


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