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Published on: June 2, 2014
Headache in Behçet's disease
E Aykutlu1, B Baykan, G Akman-Demir
1Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Headaches in Behçet's disease (BD) are often primary, like migraine or tension-type headache (TTH), not always indicating neurological issues. Some migraines in BD patients are linked to systemic inflammation and respond to its treatment.
Area of Science:
- Neurology
- Rheumatology
- Headache Medicine
Background:
- Behçet's disease (BD) is a multisystem inflammatory disorder.
- Headache is a common symptom in BD patients, but its characteristics and relationship to neurological involvement require detailed investigation.
Purpose of the Study:
- To investigate the specific characteristics of headaches experienced by patients with Behçet's disease.
- To differentiate between primary and secondary headaches in BD patients and explore potential triggers and associations with disease activity.
Main Methods:
- A retrospective electronic database study of consecutive Behçet's disease patients attending a neuro-Behçet's outpatient clinic.
- Headaches were classified according to the International Headache Society criteria.
- Analysis of headache types, prevalence, and association with BD systemic flare-ups and neurological involvement.
Main Results:
- Out of 118 BD patients, 98 reported headaches.
- Migraine was the most frequent primary headache (46.4%), followed by tension-type headache (TTH) (26.8%).
- Secondary headaches, often due to cerebral venous thrombosis or neuro-BD, occurred in 37 patients; 15 had both primary and secondary headaches. Primary headaches were exacerbated by BD flare-ups in 13 patients, and four experienced migraines triggered solely by BD activation, responding well to anti-inflammatory treatment.
Conclusions:
- The majority of headaches in Behçet's disease patients are primary types (migraine, TTH) and do not necessarily signify neurological involvement.
- A subset of BD patients experiences migraines associated with systemic inflammation, which can be effectively managed by treating the underlying inflammation.
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