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Chronic Daily Headache and Medication Overuse Headache in First-Visit Headache Patients in Korea: A Multicenter
Myoung Jin Cha1, Heui Soo Moon2, Jong Hee Sohn3
1Department of Neurology, National Police Hospital, Seoul, Korea.
Insights
Chronic daily headache (CDH) affects 15.2% of neurology patients in Korea, with chronic migraine being the most common type. Medication overuse headache (MOH) is linked to CDH, especially in chronic migraine cases.
Area of Science:
- Neurology
- Headache Medicine
- Epidemiology
Background:
- Chronic daily headache (CDH) is a disabling condition often underdiagnosed.
- Chronic migraine (CM) and medication overuse headache (MOH) are significant subtypes.
- Understanding CDH and MOH prevalence is crucial for patient care.
Purpose of the Study:
- To determine the frequency of CDH and its subtypes in Korean neurology clinics.
- To investigate the association between CDH and MOH.
- To analyze referral patterns for headache patients.
Main Methods:
- 1,627 first-visit headache patients were assessed by 11 neurologists.
- Headache diagnoses followed the International Classification of Headache Disorder (ICHD-3 beta).
- Data collected on CDH subtypes and MOH presence.
Main Results:
- CDH was diagnosed in 15.2% of patients.
- Chronic migraine (CM) was the most frequent CDH subtype (8.8%).
- Medication overuse headache (MOH) was present in 5% of patients, with a higher association in CM.
Conclusions:
- CDH affects 15.2% and MOH 5% of new neurology headache patients in Korea.
- CM is the predominant CDH subtype and shows the strongest link to MOH.
- CDH and MOH frequencies were consistent across secondary and tertiary hospitals.
Background And Purpose:
Chronic daily headache (CDH) is defined as a headache disorder in which headaches occur on a daily or near-daily basis (at least 15 days/month) for more than 3 months. Chronic migraine (CM) and medication overuse headache (MOH) are very disabling headaches that remain underdiagnosed. The aim of this study was to establish the frequency of CDH and its various subtypes, and examine the associations with MOH among first-visit headache patients presenting at neurology outpatient clinics in Korea.
Methods:
Eleven neurologists enrolled first-visit patients with complaints of headaches into outpatient clinics for further assessment. Headache disorders were classified according to the International Classification of Headache Disorder (third edition beta version) by each investigator.
Results:
Primary CDH was present in 248 (15.2%) of the 1,627 included patients, comprising CM (143, 8.8%), chronic tension-type headache (CTTH) (98, 6%), and definite new daily persistent headache (NDPH) (7, 0.4%). MOH was associated with headache in 81 patients (5%). The association with MOH was stronger among CM patients (34.5%) than patients with CTTH (13.3%) or NDPH (14.3%) (p=0.001). The frequency of CDH did not differ between secondary and tertiary referral hospitals.
Conclusions:
The frequencies of CDH and MOH diagnoses were 15.2% and 5%, respectively in first-visit headache patients presented at secondary or tertiary referral hospitals in Korea. CM was the most common subtype of CDH and was most frequently associated with MOH.
