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Comparison of chronic daily headache with and without medication overuse headache using ICHD II R and ICHD 3 beta

Sanghamitra Laskar1, Jayantee Kalita1, Usha K Misra1

  • 1Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

Clinical Neurology and Neurosurgery
|June 22, 2019
PubMed

Insights

The frequency of Medication Overuse Headache (MOH) in Chronic Daily Headache (CDH) patients is four times higher using the ICHD-3 beta criteria compared to the ICHD II R criteria. Female gender and lower education levels are significant predictors of MOH.

Area of Science:

  • Neurology
  • Headache Medicine
  • Clinical Diagnostics

Background:

  • Chronic Daily Headache (CDH) is a prevalent condition often associated with Medication Overuse Headache (MOH).
  • Accurate diagnosis of MOH is crucial for effective treatment and management of CDH.
  • Different diagnostic criteria exist, potentially impacting prevalence estimates.

Purpose of the Study:

  • To determine the frequency of MOH in CDH patients using both ICHD II R and ICHD-3 beta criteria.
  • To compare demographic and headache characteristics between CDH patients with and without MOH.
  • To identify predictors of MOH in this patient cohort.

Main Methods:

  • A consecutive series of CDH patients were evaluated between 2014 and 2015.
  • Diagnosis of MOH was based on ICHD II R and ICHD-3 beta criteria.
  • Headache characteristics (frequency, duration, severity via VAS) and demographics were recorded. Multivariate analysis identified MOH predictors.

Main Results:

  • Out of 202 CDH patients (74.8% female, median age 32), 12.3% met ICHD II R criteria for MOH, while 46.5% met ICHD-3 beta criteria.
  • Predictors of MOH included female gender (OR=3.72), lower education (OR=1.07), and higher VAS scores (OR=0.67).
  • MOH patients identified by ICHD-3 beta criteria had higher education and used fewer abortive drugs compared to those identified by ICHD II R criteria.

Conclusions:

  • The ICHD-3 beta criteria result in a four-fold increase in MOH frequency compared to ICHD II R criteria.
  • Female gender and lower educational attainment are significant risk factors for developing MOH in CDH patients.
Abstract

Keywords:
Chronic daily headacheChronic migraineChronic tension type headacheEducationICHD 3 betaPredictors

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