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Severe acute respiratory syndrome coronavirus 2 infection altered the factors associated with headache: evidence from a multicenter community-based case-control study. Pain Rep 2022; 7:e1051. [PMID: 36447953 PMCID: PMC9699507 DOI: 10.1097/pr9.0000000000001051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/05/2022] [Accepted: 10/04/2022] [Indexed: 12/08/2022] Open
Abstract
INTRODUCTION Headache is one of the significant global public health concerns. Furthermore, it is a standard feature of patients with acute and postacute COVID-19. OBJECTIVES This study aimed to estimate and compare the prevalence of headaches among postacute COVID and non-COVID individuals and identify and contrast the risk factors between both groups. METHODS This was a multicenter case-control study. Individuals who had recovered from acute SARS-CoV-2 infection were considered "case", and those who never tested positive for COVID-19 were considered "control." Headaches were measured using the musculoskeletal subscale of the subjective health complaints scale. Multiple logistic regression analysis was used to identify the predictors of headaches. RESULTS A total of 878 individuals (439 cases) aged 38.30 ± 12.77 years (mean ± standard deviation) participated in this study. The prevalence of headaches was 26.2% among COVID-19 survivors; however, only 10.7% of unaffected participants reported headaches at the same time. Regression analyses suggested that the recovery duration from acute COVID-19 ≤ 90 days (adjusted odds ratio [AOR] = 2.03, CI = 1.13-3.65) was the only predictor of headache among postacute COVID-19 survivors. However, the female gender (AOR = 3.09, 95% CI = 1.51-6.32), members of a joint family (AOR = 1.99, 95% CI = 1.02-3.90), and city dwellers (AOR = 2.43, 95% CI = 0.94-6.25) were the predictor of headache among non-COVID participants. CONCLUSION This study found a higher prevalence of headaches among COVID-19 survivors. In addition, predictors of headache among cases and controls were unmatched, indicating heterogenous impact of COVID-19 on human health. The health care providers should be informed of the study's results when discussing better practices to mitigate the burden of headaches.
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Al-Hashel JY, Abokalawa F, Alenzi M, Alroughani R, Ahmed SF. Coronavirus disease-19 and headache; impact on pre-existing and characteristics of de novo: a cross-sectional study. J Headache Pain 2021; 22:97. [PMID: 34418950 PMCID: PMC8380111 DOI: 10.1186/s10194-021-01314-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/08/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease-19 is caused by the severe acute respiratory syndrome coronavirus 2 Headache is a common symptom during and after Coronavirus disease-19. We aimed to study headache character in relation to COVID-19. METHODS This was a cross-sectional study. Patients who had Coronavirus disease-19, confirmed by reverse transcription polymerase chain reaction technique and presented to the headache clinic within 3 months after the onset of infections were identified to the study. Study included patients diagnosed as primary headache disorders according to The International Classification of Headache Disorders, 3rd edition. Participants were grouped into categories according to having previous or de novo headache. Descriptive data, paired sample t-test and the chi-squared test (X2) were used for statistical analyses of the data. RESULTS A total of 121 patients were included in this study. Their mean age was 35.29 + 9.54 and most of them were females (83.5%). Prior to Coronavirus disease-19 infections, 78 (64.5%) had migraine and 11(9.1%) experienced a tension-type headache while 32 (26.4) reported de novo headache post Coronavirus disease-19. Patient had significant increase in headache days 11.09 ± 8.45 post Coronavirus disease-19 compared with 8.66 ± 7.49 headache days before Coronavirus disease-19 infection (p < 0.006). Post Coronavirus disease-19, the usage of analgesic increased significantly by the patient with migraine (2.31 ± 1.65 vs 3.05 ± 2.09, p = 0.002) while the patient with tension type headache had statistically significant increase in severity (5.556 ± 1.86 vs 7 ± 2.25, p = 0.033) and frequency (7 ± 6.29 vs 12.72 ± 7.96, p = 0.006) of headache attacks. Bi-frontal and temporal headache are the most reported (40.6% each) headache site among de novo headache group. Patients younger than 40 years had longer duration of the headache attack (18.50 ± 16.44 vs 5.5 ± 9.07, p = 0.045) post COVID-19. Male patients compared to females (8.66 ± 1.15 versus 5.93 ± 2.01 p = 0.04) had more severe headache post Coronavirus disease-19. De novo headache resolved within 1 month in most of patients (65.3%). CONCLUSION Primary headache get worse after Coronavirus disease-19. De novo primary headache is frequent post Coronavirus disease-19 and resolve within 1 month. Headaches related to Coronavirus disease-19 are severe, present as migraine phenotype. Young male patients with Coronavirus disease-19 tend to have worse headache.
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Affiliation(s)
- Jasem Youssef Al-Hashel
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Faculty of Medicine, Kuwait University, P.O. Box 24923, 13110 Safat, Kuwait
| | - Fathi Abokalawa
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
| | - Maram Alenzi
- Internal Medicine Department, Farwaniyah Hospital, Kuwait city, Kuwait
| | - Raed Alroughani
- Division of Neurology, Amiri Hospital, Arabian Gulf Street, 13041 Sharq, Kuwait
| | - Samar Farouk Ahmed
- Neurology Department, Ibn Sina Hospital, P.O. Box 25427, 13115 Safat, Kuwait
- Neuropsychiatry department, Faculty of Medicine, Al-Minia University, P.O. Box 61519, Minia City, 61111 Egypt
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Magdy R, Hussein M, Ragaie C, Abdel-Hamid HM, Khallaf A, Rizk HI, Dahshan A. Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study. Cephalalgia 2020; 40:1422-1431. [PMID: 33146038 PMCID: PMC7645600 DOI: 10.1177/0333102420965140] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. METHODS A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. RESULTS: THE majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) (p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) (p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) (p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) (p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. CONCLUSION Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.
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Affiliation(s)
- Rehab Magdy
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
| | | | | | - Ahmed Khallaf
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
| | - Hoda I Rizk
- Public Health and Community Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Dahshan
- Department of Neurology, Cairo University, Cairo, Egypt
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Abstract
Chronic migraine has a great detrimental influence on a patient's life, with a severe impact on socioeconomic functioning and quality of life. Chronic migraine affects 1-2% of the general population, and about 8% of patients with migraine; it usually develops from episodic migraine at an annual conversion rate of about 3%. The chronification is reversible: about 26% of patients with chronic migraine go into remission within 2 years of chronification. The most important modifiable risk factors for chronic migraine include overuse of acute migraine medication, ineffective acute treatment, obesity, depression and stressful life events. Moreover, age, female sex and low educational status increase the risk of chronic migraine. The pathophysiology of migraine chronification can be understood as a threshold problem: certain predisposing factors, combined with frequent headache pain, lower the threshold of migraine attacks, thereby increasing the risk of chronic migraine. Treatment options include oral medications, nerve blockade with local anaesthetics or corticoids, and neuromodulation. Well-defined diagnostic criteria are crucial for the identification of chronic migraine. The International Headache Society classification of chronic migraine was recently updated, and now allows co-diagnosis of chronic migraine and medication overuse headache. This Review provides an up-to-date overview of the classification of chronic migraine, basic mechanisms and risk factors of migraine chronification, and the currently established treatment options.
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Affiliation(s)
- Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
| | - Laura H Schulte
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, D-20246 Hamburg, Germany
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Olesen J. International Classification of Headache Disorders, Second Edition (ICHD-2): Current Status and Future Revisions. Cephalalgia 2016; 26:1409-10. [PMID: 17116090 DOI: 10.1111/j.1468-2982.2006.01214.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Tension-type headache (TTH) is the most common form of headache in the general population. Diagnosis of TTH is based merely on clinical features and on careful exclusion of all possible causes of headache. Most of the headaches that present in the context of medical disorders (e.g., hypothyroidism, sleep disorders, and hypertensive crisis) have clinical features overlapping with those of TTH; medical history and specific features of the systemic disorder are usually the clues to establish a correct diagnosis. Some medical disorders may worsen a preexisting TTH, and is also possible the comorbidity of TTH with psychiatric disorders and fibromyalgia.
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Kirkland KE, Kirkland K, Many Jr WJ, Smitherman TA. Headache Among Patients With HIV Disease: Prevalence, Characteristics, and Associations. Headache 2011; 52:455-66. [DOI: 10.1111/j.1526-4610.2011.02025.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Linde M, Langnes HA, Hagen K, Bergh K, Stovner LJ. No increase in headache after previous intracranial infections: a historical cohort study (HUNT). Eur J Neurol 2011; 19:324-31. [PMID: 21951375 DOI: 10.1111/j.1468-1331.2011.03525.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Despite the absence of robust scientific evidence, it is today generally accepted that the acute headache typical for intracranial infections can develop into permanent headache complaints. This widespread concept was explored in the first, large, longitudinal, population-based study. METHODS Data on confirmed exposure to intracranial infections amongst all adult inhabitants in a geographical area during a 20-year period were assembled from hospital records. Surviving individuals were later invited to the third Nord-Trøndelag Health Survey (HUNT 3), where 39,690 (42%) of 94,194 invited inhabitants aged ≥20 years responded to a validated headache questionnaire. Using logistic regression, the 1-year prevalence of headache and its subtypes according to the diagnostic criteria of the International Headache Society was assessed and compared between those with and without previous confirmed intracranial infection. Age and sex were used as covariates. RESULTS Overall, 43 participants were identified with earlier intracranial infection, whereof three had more than one infection: bacterial meningitis (n=19), lymphocytic meningitis (n=18), encephalitis (n=9), and brain abscess (n=1).The mean interval from infection to participation in HUNT 3 was 11.2 (range 1.5-19.7) years. There was no significant increase in the prevalence of headache (OR 1.10, 95% CI 0.58-2.07), its subtypes (migraine, or tension-type headache), or chronic daily headache (OR 1.85, 95% CI 0.45-7.68) amongst participants with previous intracranial infection compared with the surrounding population. CONCLUSIONS This study challenges the existence of chronic post-bacterial meningitis headache and does not indicate the presence of other long-term headaches induced by intracranial infection.
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Affiliation(s)
- M Linde
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
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Abstract
Headache is the most common symptom that humans experience. While the vast majority of headaches are due to benign primary headache disorders, a small but important minority of headaches are due to secondary causes. Whereas significant emphasis is placed on educating physicians regarding prompt recognition of subarachnoid hemorrhage and headaches secondary to brain tumors, attention toward headaches secondary to infectious causes is often neglected. Unfortunately, a missed or delayed diagnosis of a headache secondary to meningitis, encephalitis, brain abscess, subdural empyema, or other infectious etiologies can lead to dire consequences for both the patient and physician. Accordingly, this article provides an overview of headaches attributed to systemic and intracranial infectious causes.
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Nappi G, Moskowitz MA. Secondary headaches introduction. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:497-500. [PMID: 20816451 DOI: 10.1016/s0072-9752(10)97045-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Giuseppe Nappi
- Chair of Neurology, "Sapienza" University of Rome and IRCSS "C. Mondino Institute of Neurology" Foundation, Pavia, Italy.
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Marchioni E, Minoli L. Headache attributed to infections nosography and differential diagnosis. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:601-26. [PMID: 20816458 DOI: 10.1016/s0072-9752(10)97052-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Headache is a very frequent symptom of infection. It has many possible underlying mechanisms, of which two or more can coexist in a single patient. It can be caused by direct stimulation of intracranial pain-producing structures, as in the case of brain abscesses, by irritation of the pachy- and leptomeninges, as in cases of bacterial or viral meningitis, or by a state of intracranial hypertension, as seen in obstructive hydrocephalus. There is no doubt that headache is often the first or the predominant symptom of serious, sometimes life-threatening, infectious diseases; certainly, it is a condition frequently encountered in all epidemiological studies. Indeed, it is estimated that over 60% of people have, at some point in their lives, experienced headache during an infection. This evidence leads to the need for a systematic approach to headache secondary to infection. This chapter provides some elements on pain mechanisms in systemic and intracranial infections and on the possible role of antimicrobial agents in the genesis of headache. The first section provides a detailed "etiology-based" description of the International Classification of Headache Disorders, 2nd edition (ICHD-II: Headache Classification Subcommittee of the International Headache Society, 2004), while the second section presents a "symptom-based" algorithm applicable in the first diagnostic assessment, according to the headache features and to the most frequently associated clinical manifestations during infections of the central nervous system (CNS).
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Affiliation(s)
- E Marchioni
- Fondazione Istituto Neurologico Nazionale C. Mondino, IRCCS, Pavia, Italy.
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Eguia P, Garcia-Monco JC, Ruiz-Lavilla N, Diaz-Konrad V, Monton F. SUNCT and trigeminal neuralgia attributed to meningoencephalitis. J Headache Pain 2008; 9:51-3. [PMID: 18217200 PMCID: PMC3476171 DOI: 10.1007/s10194-008-0008-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 12/07/2007] [Indexed: 11/01/2022] Open
Abstract
We describe a 46-year-old female with viral meningoencephalitis (likely varicella-zoster virus) who developed a SUNCT syndrome followed a few days later by trigeminal neuralgia. Both disorders resolved in parallel with the resolution of encephalitis, which suggests a causal link. In conclusion, headache attributed to intracranial infection may have the clinical features of SUNCT or TN.
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Affiliation(s)
- Pablo Eguia
- Department of Neurology, Hospital Nuestra Señora de Candelaria, Carretera del Rosario 145, 38010 Santa Cruz de Tenerife, Spain.
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