Understanding Pain Patterns in Medication Overuse Headache: Insights from Türkiye’s Real Life Experience

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Tepe N., Belen H. B., Ceren Akgör M., Vurallı D., Arı B. Ç., Eliaçık S., ...Daha Fazla

International Headache Congress (IHC) 2023, Seoul, Güney Kore, 14 - 17 Eylül 2023

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Seoul
  • Basıldığı Ülke: Güney Kore
  • Gazi Üniversitesi Adresli: Evet

Özet

Objective: The objective of this study was to gather extensive real-life data from across the country in order to understand the multifactorial pathogenesis of medication overuse headache (MOH). Methods: In this prospective study, 908 patients diagnosed with migraine and MOH were enrolled by neurologists from 18 centers. The patients’ demographic characteristics, comorbidities, changes in headache features, and treatment responses were evaluated. Results: Among the 908 patients (89% with migraine without aura, 80.1% female), several headache features exhibited significant changes during the MOH process. These changes included laterality (50.6% to 4.6% unilateral), pain quality (pulsating 30% to 11%, dull 11.8% to 48.2%, stabbing 1.6% to 54%, burning 11.4% to 58%), and prolonged attack duration. However, the frequency of associated features such as photophobia, phonophobia, nausea, osmophobia, and autonomic findings were not significantly altered. The response to NSAIDs and triptans decreased (58% to 5% and 56.7% to 11.8%, respectively), while the response to opioids and ergotamine did not show significant alterations (refer to Table 1). The frequency of migraine and MOH was significantly higher in their firstdegree relatives. Furthermore, 51% of the patients had never received any prophylactic medication. In 175 menopausal patients, the frequency and severity of headache attacks were not significantly changed compared to the premenopausal period, although analgesic intake was significantly increased (46.3%) (Table 1). Conclusion: The medication overuse headache process is associated with significant changes in pain characteristics in migraine patients with no significant influence on associated symptom frequency. Understanding changed clinical symptoms, pain patterns, family history, and confounding factors will be helpful to recognize patients early in the transformation process and to manage MOH appropriately