Do Certain Headache Syndromes Occur in “Pain-Prone” Patients?

Authors


  • This investigation was supported in part by grant 1 R01 NS 1662-01A1 from the National Institutes of Health, and the Lettie McIlvaine Endowment Fund of the University of Kansas Medical Center.

Abstract

SYNOPSIS

To clarify the actual components of headache syndromes and their possible association with other types of pain and psychological traits, 177 patients subject to severe intermittent headaches were studied. Data used were derived from (a) a de tailed headache questionnaire, (b) a second questionnaire concerning the occurrence of other pain and of feelings of good or ill health, (c) the Cornell Medical Index. A stepwise regression analysis was run for each headache characteristic using data from the pain questionnaire and the Cornell Medical Index as independent variables. Interesting associations of variables were (1) increased frequency of headache with male sex and increased duration of headache with female, (2) inability to carry on work load during headache, headache preceded by spots before the eyes, weakness of arm or leg preceding headache were all positively associated with history of fainting. Neither vomiting with headache, nor unilaterality of pain was associated with any other pain variables. Also of note was the fact that there was no evidence by testing of increased psychological disturbance in patients with back pain. The results suggest that the “tension headache-neurosis” concept is dubious, that autonomic instability as evidenced by fainting is indeed important in some headache syndromes, and that new headache syndromes need to be defined.

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