Migraine and tension-type headache triggers in a Greek population

Abstract

Migraine is a primary headache that is usually severe, unilateral and throbbing in nature. It is often accompanied by photo -or phonophobia, nausea and vomiting and it worsens with physical activity 1 . A number of external and internal factors are considered triggers for migraine. Amongst them, the most common are stress, dietary factors, environmental factors, hormonal factors and sleep disorders.Tension type headache on the other hand is the most common primary headache, and is characterized by bilateral location, pressing/tightening quality and of generally milder intensity compared to migraine. The accompanying symptoms of migraine (nausea, vomiting, photo-and phonophobia) are only rarely encountered in tension-type headache 1 .The importance of these triggers (particularly stress and dietary factors) varies significantly among studies, presumably because of the different lifestyles and cultures of cohorts 2,3,4,5 . The purpose of this article is to review the literature regarding trigger factors of headache and to present data about the prevalence of these trigger factors in a Greek cohort of migraineurs and patients with tension-type headache (TTH) in a Headache Clinic of a Tertiary Hospital in Athens. Method All patients examined at the Headache Clinic of Eginition AbstrActMigraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH) Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS) and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH) patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.Keywords: migraine, tension type headache, precipitating factors.resuMo Enxaqueca e cefaleia tipo tensional são as duas cefaleias primárias mais frequentes. O propósito deste estudo foi avaliar as diferenças e características dos fatores desencadeantes destas cefaleias numa coorte grega de 51 pacientes com enxaqueca e 12 com cefaleia tipo tensional. Pacientes com enxaqueca tinham uma idade significativamente menor por ocasião do início da cefaleia e maior frequência, maiores valores de (VAS) e maior duração dos episódios em comparação com os pacientes com (CTT). Não houve diferença entre os pacientes com enxaqueca e (CTT) com relação à qualidade e lateralidade da dor, na forma de instalação e progressão, e no padrão temporal das cefaleias. Náuseas, vômitos e fonofobia foram mais frequentes em enxaqu...

Triggers, Protectors, and Predictors in Episodic Migraine

“…It is not clear if triggers are more or less important in those with and without aura, or if triggers are specific to migraine compared to tension-type headache. As an example, one study suggested food triggers are more common in migraine than tension-type headache (19).…”

Diet and Headache: Part 1

“…Chocolate has been self-reported to be a precipitant for migraine headaches in 2-22% of persons with migraine. 3,5,[95][96][97][98] A recent diary study found that migraine was more common on days with exposure to chocolate consumption as compared to those without exposure, but this occurred in only 2.5% of migraineurs. 8 Another diary study reported that an exposure to chocolate was more likely to be encountered on migraine than non-migraine headache days.…”

To Eat or Not to eat: A Review of the Relationship between Chocolate and Migraines

“…Besides, chocolate was the second most frequently implicated trigger factor among the migraine patients in the study [61]. Similarly, other studies have also confirmed the connection between chocolate and migraines when compared to TTH and have shown no association between TTH and chocolate intake [36,76,78,79]. A study evaluating TTH in migraine and non-migraine populations found that only migraine patients had episodes of tension-type headaches precipitated by alcohol, over-matured cheese, chocolate, and physical activity [79].…”

“…Migraine patients frequently describe that certain foods may induce or even exaggerate the severity of a headache attack [3][4][5]7,[34][35][36][37]. Chocolate is the most popular food trigger of a migraine, and it has been epidemiologically implicated in triggering migraine attacks, and the classic advice given by doctors to patients with migraines is to avoid it [11].…”